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Super low hypo for no reason?

K

KC49

Active Member
Hi, bit freaked out because I have no idea why this happened- I got up this morning to take my insulin (usually on Saturdays I do it around 6.30 am like normal, then go back to bed) so Lantus and a small bolus for my morning high (1.5 units). The Lantus one didn’t hurt as much as usual, and bled afterwards (but didn’t smell of insulin like it does when some of the shot comes back out). Then I sat on my phone ordering a book online, noticed my eyes going a bit weird (like everything was a faulty fluorescent light with a flicker) and my dexcom warning came up with double drop arrows already at 4 (I’d been at 8 when I bolused). Drank some lemonade/juice (maybe 20grams carb) and ate a few little chocolate crackers, lay down back in bed and said to my bf that maybe I needed more sugar and could he get some plz, was at 2.4 by now. Then apparently I stopped replying to him and was covered in sweat and shaking and rolled off the bed in a weird position. He called the ambulance but I woke up before they came, so they just stayed while I ate bread and drank more juice til my sugar was up enough. So all ok now BUT

What the hell happened?? I definitely didn’t accidentally do my fiasp in place of my Lantus, and 1.5 units is definitely not enough to cause that reaction. Usually 1.5U would bring me down about 3mmol over the next hour or two and flatten out. Did I accidentally inject some Lantus into a small vein? Any ideas? I’m still pretty new at this, diagnosed in April.
 
If you inject Lantus into the blood stream I believe it can act like fast-acting insulin, maybe that's what happened especially since you saw blood, if this is the case that could explain the unexpected hypo and you may also find you go high later on as the Lantus is already gone, so you'll need to keep checking through the day in case some/all of said Lantus is already used up
 
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Thanks, seems like that could be the logical reason for the hypo then!

Maybe today will be a day with lots of boluses, and hopefully the next Lantus shot behaves like normal
 
I agree with @Rokaab, I've had a couple of lantus lows, dramatic drops within about 15 minutes of injecting and I had to have a massive amount of carbs before it went back up.

I've now changed my needle size to 4mm, am generally more careful about where I inject, and make sure I wait 15 minutes after injecting before I go to sleep after my night time dose. It hasn't happened since. I've been on lantus for over ten years.

Another possibility is you swapped the insulins and injected your fiasp instead of your lantus? (I've done that too, not fun.) I know you don't think you did that but I wouldn't rule it out.
 

thanks- I know it’s possible to switch them by accident but I did my insulin in a diff place than normal and am trying out a new theory of upping my basal by 2 units at the weekends, so I was awake and focused and have a very clear memory of doing it with my grey n purple pen, on the sofa rather than in bed like usual. So in this instance I’m very very sure I didn’t do a sleepy morning mistake. I keep them in diff places to stop me doing this when half asleep on work day mornings, or it would be easy to do!

if I ever get blood and/or double drop arrow that soon after my Lantus again I will just start drinking sugary things ASAP to ward off the next bit. I use 4mm needles already, but it bleeds more often from the front of my thighs, I’ll stay closer to my **** side and the safety of the fat lol

reassuring to know it’s not just me

do you find taking Lantus at night is better than in the morning? I find it harder to keep a regular evening time spot, so mornings suits me for that, but I almost always go up by 3-4mmol while I sleep. Very very occasionally I stay level all night with a small morning rise but usually more than I want!
 

I personally find that if I inject lantus in the morning it's running out just when my dawn phenomena hits, a kind of double whammy on my morning blood sugar. And I don't find it makes much difference if I have it an hour late or early as I've still got a bit of my evening bolus around then. But plenty of people inject it in the morning, others split the dose, just do whatever works best for you, which may not be what works for someone else. It's actually working OK for me at the moment, though I definitely have to have some extra bolus first thing in the morning. (Having said that, I'll probably have sky high night time levels for the next week. )

I recommend that you tell your doctor about the incident. If it happens again (hopefully it won't) there are other insulins that can be used, though availabilities vary by country.
 
