Serious BG Problem, Want Some Help Fast

[gobbly2100]

Ok basicaly I have started working in a job that means I am doing lots of lifting and moving about work so I already guessed that there would be diet/insulin changes and that is fine bu recently I dunno if this is to do with all the work am doing but I am starting to have lows where when I eat and then test again the BG can be even lower after eating 15 carbs and waiting 15 minutes before testing again.

It is getting scary because the other day I had a low and to get me up again I had the following

- 1 pint of milkshake
- Packet of crisps
- wagon wheel chocolate bar
- 2 Twiz chocolate bars
- 2 biscuits

When I tested after about 20 minutes my BG was 9.2 and after all that am kinda thinking "WTF"

Now, I have been home all day and just getting ready for bed to find my BG at 4.2 so I eat a wagon wheel chocolate (Jammie One) and test 15 minutes later to find I am only 4.4 so I can't go to bed that low and I take 2 twix chhocolates again and test a little after to find am 4.4.

What is going on, am really getting scared now, am worried that I could have some kind of strange condition or something :(

If anyone can help me fairly fast that would be great.

[JediSkipdogg]

Personally, the 15 minutes to me is ****. I have that problem 100% of the time where food doesn't do anything. I would eat what you think you need and then test in 30 minutes. Try that next time and see what happens.

Another thing to keep in mind is don't eat chocolate. Your best bet is to drink a sugar high drink. Chocolate is loaded with fat and therefore makes it take even longer for it to digest and an effect to be noticed.

Heck, all that food you at to run 9.2 I'm surprised you didn't run higher. You really loaded on there.

[Gary_W]

Hi Gobbly,

The fat in the milkshake can really slow down the absorbtion of everything else you ate with it. As all the rest of the stuff you ate to treat the hypo also had a fairly high fat content (chocolate, biscuits, crisps) then it's not too surprising that your numbers didn't make sense. Whilst your BG was 'only' 9 after 20 mins, I would take a bet that you would have been in double figures at the hour mark and stayed there for a while unless you corrected.

As far as treating hypos goes, I used to eat the same kind of stuff as you. Glucose tablets are far, far quicker than any of the above, and it is really easy to just have 15g of carbs as they don't taste so good. It's rare for me to use anything else these days as they do exactly what is needed and no more.

If you are going low all the time at the moment, it also sounds like you have too much insulin floating around and are having to feed it. Again, I own that particular t-shirt ;)

Do some searching on here regarding setting your basal rate. Personally, I can go to bed with a BG of 4.5 and frequently do. I may just be lucky, but I know that my basal rate is correct and that I can wake up at the same BG as I go to bed at. Before my basal was right, I would eat biscuits etc before bed if my BG was below a 7! It was the only way to avoid a night hypo. If I am 7 now before bed I do a correction shot, so it's a bit of a different ethos.

You will also find that, with all the extra lifting you're doing, you'll need to either eat more or inject less; you are burning it off and hence have too much insulin.

Good luck

Gary

[gobbly2100]

Well that low lasted something like 45 minutes before I was stable and able to feel good again, I have never had such serious issues with keeping my levels up but dam that was something else.

Where does all that sugar and stuff go then? I know it has alot of fat in but the sugar feels like it just vanishes in my blood lol that would be good sometimes :)

[JediSkipdogg]

Where does all that sugar and stuff go then? I know it has alot of fat in but the sugar feels like it just vanishes in my blood lol that would be good sometimes :)

If the low is due from exercise then the sugar goes towards rebuilding the strength in the muscles. The muscles are still working even after you stop and therefore are still pulling more glucose for some time. Unfortunately, it's really hard to say how long because it can depend on the kind of work being done.

[gobbly2100]

Well I recently got my blood sugars almost spot on but now I started this really active job of loads of walking, running up and down stairs, sweeping, lifting boxes up and down stairs and more I kinda am totaly losing control.

Lows followed by highs when I finaly get home.

I got my diabetes tweaked perfect for a job sat at a PC but this excersize stuff with the muscles needing glucose and such just makes things so much more complicated and hard to know what is gonna happen.

The amount of work I do each day is so different it is not like I could adjust my insulin and such before hand.

The fact it is aerobic style work and weight lifting work am sure makes things again more complicated right?

Would you suggest I found a different job if possible?

