Low Blood sugars - advise please

[Sueellen]

Hi everyone; I am really new at all of this and have had two scares in the past two days and not sure how to handle. Both afternoons I have all of sudden become really shaky, and feeling like I was going to throw up. When I took my BS it was 4.3 and 4.1 on each day. I drank a glass of orange juice and that brought it up a bit but then of course I was scared to do my novorapid when I had to eat dinner (but I did). I recently started on Weight Watchers and am wondering if I am eating something wrong? I am still at the stage of calling my BS readings into the nurse at our diabetic education center once a week and then she adjusts me that way. Any advise or help would be greatly appreciated.

[alicat61]

:) Hi Sueellen,
Feeling low is very frightening as you don't know how much worse it can get. Having the juice is a good thing but I would have a piece of fruit or bread. A bit slower to work but keeps the level up. (with juice it can go up quickly and drop quickly)
4.1 and 4.3 are not really low but when you have been a lot higher your body tells you they are low and you get all the symptoms. As your body gets used to lower blood sugars your lows will be lower.
I ran on bsl's of around 10 to whatever and anything under 6 would give me that hypo feeling. Now that I'm looking after the diabetes and my bsl's are rarely over 10 my lows kick in under 4
How much novorapid are you taking ? and what do you eat at lunch time ? Also when do you next call the diabetic nurse.
I often find my blood sugars go lower in the afternoon depending on what I eat at lunch.
If I'm not eating a lot of bread or friut I will cut back my lunch time insulin by a couple of units.I would also ring your diabetic nurse and see what she suggests
Take care from Alicat61:)

[Keezheekoni]

Hi Sue Ellen! I'm on Weight Watchers too, and noticed quite quickly that I had to adjust my basal insulin as well as my I:C ratios. (I'm on a pump by the way.)

I'll let you know one nice thing, as POINTS in WW are very precious! Don't use food to correct your lows. Run out now and get some Glucose Tablets. I get mine at Wal-Mart (their brand) and they are 1 POINT per FOUR tablets. :) 4 tablets is 16 gms. of carb, and they work quickly. After you've had the tablets, grab a banana or even better, slather a Tbsp. of low fat peanut butter on a 45 calorie slice of Sara Lee bread. :) That's 2 POINTS... I usually don't need the bread and peanut butter, because I usually go low around a meal time, so I just eat my normal meal.

Good luck!

[BlueSky]

... Both afternoons I have all of sudden become really shaky, and feeling like I was going to throw up. When I took my BS it was 4.3 and 4.1 on each day. ...
It sounds like you are taking too much insulin at lunchtime. It is common to become more insulin sensitive in the late morning, so a less insulin is needed to cover lunch than is needed to cover breakfast.

[Sueellen]

Thanks everyone for the comments; and especially the weight watchers tips! I am definitely heading to walmart tomorrow. I feel better reading everyones responses so far. For almost a year my family doctor had me sitting with BS readings of between 14-16 on a regular basis(my A1C was 15.2) and he just kept adjusting the metformin so now that I now with an endo and on insulin I have never had that feeling until the past two days. I am glad to hear that 4.3 isn't a really low number and I will call the nurses on Monday to talk about it.

[SGT Shoutmore]

I goofed this post all up. Tired eyes... edited and squashed... OOPS

[ant hill]

I recently started on Weight Watchers and am wondering if I am eating something wrong?
Here you need to lern how to carb count and mach that to bolus insulin and that magic Insulin : Carberhydrates ratio. See if you can raise that with your cordnatior at whight wachers. :)

[morrisma]

The 4.3 & 4.1 are not that low but you might have been dropping rapidly. Once you get used to the feeling, you will probably tolerate the lower bg numbers a little better but also recognize it for what it is so you can react.

Weight Watchers is great. Points are valuable indeed :) but get different flavors of those glucose tabs so you have some variety. My biggest complaint is there's no chocolate :D. Also, after you take the tabs to correct, you may feel ravenous. Don't eat everything in sight (as many have done) and end up high later.

Don't make yourself nuts over the points though - you have the extra 35 per week if things get crazy and treating the low is WAY more important than missing points for the day.
Good luck,
Mike

[Alice]

I attend Weight Watchers and highly recommend them. Having said that...I don't let the "point system" dictate my carb intake. So, if I need more carbs, I eat them. Or correct with them. That point system is not developed with insulin users in mind. We have to adapt to our priorities. So, give yourself a little break.

1) You can save those "extra points" in a sense, to allot toward lows. I just feel this is a little weird planning on lows when we are trying to prevent them...so my mind doesn't really work this way.

2) If you stick to the point system, but have to add carbs for corrections, it is usually so minimal that they really don't set you back on the scale. Maybe when you are really down to the last pound or so.

I usually cut back on my basal for a day or two...but go back to "normal" if I'm running high on very little food. Your basal shouldn't be too dependent on food intake unless you've used some of it toward food coverage. They tend to "blend" into each other easily.

Yes, I like the glucose tabs also. Saves on calories and fat. Too bad they don't have fiber! (Grins)

[xMenace]

Welcome Sueellen,

First off that NPH scares me. I don't know why some doctors insist on using it. Ask about a 24 hour basal insulin like Lantus or Levemir.

Make it your mission to learn about everything, especially how insulins behave and how food behaves. Your tester is your friend here; though how to use it mysifies many people.

Where in this snow-clogged land are you?

[Alice]

I didn't notice the NPH...that is such nasty stuff...I only know (based on my old Lente days) is that you will always get a kick-in-the-butt about 3 hours after you inject. (Or am I thinking of Humalin R?...I don't know...I'm so glad to be off those old insulins, LOL!)

Why aren't you on Lantus? (Question for your doctor, really) That will help you with Weight Watchers since you, in theory at least, won't be "feeding" your basal insulin after you've worked out the correct amount. Correct, meaning you worked out the average amount needed. It will always need to be adjust a unit or two every now and then.

[Eddy]

I didn't notice the NPH...that is such nasty stuff...I only know (based on my old Lente days) is that you will always get a kick-in-the-butt about 3 hours after you inject. (Or am I thinking of Humalin R?...I don't know...I'm so glad to be off those old insulins, LOL!)


A 3-hr kick is rather fast for NPH; that stuff hits me at 4-5.5 hrs, and I'm waaay over on the fast end of the scale. That timing is more likely Humulin-R.

Sueellen:

I agree with the others: Get some Levemir or Lantus for your basal. Even I -- who seem to be about the most pro-NPH person on here -- wouldn't use it for my primary basal.

Your shakiness and nausea sound like your body "thought" it needed more sugar, and started secreting glucagon and various stress hormones. That'll happen when it feels "too low", based on what it's used to. (I remember panicking with my first 3.1, and thinking I was going to pass out the first time I hit 2.6. Both those _are_ too low, and definitely require correction, BTW.)

As others have suggested, you might have used too much Novorapid. It's also possible that the rapid kicked in _faster_ than your food. You might test whether delaying half -- or even all -- of your bolus helps your postprandial numbers.

FWIW, my boluses usually are less than 50% rapid. The stuff just hits me too quickly; depending on what I'm eating, I mix in R and/or N to slow the effect. However, most people will delay and/or split their boluses to counter excessively-fast insulin action.

[ant hill]

Hello again Sueellen :), have some thought to low GI foods as this will have a good buffer against going low during your day like breads and the like. It's also the same with the insulins that we now use like the lantus & the levemir as this is high technology insulins that have a more true flat doses that is achieved and many people who split their doses into two 12 hourly shots in a 24 hour day as this has proven success. ;)