Sounds very much like a Lantus low to me.
It happened to me once, and like you I passed out after already having taken lots of sugary stuff.
I was alone and the last thing I remember was thinking 'don't close your eyes now or you'll never wake up again'.

I obviously did wake up, but it scared me enough to not want to use my Lantus anymore. I was very lucky with an understanding practice nurse who changed me to Tresiba right away.

Here's an article with some more information on how it works: Lantus: Lethal or Lifesaver? #DOC #gbdoc | Diabettech - Diabetes and Technology
 
Aye, I was thinking earlier that if I’d been alone, or not had a dexcom warning, it could have had a very different outcome. Scary **** for you, being alone when it happened.

I’ll call the diabetes nurse on Monday and ask about it, Lantus is my third langtidsinsulin, NPH gave me a terrible skin reaction and Levemir either did as well, or it was still after effects of the NPH, so might stick with Lantus for now, but I’ll sure as hell watch out for this. Now I’m kinda nervous of it, cz there’s no shorter needles and no way to know it’s happening while injecting. And I don’t wanna lose my driving license!
 
Hi @KC49 ,

Got to agree with the above comments. Had you also been drinking alcohol the night before??
Alcohol retards morning liver dump which could also have affected severity of the drop, too?
 
Jaylee said:
Hi @KC49 ,

Got to agree with the above comments. Had you also been drinking alcohol the night before??
Alcohol retards morning liver dump which could also have affected severity of the drop, too?
Click to expand...

I’d had a single can of beer with dinner but don’t think it was enough to affect anything much the next morning. I think it must have been the blood thing like everyone is saying
 
KC49 said:
I’d had a single can of beer with dinner but don’t think it was enough to affect anything much the next morning. I think it must have been the blood thing like everyone is saying
Click to expand...

Yep, it don't sound like your were on a traditional "Lash."
Your low symptoms I can relate to with the eyes on Lantus.

You mention using a Dexcom. Did you test using a meter too, regarding the correction bolus?
I also notice you are recently diagnosed in April? Hmm, possibly the "Honeymoon" with an unhelpful pancreas spluttering at an inconvenient time??
 

As in did I finger stick to decide my morning bolus as well as my dexcom reading? No bc the dexcom 6 says you’re not even supposed to calibrate it, I only do that if it’s a new sensor and it seems a bit weird. Once it’s settled in I use it as per instructions, to base my bolus amounts on. Only use a meter for after a very low low, when the dexcom can take a while to catch up on sugar levels having risen.

also I only bolused 1.5 units, so even if the reading wasn’t perfect it wouldn’t have caused the drop.

and too long to type it all out but they think I’m beyond the honeymooning, and that my pancreas is already done. I’ll speak to the nurse about whether to stick with the Lantus tomorrow.
 

Hi,

I use the Libre 2. (Pretty much the same principle.)
Which counter to some reports on accuracy, works from the get go for me. Certainly an improvement on the first Libre. Infact, I've found I've not needed to calibrate the L2 at all?
But even the Libre lags on a rise from a low. I just take note "that my meter says otherwise," when back up.
Just incase a DSN suggests, "you were hypo a long time?!" It can sometimes look like I was for nearly an hour??
I'm still hypo aware. Strangely for me it is reasonably on the ball regarding any drops..

I have a therory (just a therory.) on this that the interstitial fluid the filliment reads possibly is the last to register a rise in BG before the brain? But I maybe totally of the mark on this.

Good luck & best wishes with your nurse.
 

Thanks

Sometimes my chart/line is a bit jumpy the first 12 hours of a new sensor, but roughly correct- was only once that I put a new sensor in and it kept buzzing the low sugar alarms, and since I had zero symptoms of being low I finger stick tested a few times, and it was just the sensor being weird. But still back to being fine after 12 hours or so.

does the libre do the same as a dexcom, send continuous data to your phone? Some people seem to have ones that you scan to check?
 
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