[Funnygrl]

None of those carbs are SIMPLE carbs. Juice, soda, glucose tabs, fruit. That stuff is good for lows. Skip the chocolate.

[duck]

Gobbly, to expound on what Gary said about the milkshake--the sheer cold of it slows its absorption down (remember in chemistry and 'energy of activation'? Yeah, I hated that **** but remarkably it can be applied to real life). Also, it will slow down the absorption of other nutrients as well, so steer clear of it next time.

You never said how much insulin you are taken or WHEN you took it in relation to work. That can help us help you if we know.

There are a few things to consider/do: I agree with Jedi that 15 mins is BS. I have at times been low for an hour after treating and treating aggressively. It really depends on what caused the low. You may want to keep juice/soda etc., like funnygirl said, close. You'll probably want to cut the insulin you are taking, either the basal or the fast-acting or maybe both. TELL YOUR COWORKERS and boss that you have Type 1, and that initially you may need to "adjust" your insulin to the work environment (this is a toughy, I know). And I have noted in my life that the more acclimated I get to doing hard work like manual labor, the more efficient my body gets and the less insulin I need, the less sugar I need as well. Weird, eh?

[LancetChick]

Oh poor you...... I've had that totally out of control feeling, and it usually means too much insulin. Exercise will lower your overall basal needs, sometimes by a lot. What happens to me is that my first day of exercise my basal insulin needs to be reduced that night. Second day it needs an even further reduction, and the third day an even further one. From that point on it stays the same. Of course, this doesn't happen to everyone, but it's something to look out for. The new basal sensitivity to insulin doesn't last one day and then tomorrow is another day..... it's more of a reaction to just the fact that you're exercising, not how many hours you're putting in. For me, skipping a day of exercise doesn't make my basal needs suddenly go up, so I doubt that the inconsistency of your routine will be much of a problem if you set your new basal correctly (please say you're not still taking that mixed insulin!). You could react in a very different way, though, but this has been my experience.

[gobbly2100]

Am on Humalog Mix25, I am on mix because I don't want to be doing more than 2 injections a day and as I said I was in good control of my dibetes before this work so I don't fancy changing my insulin.

I am taking 50 units in the morning and 50 at night, if am high then I take some act rapid which was not too often but now things are just all over the place, before I used to eat a wagon wheel and blood would be so perfect and hold me there nicely.

I forgot to say that the milkshake was the last thing I had when I was running out of things to take so I dunno if that would make a difference as it was drunk after about 40 minutes into the low.

Also the other morning I woke up with a normal BG then had insulin and normal breakfast but had a low of 1.6 about 20 minutes after which NEVER happens so I dunno if this new routine is effecting me days after work because the previous day I did no work.

Am also not waking up when I go low until am seriously low, I used to wake up around 3.4 but now am waking up around 1.5 and stuff which I don't like.

Everyone is different I know and am really wondering if it would be better to get a new job.

[Gary_W]

Gobbly, to expound on what Gary said about the milkshake--the sheer cold of it slows its absorption down



Way cool. I am going to live on nothing but B+J's icecream from now on in. It's mostly fat which will please the low carb folks and the cold will slow down the carbs :D

Thanks for the info, Duck. It makes sense from a chemistry point of view, but the temperature of food is another thing I'd never considered...

[Gary_W]

Am on Humalog Mix25, I am on mix because I don't want to be doing more than 2 injections a day and as I said I was in good control of my dibetes before this work so I don't fancy changing my insulin.

I am taking 50 units in the morning and 50 at night, if am high then I take some act rapid which was not too often but now things are just all over the place, before I used to eat a wagon wheel and blood would be so perfect and hold me there nicely.

I forgot to say that the milkshake was the last thing I had when I was running out of things to take so I dunno if that would make a difference as it was drunk after about 40 minutes into the low.

Also the other morning I woke up with a normal BG then had insulin and normal breakfast but had a low of 1.6 about 20 minutes after which NEVER happens so I dunno if this new routine is effecting me days after work because the previous day I did no work.

Am also not waking up when I go low until am seriously low, I used to wake up around 3.4 but now am waking up around 1.5 and stuff which I don't like.

Everyone is different I know and am really wondering if it would be better to get a new job.


