Sudden Hypos (after covid?)

[Deleted member 559136]

Hello everyone. I'm the daughter of a parent with diabetes. My mum first started with type 1 diabetes when she was 40 and has had it for 20 years. She has always been well controlled, takes insulin 4 times a day, hypos at most maybe twice a week, some weeks doesn't hypo at all. In the past month she has been having more hypos than normal at lower BG than normal. She had several at 2.8 and 2.5. Yesterday she had a severe hypo. It tested 2.5 so she drank isotonic fruit juice as usual but it dropped even more, rapidly, and she said she couldn't speak or move and was having uncontrollable jerking head movements. Luckily the juice she initially drank must have kicked in and her BG went higher and she was fine afterwards. Her BG the next morning before breakfast though was 20. She has never had a severe hypo before. They have always been in the BG levels of 3. I've never been worried about her hypos before because they were mild and self managed easily. But now I am extremely worried about her. We don't know what's causing these more frequent hypos or why they are so low. She had a couple of "mild" hypos last week with BG levels in the 3s so I don't think she's developed hypo unawareness. She blamed the warmer weather but it's not hot anymore, it was only 21/22 degrees C yesterday. A month ago she had covid and I wonder if that may be the cause. She still has a lingering cough and some tiredness 4 weeks after symptoms started.

Has anyone else had low blood sugars after having covid? Everything I've read online only mentions high blood sugars because of covid, not low.

 

[NicoleC1971]

Firstly, I'd expect your mum to have higher bgs if she is still fighting a virus but an indirect effect could be that she is eating less or lost a bit of weight. Both things would make her more sensitive to insulin. I'm assuming nothing else has changed.
I think she needs to adjust her basal and bolus insulins or eat more to avoid unpleasant hypos which must be horrible for her and worrying for you.
She could try and work out if she is having the hypo within 2 hours of a meal in which case her bolus to carb ratio needs adjustment or whether she is just generally going much lower all day long in which case it could be the basal. And finally Diabetes UK.org run a free Careline so you could speak to them or suggest your mum does so.
I hope she irons this glitch out soon.
I'd hope that she also has a diabetes nurse to chat this through with.

(mod edit to remove dosing advice)

 

[Deleted member 559136]

Firstly, I'd expect your mum to have higher bgs if she is still fighting a virus but an indirect effect could be that she is eating less or lost a bit of weight. Both things would make her more sensitive to insulin. I'm assuming nothing else has changed.
I think she needs to adjust her basal and bolus insulins or eat more to avoid unpleasant hypos which must be horrible for her and worrying for you.
She could try and work out if she is having the hypo within 2 hours of a meal in which case her bolus to carb ratio needs adjustment or whether she is just generally going much lower all day long in which case it could be the basal. And finally Diabetes UK.org run a free Careline so you could speak to them or suggest your mum does so.
I hope she irons this glitch out soon.
I'd hope that she also has a diabetes nurse to chat this through with.
(mod edit)

Thanks for the advice. Her blood sugars were never high even during the worst of covid. She isn't eating less, the hypos have happened at various different times of day and night. She checks her bg before every meal and at bedtime and they haven't been unusual. She doesn't have a diabetes nurse or speak to anyone regularly about it, she just has the annual diabetic checkup every 12 months at the gp surgery.

 

[Hertfordshiremum]

Thanks for the advice. Her blood sugars were never high even during the worst of covid. She isn't eating less, the hypos have happened at various different times of day and night. She checks her bg before every meal and at bedtime and they haven't been unusual. She doesn't have a diabetes nurse or speak to anyone regularly about it, she just has the annual diabetic checkup every 12 months at the gp surgery.

Hello It doesn’t sound like she is wearing a continuous blood glucose monitor? As she is Type 1 the GP will issue a Libre (I am hoping you are in the Uk?) the Libre 2 has alarms which would alert her to any problem in time before things got too serious. I would be on the phone to the GP asking for this asap based on what’s happened recently. FYI I was pretty poorly with Covid in March, week 1 I had a few sudden hypos, would drop from 8 to 3 in 10 mins, no apparent reason. I felt like I was falling when this happened. Ended up carrying jelly babies in my pocket Week 2 my BG was very high and I ended up with DKA However whatever the reason, get some tech to help with this. It will give her 24 hour coverage and you can see what is going on.

