big drop

[hedge]

My OH Bg this arvo was 254, before his dinner tonight it was 134. He had a good plate of tuna steak, potatoes, spinnach, cabbage, carrots and brussle sprouts with gravy for his tea, yet an hour after he'd eaten his bg was 44!!
Any ideas as to what can cause such a big drop in his levels?
We're totally baffled!

[Cinnabon]

My OH Bg this arvo was 254, before his dinner tonight it was 134. He had a good plate of tuna steak, potatoes, spinnach, cabbage, carrots and brussle sprouts with gravy for his tea, yet an hour after he'd eaten his bg was 44!!
Any ideas as to what can cause such a big drop in his levels?
We're totally baffled!

What medications is this person on? and what is this abbreviation for?

OH Bg this arvo was 254

[lgvincent]

I have, on occasion, had my blood sugar to drop fast after eating. I've been told since childhood that your blood sugar will drop quickly if you inject the insulin into a blood vein but I don't know if it is true or not.

[hedge]

Sorry, a bit lazy with the typing! OH = Other Half BG=blood-Glucose and Arvy=afternoon.
He's on 20units of lantus in the morning and 5 of novarapid before each meal. These lows (he had a 70 an hour after lunch) are the first below 140 he's had in the 3 weeks he's been diagnosed type1 and I'm wondering if this has happened today because his lantus was increased from 16 to 20. Can such a small increase have such a drastic affect? Would eating some fast carbs straight after his main meal help? thanks for replying as we're in Spain and have had little or no help from the doctors over here.

[Cinnabon]

I want to visit you, I would love to see Spain... lol

#1-FIRST.... ALWAYS TREAT A LOW!

Yes small changes can cause this, but if he has been running high on the usual basis, his body is simply reacting to getting used to normalizing, but always (go to #1)

Treat a low w/ 15 carbs and wait 15 min and retest so u wont over do it.

[lgvincent]

An increase in the long-acting can have an influence on the short-acting insulin. I don't know anything about Lantus, though. I always have to keep an eye on the short-acting doses any time I change the dose of the long-acting insulin, and often have to lower them.

[hedge]

Thanks for the advice, maybe we'll keep a close watch tommorow and if the lows happen again, go back to 16 units of long acting doses or reduce the short ones. I would like to try and control it by diet rather than insulin though. I to would love to see Spain Cinnabon, been here 4 years and not ventured much further than the local Irish bar!!!!

[Cinnabon]

I would like to try and control it by diet rather than insulin though.

Hedge,
I dont want to sound rude, but T1 diabetes has only 1 type of treatment. As much as all of the T1s like this, We cant. Our pancreas gave up, just like all the T1s. Please dont be reluctant to the treatment he needs, this is only for his health and to last many more years.

It has been a VERY short time dince his dx... HE IS IN THE HONEYMOON PHASE. His pancreas still works a lil, but that wont be for too much more time till his body will regulate to a normal dose.

[Erin]

Why was he changed from 16 units of lantus to 20? Why not 18? (or even 17 or 19 for that matter?) That is a BIG jump all at once.

Small changes in lantus dose, for me, make a HUGE difference. at 16 my levels are perfect, at 18 I'm hypoing left and right. Lantus also takes a day or two for changes to take effect... i don't know why, but it is true, the first day on a new dose you don't see the difference, but the second day, that's crazy.

Also why is he taking a set amount of fast acting before each meal? Most of us have more success if we change our doses based on what our blood sugar is before the meal, and how many grams of carbohydrate we are going to eat. You should ask his doc about an "insulin to carb ratio"

And yeah, if he is a type 1, there's really no possible way to control it with diet and exercise alone, our pancreases are shot and there's no way around it.

[Tokyo Cate]

I am completely with Erin here. A four unit increase in Lantus dose is quite huge. For me, the difference between 13 and 14 was quite significant.

If your OH is having trouble with 20, then reduce the dose, but don't reduce it back to 16 (because clearly the increase was made because his blood sugar levels were too high). My doc recommended increases of one unit every two days when I first started on Lantus until I reached the correct basal level (start at "x" dose, if fasting sugars are too high, increase by one unit and continue for two days; if fasting sugars remain too high, increase by one unit and continue for two days; if fasting sugars remain too high, increase by one unit and continue for two days" until reaching a basal rate that works. It worked for me.

I hope your boyfriend finds a stable basal rate soon and that all is well in Spain.

[hedge]

Thanks for the advice, maybe we'll keep a close watch tommorow and if the lows happen again, go back to 16 units of long acting doses or reduce the short ones. I would like to try and control it by diet rather than insulin though. I to would love to see Spain Cinnabon, been here 4 years and not ventured much further than the local Irish bar!!!!

*points up
This was my other half posting - I'll get him to start his own account.
:marchmell

We have no idea why the increase was made from 16 to 20, the doctors here are useless and we have had no support or information or nada! That's why you guys are so great, we'd really be lost without all the help and support we've had here.
The OH had 18 units this morning, as well as his usual 5 of novorapid before each meal and we'll see what happens.

tell you what though guys - it's bloody scary isn't it!!

[Shocked]

For me, when I was first diagnosed, I started out at 15 units of Lantus at night and a 15:1 carb:Humalog ratio for carbs eaten and a 60:1 ratio for bg above 100. My endocrinologist recommended a change of 2-4 units of Lantus increase holding that for 3-4 days and adjusting again if needed. Well, I couldn't handle a 2-4 unit change. Only 1 unit change every 3-4 days. I've worked my way to 26 units with morning breakfast time readings around 90-110 consistently. And, I've virtually eliminated my Humalog for the moment. When needed, it's more like 1-2 units.

However, something has changed, probably stress as get ready for ISO9001 registration, I've had to back off my Lantus 1 unit at night without affecting my Humalog at meal time. Strange.