IMO, you'll be hard pushed to get decent control on 2 injections a day if you do the same thing day in day out. Putting hard work into the equation 5 days a week is going to make it impossible. Using that kind of insulin twice a day is really doing you no favours if you want to be free to live your life without being a complete slave to this illness. Change the insulin regime, not the job. It will be far better for your health long term and for your daily existance.

I was so needle phobic before I had this that I couldn't even watch someone else have an injection. That would be me passed out. I got over it when I realised that the alternative was feeling dire for the rest of my days...

[gobbly2100]

The thing is which really is getting to me is the fact that I had great control until this change in lifestyle, I had adjusted to just light exercise and sitting behind a PC or going out somewhere.

Everytime I do an injection I have this thing about wanting to only do it at peoples houses in a really clean enviroment an stuff, I am also slow with injections and only do them in my legs so it really would be a pain doing 4+ injections a day.

What kind of life would that be for me to do so many injections when it gets to me so bad?

[LancetChick]

Get a new job.

[JasonJayhawk]

Like Gary and LancetChick (and others) have said... chocolate is not intended for treating hypoglycemia.

It's loaded with fat. Fat takes time (hours!) to digest, and it even slows down the absorption of other foods.

You need to carry around dextrose/glucose around. It's absorbed very quickly -- in fact, it's absorbed into your bloodstream simply by placing it into your mouth via your salvilary glands!

Fatty stuff makes dosing difficult because the glucose peak occurs at some time later than when your fast-acting insulin hits. Thus, you'll have a low early on and a high hours later, unless you master the timing of when the glucose peak occurs with each food item.

[ant hill]

Everyone is different I know and am really wondering if it would be better to get a new job.
Ho no! Don't do that, Diabetes is expensive desiese plus you have a healthy job and good on you for taking on the job!.:top: :congrats:
Anyway do the adjustments for insulin and look at the three things that will keep your well bieng. Insulin Exercise and food Ho!! and another one Get happy. :D :D :D :thrasher:

[SueM]

Gobbly as you are using a lot more energy you will go low so simple solution is to cut your insulin :D the fact you have to eat so much to correct a low is obvious that to much insulin is swiming around in you. Cut the insulin right down, Make sure you have glucose tablets in your pocket they work very quickly. The Isophane in your mix is causing the problems as it just carries on working.
Once insulin is cut you should be fine. If you then find you havent done as much physical work go for a walk/run to make up for it.

[DeusXM]

Two things to bear in mind:

1. Treat your hypos with glucose. It's not an opportunity for you to eat 'forbidden' foods. When you have a hypo, you need to get glucose into your blood FAST. So cut out the middle man and eat the stuff directly.

2. Here's the harsh part. If you're not going to change your treatment regime then you're going to have to get another job. You cannot have a variable activity schedule and survive on two injections a day. The human body is not designed to do that. Two injections a day is not a suitable treatment regime for diabetes - it's a very, very bad one that's only marginally better than not taking insulin at all and really it should be considered the equivalent of using stabilisers on a bike.

Until you have a treatment regime that mimics normal pancreatic action, you are never, ever going to be able to do things that 'normal' people do. I'm sorry if that sounds harsh but there really is no point in sugar-coating this.

[Funnygrl]

I would not quit my job before I went on more than 2 shots a day. That's just a bad idea imo. Even if you absolute insist on 2 shot a day, separate N and R (or humalog, or novolog) would be better than premixed.

[Just_Plain_John]

The amount of work I do each day is so different it is not like I could adjust my insulin and such before hand.

The fact it is aerobic style work and weight lifting work am sure makes things again more complicated right?

Would you suggest I found a different job if possible?

This type of variation is why a lot of active people like insulin pumps - you are always getting a small trickle, and can reduce that a little when you know you are going to be working hard for a while.

For me (and perhaps ONLY me :D ) I get the same BG effect from 1/2 hr of very hard, fast walking as I do from sets of weightlifting exercises. Sometimes at work I have to move PCs in quantity, which means loading them in stacks into the van for 1/2 hr, etc. My reaction to this appears to be the same as weights/walking. The one exception is trotting quickly up many flights of stairs - that's especially intense.

It does sound like you are "feeding the insulin" when a lower base rate would be easier and involve less complication. If you take multiple daily injections now and this is a regular or fairly predictable job, you could perhaps split your long-acting insulin into two doses 12 hr apart - one a little less for the daytime at work, and half of your "normal" amount for inactive times at night.