 

[david4503]

Thanks for posting about the possibility of a connection between very low blood sugar and the post-Covid period. Covid does some strange and unexpected things so I wouldn’t be surprised if that were also true with diabetes. Please post again if and when you have more information. Hope the situation resolves quickly so you don’t have to worry.

 

[EllieM]

Thanks for the advice. Her blood sugars were never high even during the worst of covid. She isn't eating less, the hypos have happened at various different times of day and night. She checks her bg before every meal and at bedtime and they haven't been unusual. She doesn't have a diabetes nurse or speak to anyone regularly about it, she just has the annual diabetic checkup every 12 months at the gp surgery.

If she's not confident to adjust her own doses (after 52 years I adjust my basal and bolus rates pretty readily) she really needs to consult urgently with a medical professional (or ring the diabetes.org site who are allowed to give dosing advice, as @NicoleC1971 suggested). Forum rules prohibit specific dosing advice from us, partly because we are not medical professionals and partly because we don't have access to your Mum's medical history.

I second @Hertfordshiremum 's suggestion that she asks her surgery for a libre, it can be a massive help to diabetes control, particularly when trying to avoid hypos. (Though it doesn't replace fingerpricking, as it does need a double check when high or low).

Good luck.

 

[Deleted member 559136]

Thanks for the advice everyone. I've read that a CGM has a delay of up to 15 mins, so how does it prevent hypos with such a delay to the alert?

 

[ert]

Thanks for the advice everyone. I've read that a CGM has a delay of up to 15 mins, so how does it prevent hypos with such a delay to the alert?

I tend to eat fruit if my blood sugars are dropping (in my normal limits) which avoids hypos. Also, you can set an alarm for dropping blood sugars as well as lower limits. I suggest you check basal insulin first. I always reduce my basal if I'm dropping low at a regular time/s.

 

[Deleted member 559136]

This basal and bolus stuff is all new to me. My mum takes Humalog 3 times a day with meals (short acting insulin) and a long acting insulin just once with supper at bedtime.

 

[EllieM]

This basal and bolus stuff is all new to me. My mum takes Humalog 3 times a day with meals (short acting insulin) and a long acting insulin just once with supper at bedtime.

The basal is the long acting, her humalog is her bolus.

 

[Deleted member 559136]

The basal is the long acting, her humalog is her bolus.

Thanks.

 

[Ipodlistener]

Thanks for the advice everyone. I've read that a CGM has a delay of up to 15 mins, so how does it prevent hypos with such a delay to the alert?

YouTube can explain it a lot easier if you use it. Type One Talks is a good channel to tune into. I learnt so much after being diagnosed about Libre2. Diabetes Diet Guy is another good one

 

[RobertJ]

I have Covid-19 right now and I seem to be going low all the time. The actual virus is just a normal cold but my insulin requirements seem to have dropped to unforeseen levels, it's very strange. Has this been anyone else's experience?

 

[Deleted member 559136]

I have Covid-19 right now and I seem to be going low all the time. The actual virus is just a normal cold but my insulin requirements seem to have dropped to unforeseen levels, it's very strange. Has this been anyone else's experience?

I'm sorry you're experiencing it and I hope you feel better soon. Thanks for sharing, I think that everyone responds to covid differently and there are some effects that aren't yet documented.

 

[ashleyneildas]

I had Covid a month ago and I also seem to be having sometimes several lows during the day now especially if I do any kind of activity?

 

[Deleted member 559136]

I had Covid a month ago and I also seem to be having sometimes several lows during the day now especially if I do any kind of activity?

Thanks for sharing. It's interesting you are still having lows a month after covid. It's nearly 6 weeks ago and the lows are still happening pretty much every other day. Some are related to activity, others when it's almost meal time, others have been random.

 

[RobertJ]

I'm sorry you're experiencing it and I hope you feel better soon. Thanks for sharing, I think that everyone responds to covid differently and there are some effects that aren't yet documented.

Thanks, it's kind of gone back to normal now. The actual Covid itself was nothing, milder than most colds I get.