honeymooning and lows question

[tcc123]

hey guys.. first post on here.. I was just diagnosed with type 1 about 2 weeks ago after a stay with DKA in the hospital. Since then I have been taking lantus at night and using insulin/carb ratios for my novolog doses. I started out with a 15 to 1 ratio whish worked ok for a while, but started going low after every meal. I moved to 20 to 1 and it worked for a few days but I have now been creeping low again. (I usually dont go too low because I catch it a couple hours after a meal and eat something). So today I have been doing 25 to 1 and still it is going low. I was wondering if this will continue for a while or level off eventually. I have also started working out alot more and am wondering how long the working out affects my blood sugar.. A second question I have is about my blood sugar dropping overnight. I usually eat something before bed and my blood sugar will still drop about 50 or so points (if i dont eat it drops about 100). Is this normal or would this signal a need to lower the lantus dose?
Thanks for all the help.. just trying to learn about my new lifestyle while still keeping a good attitude.
Cary

[spike]

hey guys.. first post on here.. I was just diagnosed with type 1 about 2 weeks ago after a stay with DKA in the hospital. Since then I have been taking lantus at night and using insulin/carb ratios for my novolog doses. I started out with a 15 to 1 ratio whish worked ok for a while, but started going low after every meal. I moved to 20 to 1 and it worked for a few days but I have now been creeping low again. (I usually dont go too low because I catch it a couple hours after a meal and eat something). So today I have been doing 25 to 1 and still it is going low. I was wondering if this will continue for a while or level off eventually. I have also started working out alot more and am wondering how long the working out affects my blood sugar.. A second question I have is about my blood sugar dropping overnight. I usually eat something before bed and my blood sugar will still drop about 50 or so points (if i dont eat it drops about 100). Is this normal or would this signal a need to lower the lantus dose?
Thanks for all the help.. just trying to learn about my new lifestyle while still keeping a good attitude.
Cary

Talk to your doc about reducing your basal insulin immediately.

Are you sure you are counting the carbs correctly each meal? If so, then talk to the doc about increasing the carb/insulin ratio even further until you stop getting hypo so often. You don't want the cure to be worse than the disease!

[Lex4153]

I'm not T1 and don't know too much about honeymooning as I never experienced it but I wanted to welcome you to the board! :ciao:

Also, even though you said you had DKA, was a test taken to confirm you are T1 and not T2? I just ask because I was mistakenly diagnosed as T1. Mistakes do happen.

[Lex4153]

Also, like stated above, your bg's are TOO low. 50's can be very dangerous. You might want to ask the doc to move the ratio wayyy up and try to stablize it back down rather than up. Especially when first diagnosed, your target should be to come down a bit slower. You don't want to jump from having blood sugars in the 400's to down to less than a hundred immediately. Typically they'll shoot for 150 and then slowly adjust you down from there.

[tcc123]

thanks for the replys.. I think i may have misspoken.. I haven't had a bg down to 50 yet.. I meant my bgs drop about 50-100 points overnight.. so i try to go to bed at about 180 and will wake up at about 125 or so. Except one morning i woke up at 70 and that scared me.. I am sending my doc an email with my bgs tonight b/c i am tired of snacking to keep up with my insulin.. I am pretty sure I am counting carbs right ( my mom cooks alot and has taken a huge interest in making sure my carbs are just right with measuring cups, scales etc...). The only thing I don't understand yet is how fiber and sugar alsohols figure into carbs. Also about being misdiagnosed, I am 20 and in pretty good shape so I don't know how likely it would be for me to be type 2.
thanks for the help. hopefully my doc will get back to me in the morning

[Lex4153]

From what I've learned, it doesn't matter what age you are or what shape you're in . . . I was a normal weight at 13 when diagnosed. But if you were in DKA, chances are high that you are indeed T1. I just get concerned because doctors are so quick to diagnose without testing just based on symtoms. I do believe it is possible for a T2 to get DKA, but I don't know of anyone who has. I just don't want anyone to go through what I went through with being misdiagnosed. Ask your doc just to be sure, k? :)

125 is wonderful for just being diagnosed! Are you just sick of eating so much? I've heard that docs tend to tell people to eat 45 g of carb per meal which can be a lot to some people. You might want to discuss with the doctor what how much YOU want to eat, and go from there.