If you can work an active job like this, it's certainly good exercise - aside from hypos, it could be beneficial to your health.

Good luck, and congratulations for making such an effort !

[Gizmo]

I need so help with this, I was driving big truck over there road. Felt like **** went to er. My blood surger was 824, it took over 6 hours to get it down with IV.

I have been screw around with Doc's that don't know what they are doing. Well over 3 years.

When my bs is around 200 I feel fair. When I take insulin Humalog to bring it down I feel very ,very bad. My body does not like it below 200 so what does a person do ?

One more thing If I go out and walk, or do something out side
I have to rest two or three days after ward.

After reading the above message I think I hit on something.

What is every body thought on this. I can't sleep very good at night. Need some help New email address

Gizmo1955@woh.rr.com

[JasonJayhawk]

Gizmo,
I wouldn't post your email address in the forums. Spambots target specific types of sites (like diabetes) and will start sending you every snake oil product advertisement in the galaxy.

As far as your glucose control, your doctors are your consultants. You're the lead on your team. You've taken the right step to be proactive by joining the forum!

I sort of know what you're experiencing. Your body is adapted to having a high glucose level. When you start to return to normal levels, you end up feeling yucky.

Unfortunately, you're going to need to stabilize yourself at "normal" levels for 2-3 months -- and to get over the yuckiness -- before realizing what you've been missing out on.

You'll even feel shakey. You may even get bloated. Your body thinks "hypoglycemia" is when you drop below 200 mg/dl, not when you drop below 70 mg/dl. You're going to have to retrain it.

If you don't retrain it, microvascular damage will continue to occur, as the body isn't built to handle glucose levels that high, even if your physiological system is fooling you by preferring to stay at 200+ mg/dl.

Also, your kidneys are overworked at 180mg/dl and higher -- the kidneys help filter high glucose out (the "renal threshold").

Have you seen a board-certified endocrinologist? PCP's generally are not trained for dealing with Type 1 diabetes.

It will be up to you to manage it, adjust your medication, and so on. The doctor can only sign the piece of paper that gives you the lab tests and the prescriptions.

[xMenace]

Maybe cut your normal doses in half and work your way back up if she's too high. Also, as your body gets more used to the activity, you should settle down

[DeusXM]

When my bs is around 200 I feel fair. When I take insulin Humalog to bring it down I feel very ,very bad. My body does not like it below 200 so what does a person do ?

Because your BGs have been so high for so long, your body has been conditioned to see normal blood sugars as 'low'. What you need to do is to retrain your body to be used to normal blood sugars. For two weeks, you should aim to get your BGs into the 200-250 range - this is still very high but it will be lower than what you are at now. Your body will adjust to feel more comfortable at this range. Then after that two weeks, aim for BGs between 150-200. This is still 'elevated', but much closer to normal. Your body will adapt and then after those two weeks you can aim for 100-150, which is 'normal'.

It's a bit like temperature - if you're currently living in an igloo and someone suddenly puts you in the Sahara, you're going to feel very bad. But if you make the move in small steps, you'll acclimatise and be able to achieve normal BGs without feeling bad.

[ant hill]

Two things to bear in mind:

1. Treat your hypos with glucose. It's not an opportunity for you to eat 'forbidden' foods. When you have a hypo, you need to get glucose into your blood FAST. So cut out the middle man and eat the stuff directly.

2. Here's the harsh part. If you're not going to change your treatment regime then you're going to have to get another job. You cannot have a variable activity schedule and survive on two injections a day. The human body is not designed to do that. Two injections a day is not a suitable treatment regime for diabetes - it's a very, very bad one that's only marginally better than not taking insulin at all and really it should be considered the equivalent of using stabilisers on a bike.

Until you have a treatment regime that mimics normal pancreatic action, you are never, ever going to be able to do things that 'normal' people do. I'm sorry if that sounds harsh but there really is no point in sugar-coating this.

