[shiftzor]

Very similar to a hit n' run, moral of the story don't do it!

6:02pm: 5.5mmol/L
6:45pm: 2.5units of novo
9:20pm: 9.3 - doh one too many carbs
9:26pm: 0.5units (should be spot a 3mmol/L drop)
10:00pm: Had a hot shower
10:57pm: 2.8mmol/L - had 15g of carbs
11:49pm: 5.8mmol/L
12:31am: 7.0mmol/L

I can't believe the point drop from 0.5units when combined with a shower. Its madness, anyone know why a hot shower would seemingly heighten my sensitivity to insulin?

[RobiJo]

Probably the same reason Diabetics are "suggested" to not get into hot tubs or saunas. I'm not sure what the scientific reasoning is. It can be dangerous b/c you don't feel the hypo in the heat. If I get in a hot tub I test before I get in, and every 20-30 minutes thereafter. I've seen decreases in my bg that can not otherwise be explained. My guess--increased circulation=more/faster insulin absorption.

[Real4]

Originally Posted by RobiJo

Probably the same reason Diabetics are "suggested" to not get into hot tubs or saunas.

The reason for not having hot showers is that diabetics with advanced neropathy will not notice that the hot water is causing low intensity burns on the feet.

[RobiJo]

Originally Posted by Real4

The reason for not having hot showers is that diabetics with advanced neropathy will not notice that the hot water is causing low intensity burns on the feet.

You're right. I failed to mention that part. However I think there is also concerns with becoming hypo unaware while you are in the hot water as well.

[Eddy]

Whatever the mechanism, I also have observed increased sensitivity (up to 50% increase) and rapidity (R completing in 1 hr instead of my normal 2 hr) while showering.

Hypers leave my skin sweaty and gross. If I need a 3U+ correction (BG of 200+), I'll usually shoot R (reducing my dose by 20% to 25%) and have a nice shower.

After a mealtime bolus, though, I avoid showering until any rapid/R has cleared. NPH doesn't seem problematic.

[xMenace]

Originally Posted by shiftzor

I can't believe the point drop from 0.5units when combined with a shower. Its madness, anyone know why a hot shower would seemingly heighten my sensitivity to insulin?

Improved circulation!?

But I suspect your carbs. Were they high GI? Many times I've had high GI meals, a high PP, then a normal 4 or 5 hour test. If this was the case, adding a correction compounded things.

It could have been a bad meter reading too. Carbs on the fingers.

[duck]

Originally Posted by xMenace

Improved circulation!?

But I suspect your carbs. Were they high GI? Many times I've had high GI meals, a high PP, then a normal 4 or 5 hour test. If this was the case, adding a correction compounded things.

It could have been a bad meter reading too. Carbs on the fingers.

Yeah, that's what I was taught--as a matter of fact, it has been suggested if you are high to take a bolus and a hot shower, and rub the shot area for an even more dramatic increase in blood flow to the area...

[Gary_W]

Originally Posted by xMenace

Improved circulation!?

But I suspect your carbs. Were they high GI? Many times I've had high GI meals, a high PP, then a normal 4 or 5 hour test. If this was the case, adding a correction compounded things.

It could have been a bad meter reading too. Carbs on the fingers.

Whilst the shower could have changed things (show me a single thing we can do that doesn't alter insulin / food profiles ) I'm with XMenace on the carbs thing.

Novorapid (according to Novo's profile graph) lasts nigh on 6 hours in the 'average' person. Whatever that is!

Anyway, you blood tested at hour 2.5. At that point, around 1/2 of your Novo will still be in your system. As you've said that 1u drops you by 6.0mmol, you've got more than enough insulin left to send you hypo anyway PROVIDING there is no food still absorbing to soak up that extra insulin.

When testing at the 2 hour point, I've learned that the reading I hope for depends a lot on what I ate. If I ate all high GI rapid absorbing carbs and I test 'in normal range' then I'm worried. I know that most of the food will be gone but (even with Apidra which is faster than Novo for me) the insulin will still have 30% of its action left. Not good.

If all the stuff I ate was high GI I kind of expect my two hour reading to be a little 'off'. I've experimented with this, and you'd be amazed how often it comes down to normal by itself by hour 3 or 4.

Now, if you ate lots of low GI stuff and test high at hour 2 then a correction shot is a far more reasonable thing to do. It is just making that judgement call as to 'what is the reasonable response to this reading?'.

Another thing that may bite you is basal. Since pumping, I've discovered that my basal needs taper off a great deal starting around 10pm at night; the time you went hypo may have coincided with your body needing less basal. Unfortunately on MDI you cannot turn the once or twice a day injection down or turn it off like you can with a pump so this wonderful factor can also get you.

And then we have the phases of the moon, stress, the shower, something scary you just watched on TV and a million and one other wonders of the world that are here just to keep us all on our toes when we think we know it all

Gary

[shiftzor]

Originally Posted by xMenace

Improved circulation!?

But I suspect your carbs. Were they high GI? Many times I've had high GI meals, a high PP, then a normal 4 or 5 hour test. If this was the case, adding a correction compounded things.

It could have been a bad meter reading too. Carbs on the fingers.