[tcc123]

Ill definitely check out the type 2 posibility.. just in case..
Its not that i am sick of eating.. (i eat betweeen 60 and 75 carbs for each meal). It is just that I am constantly worried about being low. Normally 2 hours after a meal I will be at about 100 so I will eat more because I know it will go lower..for example right now i am at 103 and am about to take lantus.. Since my blood sugar has been dropping alot at night I am going to have to eat about 30 carbs to bring it up so i dont go l ow over night.. I just want to get the doses right so i don't have to be worrying about being low after every shot i take

[corwin]

Hi Cary, welcome to the forum, I'm sure you'll find it a great place for tips and advice.
This early in the game you might want to get your endo's stamp of approval for any change of doses but soon enough you'll be doing it yourself easily. It's a major change of life style but you'll be surprised at how quickly you get used to it and it becomes as natural as brushing your teeth every day.
Your honeymoon is progressing like it usually does, every now and then you suddenly start going low today from the same dose that was just fine yesterday. You just need to lower your dose (both lantus and novo) to match your new requirments. I kept going from ratio of 1:15 (1u novo for 15 gram carbs) to 1:25, it's normal, as long as you test early enough to catch it and change the ratio it's not a problem. Same thing happened to me with lantus, I went from 22u at night to 14. If you keep waking up below 80-90 (or whatever you decide to be your ideal number) then you need to lower your lantus.
As for your question if it will continue for a while, nobody can answer that, the honeymoon can last from few weeks to 1-2 years. Just as you need less and less insulin now you'll eventually need more and more insulin and then it will stabalize when the honeymoon ends. Even then sometimes weird things happen when you need more or less insulin, you just learn to work with it.
For your question about having to eat before you go to bed, no it's not normal, with the modern insulins you are using you take it to cover food and basal needs, not take food to cover the insulin. If you have to eat on a regular basis it means you are taking too much insulin.
Another thing worth mentioning is that you shouldn't be too scared of going low, you are so newly diagnosed that you'll probably feel very strongly every minor low and using a fast acting sugar to correct it is easy and safe. Your body still produces insulin so your numbers will push toward 80-90 anyway when you don't give it too much carbs to digest, don't worry about it as long as it stays at the normal range.
Keep asking questions and educating yourself and you'll find the impact of diabetes on your life is very minor.
goodluck.

[tcc123]

thanks for all the help guys.. my doc finally got back to me and told me to lower my lantus dose 2 units every couple of nights until it stabalizes. I can see this disease is something you have to have alot of knowledge about to control and i hope this board will help me.
thanks
Cary

[Cyborg]

would this signal a need to lower the lantus dose?

Perhaps some basal testing could help to fine tune your lantus dosage. You can also split your lantus into 2 daily injections which may help if the lows continue after you determine your basal requirements.

Welcome aboard, BTW. :)

[sbuff28@charter]

hey guys.. first post on here.. I was just diagnosed with type 1 about 2 weeks ago after a stay with DKA in the hospital. Since then I have been taking lantus at night and using insulin/carb ratios for my novolog doses. I started out with a 15 to 1 ratio whish worked ok for a while, but started going low after every meal. I moved to 20 to 1 and it worked for a few days but I have now been creeping low again. (I usually dont go too low because I catch it a couple hours after a meal and eat something). So today I have been doing 25 to 1 and still it is going low. I was wondering if this will continue for a while or level off eventually. I have also started working out alot more and am wondering how long the working out affects my blood sugar.. A second question I have is about my blood sugar dropping overnight. I usually eat something before bed and my blood sugar will still drop about 50 or so points (if i dont eat it drops about 100). Is this normal or would this signal a need to lower the lantus dose?
Thanks for all the help.. just trying to learn about my new lifestyle while still keeping a good attitude.
Cary


Same with me. 2 weeks after diagnosis i started to do the same thing; reducing my numbers like everyday. Eventually my highest ratio was 1:80 with 8 units of lantus which was before i got the pump. Now 7+ months after diagnosis i am on 10 units per day total since im on the pump. try lowering the lantus if lows become a problem. During honeymoon most people dont need any basal, but still to to put a little slide in the blood sugars. You seem to be doing quite well only 2 weeks after diagnosis. Your doing the right thing, keep reducing the insulin and constantly check the BS until under control.