Type 1 - Lots of hypos

[acron^]

Hi guys,

I've been lurking for a few weeks now. Got diagnosed with Type 1 in September and It's been going well until the last week. I've not made any significant changes to my diet and i've been slowly adjusting my insulin (Novomix 30, twice daily) to suit, but during the last three days i've had nearly ten hypos and I'm starting to panic a bit.

Take this evening for example. I've just eaten my weight in Spaghetti Bolognese and my readings 2 hours later is 2.5...

I don't really know what could be causing this but I'm hesitant to take my insulin levels down in case I shoot up again.

Argh.

 

[caitycakes]

Hi Acron^,

Welcome to the forum. How many units of your pre-mix are you having? Quite often when diagnosed Type 1 you have whats called a "honeymoon" period where the pancreas after being given some "help" with injected insulin, start to get very productive by itself. This is maybe what's happening to you. If, as you say, you have eaten your weight in spag bol and hypoed, then you must be taking too much insulin. Let us know how many units you are on.

Caitycakes x

 

[chocoholic]

I never feel it's right for any of us to tell anyone to adjust their insulin BUT it seems that is what you need to do. I'd speak to your Dr or D.N. and they will probably recommend you adjust your insulin by a unit or two at a time and test yourself. When I started to cut the carbs in my diet I had to adjust my insulin because of hypos and was very wary of doing so but I just did it little by little and tested blood sugars when I could. I was on Novomix30 but have been changed to a basal/bolus regime, so I'm learning all over again what levels suit my body. You'll soon find what is right for you too. Honest.

 

[TROUBR]

As chocoholic as if it not for us to tell you to advise you on your insulin intake. I would definately contact your DSN and discuss this with them. It does sound like you are on too much which could be due to being the in the honeymoon period but given that you only were diagnosed in September it might also be that you still haven't found the right amount for you. I was diagnosed in April and it took a while changing things to find the right units for me (I am on basal/bolus so don't know much about novomix 30 I am afraid)

I think one thing I have learnt is that things will keep needing to be reviewed at times through out my life.

Best of luck and hope you get it sorted soon - 10 hypos in 3 days can't have been nice.

Louise

 

[acron^]

Hi guys,

Thanks for your responses. This 'honeymoon period' sounds exactly what might be happening.
I'm on 18 before breakfast and 18/20 before my evening meal. I've gradually brought it up from 14, which is what the nurse initially recommended. During that time I was still reaching highs of 15-20 and after being on 18/18 for a while, I seemed to settle quite nicely. As I say, that is until very recently.

The hypos aren't nice at all, although I'm getting pretty good at predicting them. The worst one was waking up, shaking at 2am, nearly falling down the stairs and then burning my fingers on the toaster. Sigh.

 

[hanadr]

May I recommend that you keep either some Glucose tabs or a bottle of Lucozade by your bed. You shouldn't walk downstairs whilst hypo. A broken neck won't help at all. I'm assuming that you'll iron out the present blips, but a night time hypo is always possible and should be prepared for.
You'll need to reduce your insulin, at least temporarily. With the help of your Dr. Or Nurse hopefully.
That doesn't mean it will never happen again. My T1 husband had a hypo in the night quite recently and fall onto the vanity unit, knocking the TV to the floor and cracking some ribs. Luckily the noise woke me and I caught him before he got down the stairs,made him sit at the top, whilst I went down for the Lucozade, which I'd reminded him to take upstairs earlier that day( and he hadn't)

 

[caitycakes]

Hi Acron^,

I keep dextrose tablets and digestive biccies on my bedside table at night. That way you can treat the hypo without even getting out of bed! No staggering down dangerous stairs in the dark or burning oneself on the toaster! Seriously though, you should really try to avoid stairs etc when hypo. Hope you get your dosage sorted out soon. I started on 10 units am and 10 units pm. I am now 1/2 unit am and 5 pm because I am still honeymooning (3 months since diagnosis) Let us know how you get on.

Caitycakes x

 

[sofaraway]

pre-mixed insulin is difficult for for most people to get good control on.
You may find things better on a basal bolus regieme, where you can vary the timings of when you eat, eat different amount of carbs at each meal is you wish.

I would definatly speak to your DSN for some dosage advice

 

[Katharine]

You can't carry on with these hypos. You need to cut the dose of insulin and you need to start with your next injection. I don't think you should wait till Monday morning till you phone them.

A reasonable thing to do is to cut the dose by four units each shot.

So you would cut back to 14 units twice a day. This is a considerable reduction in insulin and should get you out of the hypos but if it doesn't you will need to cut further.

If you have low blood sugars 5pm
-8am cut down on the evening insulin.

If you have low blood sugars 8am to 5pm cut down on the morning insulin.

It does sound like your pancreatic beta cells have recovered to some extent. This is great as your pancreas can fine control much better than you can.

Let us know what is happening but make sure you phone the hospital. Very often you can speak to a duty diabetes nurse or an experienced ward sister even if you have to leave your number and they call you back.

 

[acron^]

OK, so, I've cut my dose down by just two units (so 16/16) and no hypos yet today. My post-lunch reading was a bit high but my before-bed reading is 9.1 instead of the usual 5.x, so my chances of getting through tonight look good. Great idea about the tablets and digestives though - came in very handy last night when I had a crash at about 3!