Horrific day - hypo

[Raisin]

I think this may be one of my worst days as a diabetic. For the past 1 1/2 weeks, I've been having a lot of lows. Today has been the ultimate. I went low after lunch and have not been able to get my sugar levels to rise above 68. I gave up on M&M's, and now I am eating my glucose tablets until I find a way to get my glucose up.

I was dx at 36 (4 1/2 yrs ago) and my endo said I was a type 1, but when I talked to my MM trainer today, he said that I could be a 1.5 given my issue with lows lately (lows without a good explanation for why). I'm new to reading up on 1.5. Is the problem I'm experiencing today a "classic" illustration of a 1.5?

I've had problems with lows since being dx, but nothing that has lasted this long (going on 10 hrs). I have gone through numerous changes in my basal rates (over the 4 yrs, I've had to more than double my cumulative 24 hr basal amount). I knew my body had changed when I would go a week or longer running high, but now to have a constant low is something I've never experienced, nor have an explanation for. I have a desk job and I have not done anything strenuous today. I'm at a loss on what to do other than keep eating or cut off my pump. Ugh!

[ant hill]

Well at least you know what to do with a low as for me i woke up with a low and tested 2.1 / 37.8 and annaseed jelly beans are not well liked at that hour of the morning. :(
I am a type one and i was diagnosed in '71 36 years ago. As for type 1.5 i can imagine that the treatment is the same as type one.

[Cyborg]

Keep glucose tabs within arms reach at all times and redo your basal testing. Set a new basal profile for this type of situation. In the mean time, temp basals may help.

Good luck. It ain't no fun waiting around for your bg to come up...

[shabbie6247]

I think this may be one of my worst days as a diabetic. For the past 1 1/2 weeks, I've been having a lot of lows. Today has been the ultimate. I went low after lunch and have not been able to get my sugar levels to rise above 68. I gave up on M&M's, and now I am eating my glucose tablets until I find a way to get my glucose up.

I was dx at 36 (4 1/2 yrs ago) and my endo said I was a type 1, but when I talked to my MM trainer today, he said that I could be a 1.5 given my issue with lows lately (lows without a good explanation for why). I'm new to reading up on 1.5. Is the problem I'm experiencing today a "classic" illustration of a 1.5?

I've had problems with lows since being dx, but nothing that has lasted this long (going on 10 hrs). I have gone through numerous changes in my basal rates (over the 4 yrs, I've had to more than double my cumulative 24 hr basal amount). I knew my body had changed when I would go a week or longer running high, but now to have a constant low is something I've never experienced, nor have an explanation for. I have a desk job and I have not done anything strenuous today. I'm at a loss on what to do other than keep eating or cut off my pump. Ugh!

could it be you are still honeymooning? is that possible after 4 years? if your pancreas still has some life in it may just be it bounces on and off?

are you still bolusing for food? or do you just have a minimum
basal rate?

[xMenace]

While you may be honeymooning, I highly suspect your rates are off. The fact that you've doubled your basals is a red flag. Ya, I'd be retesting the basals asap. Remember, there's much error built into testing and any error in results or procedure may lead to very bad rates. Perhaps your previous testing was during a time of stress or hidden illness/infection. Lots can go wrong and I know it's frustrating tring to sort things out.

[Raisin]

The days following the episode were fine (ie, I had very few problems), so I don't see it as a basal issue. I do know that I need to tweak my overnight basal - which I have already started, but I rarely had issues around 4 PM-7PM.

Having said that, I was doing well until this past Friday - so, it has been 1 1/2 wks since the extreme hypo. It started all over again. Starting around 4 PM again. My glucose levels fell into the 60s. I ate some candy. An hr later, I tested and I was in the 50s. I ate three glucose tablets. This should have risen my sugar levels into the 80s at a minimum. Nothing. I ate two more tablets when I got home. I went ahead and had dinner without bolusing, but there was only about 10 carbs in the dinner. About 45 min later, I saw no movement, so I ate an ice cream cookie. I bolused 1 unit less than normal. Within an hr, I was in the 40s. I ate 6 tablets. I only rose to 68 then started falling. By 11 PM, I did a temp basal and reduced my basal by 30%. All in all, between 4PM and 3:30 am, I had eaten 23 glucose tablets and a handful of candy without bolusing for those items (over 100 carbs) and at 3:30 am, I was 97. It was a rough time. Sat and Sun, I had no problems (no temp basals and no extreme amts of glucose tablets - I now hate grape tablets!). If it wasn't for the CGMS, I would never had known or believed what was happening. It was as if my body was ignoring/rejecting the carbs. I've got a call into my endo to discuss, but I don't know what he can say when I had no issues Sat and Sun.

As far as doubling my basal rates, that has been a slow process over the 4 yrs. I would go for a few months without problems, then I would run high for 1-3 wks. I would inc my basals (which took a few weeks to determine since I was having to test every 2 hrs to get it right) and I would be in tolerance for months. Then, the cycle would happen again.

[xMenace]

The days following the episode were fine (ie, I had very few problems), so I don't see it as a basal issue.

Your bolus and basal rates can offset each other in a fine balance. You only notice when something changes such as meal size or activity. You have to take the bolus out of the equation by skipping meals. It's the surest way to set them.

[Simons70]

Hi- It sounds like you are just having a very common yoo-yoo in your insulin needs. I would lower my insulin until you get your bs' where you want them. Than in time you will probably need to increase your insulin again. That is just kind of the way to goes for me.
I always keep hard candy in my pocket. That has saved me a good many times.

[SueM]

It is just a sugestion but get your Endo to test your cortisol levels.
When I developed addison's disease I would go for days without insulin and still be hypo no matter what I ate. Other days I would be fine. I had for a very long time the diagnoses "it's your diabetes"! and control it.
It wasn't untill a bright spark of a GP suddenly woke up and decided I had a major problem, that I was tested for addison's disease. The rest is history.

[marked]

For the record eating chocolate to raise blood sugar guickly is not the best way to go. It contains too much fat that slows the absorption of the sugar into the blood.
Mark

[xMenace]

Hi- It sounds like you are just having a very common yoo-yoo in your insulin needs. I would lower my insulin until you get your bs' where you want them. Than in time you will probably need to increase your insulin again. That is just kind of the way to goes for me.
I always keep hard candy in my pocket. That has saved me a good many times.

I go up for unknown reasons, but I don't go down, especially for extended time periods. I do agree there are likely basal ranges. For somebody that's hypo-unaware like I am, setting basals at the bottom of the range is a must.

[Raisin]

Thanks for the suggestion. I know he tested me for this issue about a yr after dx and my hormone levels were fine. Maybe I should mention it to him since I'm supposed to go in for bloodwork within the next few weeks for my Sept appt.

It is just a sugestion but get your Endo to test your cortisol levels.
When I developed addison's disease I would go for days without insulin and still be hypo no matter what I ate. Other days I would be fine. I had for a very long time the diagnoses "it's your diabetes"! and control it.
It wasn't untill a bright spark of a GP suddenly woke up and decided I had a major problem, that I was tested for addison's disease. The rest is history.

[SueM]

Hi Raisin, the test that you need done is the ACTH test and it needs to be done 1st thing in the morning.
Make sure you tell your Endo that no matter what you eat your numbers do not rise. Also tell him the amount of carbs you are eating to correct a low with no improvement.