DeusXM, I'm sorry that i am going to disagree with you.
1. Don't let the desiese rule your life!!! Point Blank.
2. The activity is a pyisical one and that is a healthy thing to do and sure they are times that there is no activity. There is some times that you have to adjust to life. So your BG meter is a light for you to see that you stay in control so good luck with your job! ;)

[BriOnH]

Gobbly as you are using a lot more energy you will go low so simple solution is to cut your insulin :D the fact you have to eat so much to correct a low is obvious that to much insulin is swiming around in you. Cut the insulin right down, Make sure you have glucose tablets in your pocket they work very quickly. The Isophane in your mix is causing the problems as it just carries on working.
Once insulin is cut you should be fine. If you then find you havent done as much physical work go for a walk/run to make up for it.

Ditto

I totally agree Sue. IMO this is the answer to his short term problem to his question and am surprised it took til the second page for the answer to be revealed.

Like said in this and every other thread gobbly has problems in; You need a better insulin therapy Gobbly. The sooner you accept and do it, the better your life will be.

[DeusXM]

1. Don't let the desiese rule your life!!! Point Blank.

Precisely. But you can only do that if you treat your disease properly. MDI means that the disease doesn't rule your life - you can eat what you want, and do what you want, whenever you want. You cannot do this with just two injections a day. With 2 injections, you have to eat the same amount at the same time every day and do the same level of activity every day.

In other words, with 2 injections, the disease rules you. With MDI, you're the king.

2. The activity is a pyisical one and that is a healthy thing to do and sure they are times that there is no activity. There is some times that you have to adjust to life. So your BG meter is a light for you to see that you stay in control so good luck with your job!

Yes and you can't make those adjustments with just 2 injections a day. You can with MDI.

Good luck isn't going to fix frequent hypos. MDI will.

[duck]

Yes and you can't make those adjustments with just 2 injections a day. You can with MDI.



I have to completely agree with this; I know many people would LOVE to take one shot, two shots a day and be in perfect control (or, really, no shots). But you are literally shackling yourself.

Having said that, it is your life and your choice. If staying on two shots is more important than keeping your job, then get a job that allows you to live the twice a day lifestyle. I'm not sure how that strategy can be considered "living life" as opposed to taking control from your diabetes.

[pooh3465]

I find the best thing for me is to carry a bottle of orange juice with me. orange juice kicks my sugars into very high gear and it is the thing that works the fastest for me. I have had that problem before but mine was from bolusing and forgetting to eat, then going to church and running around like a mad woman trying to get to all my classes and singing and such, I ended up driving home(really a stupid thing to do) and from there it took me 45 minutes to get my sugars to go up to 80 so neeedless to say it was a horrible day. At least after reading all the comments I know why now. I was trying to get it down by eating the same types of food you did and nothing seeemed to work the rest of the day was spent trying to get my sugars normal again. So thanks everyone for your info it helped me alot.

[cheryl]

All the advice is good that everyone else has suggested, but no one seems to realize that you are on a mix insulin, and to be quite honest without disrespect to any one on here, insulintard insulin or a mix, you will probably need that fat later on cause the mix will keep you dropping, I hated when i was on nph when people would tell me the 15 15 rule cause for that insulin it don't always apply, what I used to do is drink some soda and eat some peanut mm's so that it took care of the blood sugar quick and then kept it stable later on but the problem is going over board so a half a can of soda and 10 peanut mm's should do the trick in my humble personal opinion on that type of insulin or the old oj and peanut butter crackers, seriously I know you don't want to change to mdi's that is fine, but then you must seriously think of something fast acting like soda, oj, or glucose tabs and then a small little meal........that is my opinion on that type of insulin.

cheryl

[duck]

I hate NPH and I hate the mixes, they offer no flexibility and NPH can become very volatile for users...But gobbly said he was happy with it, so I opted not to pontificate on the evils of NPH and the compounding evils of mixes...

[Funnygrl]

I'd rather see someone take a shot of Lantus once a day than use mixes. At least lantus is flat. You'd just have to eat very low carb.

[SueM]

I'd rather see someone take a shot of Lantus once a day than use mixes. At least lantus is flat. You'd just have to eat very low carb.

It's all very well you and everyone else coming up with what they would rather gobbly did but................. he has already stated he has a massive fear of needles it is all he can do to cope with 2 shots a day.
Not many people can get away with lantus once a day as it doesn't always last 24 hrs then he would have to inject 3 times for meals at least. That in my book adds up to 5 shots a day which he can not cope with.

Yes he can get fairly good control with 2 shots a day but he has to work on it.