Low blood sugar levels over an extended period??

[Pitzi]

I am not talking about hypo stuff, just reasonably low, lets say between 3.0 and 4.0

Are there any side effects to that?

[Cinnabon]

Well I have had to deal with that for long periods at a time, even more while I was pregnant with my daughter. The doctor would tell me that "As long as My blood sugar wasn't high, the baby would NEVER feel anything". I never believed that, but thankfully my daughter was ok. Still now I go through that, I even go to the 30-40 (2.0-2.5). In my case is a bit too much insulin or not enough food. If you were recently diagnosed your pancreas might still be producing insulin and that along w/ the medication you are taking for your diabetes might be a bit much. Were you able to get a good Endo/ doctor?

[MarkMunday]

As far as I can make out, blood sugars like that don't do any harm. It is only when it drops below 1.0 that brain damage starts to occur. The only negative effect of moderately low blood suagrs is that your body gets used to them. And you stop feeling hypos coming on. The danger of this is that you may be uanaware of a dropping blood sugar level until it is too late to take corrective action. So it is best not to let your blood sugar drop below 4.0 too often.

Cheers,

Mark

[Pitzi]

Cinnabon, been a diabetic for the last 11 years. i also sometimes go low like you, depending on he amounts of exercise etc. One thing i hjhave discovered though, till about 3 years ago i could feel the onset of a hypo coming on, nowadays it just comes and I feel nothing.

Markmunday, my threshold for showing signs of hypo is very low, if I go below 2.0 i will show signs.

[Pitzi]

Were you able to get a good Endo/ doctor?Sorry, only read this now. I have a good doctor down here, but no Endo. I dont really need one except for when I do my 2 yearly checkups. Everything is pretty much fine these days. I have a good (lowish) but stable blood sugar. During the day I hover between 3.4 and 7.5 and in the morning before taking food I am around 3.0. Sometimes (in very rare cases) I will go high, but never above 11.0

The only times I feel bad is after a hypo, but these days its very very rare. I hate the feeling I get for a day after I get a hypo, especially if it hits me when i wake up in the morning. During daytime I check my blood too often and correct it if its going too low. The morning catches me out, but at the moment its at less than an episode a month which I think is not too bad.

[MarkMunday]

.............. my threshold for showing signs of hypo is very low, if I go below 2.0 i will show signs.
You can raise this threshold, and it is a good idea to do this. The biggest problem with hypo unawareness is driving when you 2.0-2.5 and feeling fine. You may not realise it, but your ability to judge speed and distance is impaired. This can lead to accidents and losing your licence.

You raise the threshold at which you feel hypo by ensuring that your blood sugar doesn't go so low. Your body will re-adjust and your hypo awareness will be restored. Sounds like you are vulnerable to low blood sugars over night. So you may have to have low GI snacks before bed and/or reduce your basal insulin.

Cheers,

Mark

[Belinda]

I agree with Mark...you need to raise your threshold. I have had to do this several times. Normally all I do is change my basal rates for about 2 weeks and that does the trick.

[Pitzi]

You can raise this threshold, and it is a good idea to do this. The biggest problem with hypo unawareness is driving when you 2.0-2.5 and feeling fine. You may not realise it, but your ability to judge speed and distance is impaired. This can lead to accidents and losing your licence.

You raise the threshold at which you feel hypo by ensuring that your blood sugar doesn't go so low. Your body will re-adjust and your hypo awareness will be restored. Sounds like you are vulnerable to low blood sugars over night. So you may have to have low GI snacks before bed and/or reduce your basal insulin.

Cheers,

MarkThe problem I encounter with having too much to eat the night before is that the next morning either my blood sugar will be highish (eg 7 +) or around 4.5-5.0 and if I eat anything for breakfast it will spike very high (11)

I take my Humulin I before lunch (around 12:00) and before supper (around 18:00)

[MarkMunday]

Is Humulin I NPH? Because if it is, the overlapping action of your lunch and supper shots could explain why you go low at night. Have you tried Lantus? It sounds like you are still in your honeymoon period and the flat action of Lantus may suit you better.

Cheers,

Mark

[Pitzi]

Is Humulin I NPH? Because if it is, the overlapping action of your lunch and supper shots could explain why you go low at night. Have you tried Lantus? It sounds like you are still in your honeymoon period and the flat action of Lantus may suit you better.

Cheers,

MarkI am not sure what NPH means, but Humulin is an intermediate acting insulin.

Honeymoon period? whats that? can it last 11 years? :eek:

Lantus is not available down here.

[MarkMunday]

Pitzi,

I didn't realise you had been diabetic so long. So the honeymoon will have ended long ago. NPH is a generic name for a type of intermediate acting insulin. And Humalin I (which stands for Isophane) is in fact NPH. Below is a chart of the different insulins actio n profiles.

You will notice that NPH has a pronounced peak at about 6 hours but doesnt finsh until about 20 hours. So having shots at lunch and supper time doesn't give youeven coverage over the day. Action is concentrated in the night time. The next image shows houw you could improve the coverage by changing te timing of injections
http://www.med.umich.edu/1libr/pa/insulin.gif

Looking at the chart below, the generic name for Lantus is Glargine. It has a flat action profile and should only need one shot a day.

Cheers,

Mark

[MarkMunday]

The chart didnt upload because to was too big. So I have compressed it. If it is too small. NPH is on the top right and Glargine is bottom right. Here goes ...

[DeusXM]

If you cannot get Lantus in South Africa, you may wish to to see if you can get Levemir. It has an even flatter action profile than Lantus, with fewer side effects.

As an extra note, if you are keeping your bg between 3-4, you are definitely running too low, as a non-diabetic's levels are 4-5.

If you cannot get Levemir or Lantus, try Insulatard. It has a longer profile than Humalin I, and if you take it in the morning and in the evening, you will find it will help cover your morning bg spike (providing you take a bolus insulin at the same time).

You may also want to check that you are not having liver dumps as a result of hypos whislt sleeping, or the dawn phenomenon.