Type 1: Low BG after dinner

[miszu]

Diabetic since December, first few weeks my BG in the mornings were around 8-9, my doc said then that i need basal for the nights if that continues. Then i started understanding what carbs r better for me etc, in a few days my morning BG went down to 5-6, so doc said i dont need basal for now. Since then its always between around that, 5-6.
But.. since not long ago, maybe since feb this been happening: After dinner my BG is normal between 6-8, but when i go to bed it drops to around 4 and i can already feel sick. I tried eating a bit more for dinner, but for the time i go to bed it drops. also this happens the end of the day only, never after other meals unless i missed some carbs. So my BG drops then, so i get something to eat but i need like 20g carbs to get it higher. and with that, my BG goes up to 6. it doesnt go higher by morning either. if i dont get smt to eat then it drops more. i take 7 units of insulin before dinner btw and have to take in 40-50g carbs to keep my BG above 5 after meal. for other meals i have:
morning 8 units insulin - 20g carbs,
lunch 6 units - 30g carbs.
i dont always eat inbetween but when i do its 5g carbs. is this normal ? it started like 2-3 weeks ago, i find it odd. also reading how much carbs some peope have here i feel like im having way too much ? if i dont take this much my BG drops, my doc said im already getting low amount of insulin..? idk how much others get but i think we should lower it maybe especially for dinner. anyone can suggest me what to do please ?

 

[Juicyj]

Hello @miszu This isn't odd at all for a newly diagnosed. Once you start taking insulin it can relieve the stress on the pancreas so it starts to function again, albeit very slightly, it's the honeymoon period, it means you have to keep a close eye on your insulin/BG levels. You will need to contact your GP/DSN to advise them about your results, also try using a half unit pen which your diabetic team can give you, which will help you administer smaller doses. In regards to carbs eaten we all consume different amounts so it's up to you if you think you are eating too few/too many. Unfortunately we cannot advise you on your doses so please call them asap to go through this with them.

 

[urbanracer]

In addition to JJ's comments above, don't judge your carb intake by what other people are doing - you have to work out what's right for you. It's very individual.

As JJ has stated, your pancreas may be producing a little insulin to complicate things for you. I am also wondering.......

Which rapid acting inulin are you actually using?
What is the time relationship between injecting/eating/sleeping?
Are you doing any activities after your evening meal that might speed up the rate of insulin absorption?

The activity of rapid acting insulin usually peaks in a couple of hours but depending on which type you are using it may keep working at a reduced level for a few hours after injecting.

 

[miszu]

im using novo nordisk actrapid penfill.
i eat 30 mins after injecting. its around 8pm, and i go to bed around 1am usually.
i excerise after dinner, but i tried skipping that this week to see if thats the problem but still my BG drops.

 

[azure]

No, you're not having too many carbs @miszu Most Type 1s eat moderate carbs. I eat 180g a day, for example. You should eat what suits you as Urbanracer has said.

Two things occur to me - could you drop your evening insulin slightly, and could you find a supper snack that works for you? When I took Actrapid, I had a supper of approx 15g carbs but you may need more or less than that.

 

[miszu]

@azure yes i ll try to drop insulin before dinner.
sorry what do u mean by supper snack ?

 

[azure]

@azure yes i ll try to drop insulin before dinner.
sorry what do u mean by supper snack ?

A snack before bed

 

[miszu]

aha ! thank you, ll see my BG after dinner and have something if its a bit low again.

 

[vans]

Not really any advice to add other than to consider talking to your nurse/specialist about moving to MDI rather than set bolus

I found that very quickly after diagnosis the set bolus didn't work for me and I got much better control after moving to MDIs - much more flexibility. This was then increased even more so (flexibility) when I moved to a pump

 

[miszu]

Not really any advice to add other than to consider talking to your nurse/specialist about moving to MDI rather than set bolus

I found that very quickly after diagnosis the set bolus didn't work for me and I got much better control after moving to MDIs - much more flexibility. This was then increased even more so (flexibility) when I moved to a pump

i wasnt sure what MDI is first so i searched it on the forum, i think i get it now. I have no problem with the strict schedule, im home most of the time. I think if i had more flexibility i would get lazy and eat too late or forget about it and just skip it... tho im sure i ll be sick of it when i get busier.
how was ur BG with MDI ?

 

[vans]

Sorry. Multiple daily injections!
See I found the restriction of having to eat at same time & same amount was awful. If I was late having lunch I would go low.
Eating late or even forgetting to eat doesn't matter because you don't have any insulin on board as you haven't had an injection
My BG was loads better with mdi. I preferred to have control over what and when I ate rather than the injection / insulin calling the shots (if you'll excuse the pun!)