I had 18.8g of carbs in the soup and 56.55g of carbs in the bread (75.35g total). I would say thats a medium GI meal? I am in lazy meal mode due to my exams.

Originally Posted by Gary_W

Whilst the shower could have changed things (show me a single thing we can do that doesn't alter insulin / food profiles ) I'm with XMenace on the carbs thing.

Novorapid (according to Novo's profile graph) lasts nigh on 6 hours in the 'average' person. Whatever that is!

Anyway, you blood tested at hour 2.5. At that point, around 1/2 of your Novo will still be in your system. As you've said that 1u drops you by 6.0mmol, you've got more than enough insulin left to send you hypo anyway PROVIDING there is no food still absorbing to soak up that extra insulin.

When testing at the 2 hour point, I've learned that the reading I hope for depends a lot on what I ate. If I ate all high GI rapid absorbing carbs and I test 'in normal range' then I'm worried. I know that most of the food will be gone but (even with Apidra which is faster than Novo for me) the insulin will still have 30% of its action left. Not good.

If all the stuff I ate was high GI I kind of expect my two hour reading to be a little 'off'. I've experimented with this, and you'd be amazed how often it comes down to normal by itself by hour 3 or 4.

Now, if you ate lots of low GI stuff and test high at hour 2 then a correction shot is a far more reasonable thing to do. It is just making that judgement call as to 'what is the reasonable response to this reading?'.

Another thing that may bite you is basal. Since pumping, I've discovered that my basal needs taper off a great deal starting around 10pm at night; the time you went hypo may have coincided with your body needing less basal. Unfortunately on MDI you cannot turn the once or twice a day injection down or turn it off like you can with a pump so this wonderful factor can also get you.

And then we have the phases of the moon, stress, the shower, something scary you just watched on TV and a million and one other wonders of the world that are here just to keep us all on our toes when we think we know it all

Gary

I did think about basal, I am currently doing a fasting basal test this morning to ensure that basals are set right or at least as good as i can get them. It could be stress I am very stressy at the moment . I will have to be more patient with my bolus and not so quick, next time I won’t shower and take it as it comes . This is not the first time its happened which is why i posted .

[Gary_W]

The vast majority of breads are high GI. There are some of the rye ones that are a bit kinder, but 125g odd of bread will spike most people quite badly. A lot of folks would say you were lucky to get away with being in single figures at the two hour point with that kind of amount The French stuff is a killer (or at least most of the French styled breads over here are). What kind did you go for?

Soup. Well, the more you blend something, the less work your digestive system has to do to break it down and the faster it will spike you. That's why 30g of carbs in an apple will raise your BG more gently than 30g of carbs from apple juice. Unless it was a really chunky soup, those carbs would have been pretty quick as well. No matter, the main culprit was the bread IMO.

I love bread, and do sometimes eat a lot in one go but I know that it has the potential to bite back. And I consider that I tollerate bread pretty well in the great scheme of things.

Soup and a hot shower. You students know how to live....

Gary

[shiftzor]

Well i give you two things: firstly honey moon and secondly: taste the difference soft wholemeal oat topped batch. It has 37.7g carbs per 100g, I wouldn't say it has a high GI as such I usually have it at lunch without these spikes. However I have known for a while that I have a whole in my Lantus coverage which is causing me problems. I am guessing that it’s the soup in this case. I take your point about waiting for it to come down, you were spot on today. I will replace the bread with noodles next time I have soup see if I get that spike.

I think I am going to remove all my high GI foods from my diet, it doesn't do my A1c any good. The longer I have the D the worse I experience these high GI foods. Honeymoon is coming to an end I fear. I guess the problem is my GI is usually based on my honeymooned experience of that food which is becoming ever more suicidal, I should stop kidding myself about these foods before I do myself some damage. Live and learn.

[Gary_W]

I stopped honeymooning a loooong time ago, but I still do some of the foods that people consider 'forbidden'. And I still managed a sub-6 HBA1c on MDI whilst eating bread, mashed spuds, pasta, rice, cous cous etc. It can be done; no, not everyone can but it's down to learning what YOUR body copes with and what it can't.

GI only tells half the story. Like everything with diabetes, the 'rules' are just a good starting point and then it's down to each of us to find what affects us.

I would venture that you still carry on with those there rolls, but have a little bit less of them; it's the glycemic load that does it (in case you're not familiar, this is a fudge factor between glycemic index and the sheer amount of carbs in a particular food). If you reduce the amount of carbs in something, you'll obviously minimise the spike. Having said that (IMO) a spike of 9ish at hour 2 that then comes down to normal a few hours later is worth it if it's a food you enjoy and your control is otherwise good. Some folks will disagree with that statement but there we go

You might also like to consider trying Apidra. Evil stuff that comes on to you like a drunk at a party, but for minimising spikes it really does knock Novo into touch as far as I'm concerned. If you have slow digestion or eat ALL low GI stuff, it probably won't suit you but if you're into bread and noodles (and I know I am) then it's great. Having the luxury of a pump, I can now slow the stuff down for the foods that require it. It does get a little over excited if you let it, so be careful out there. Oh, and if you do go with it, get the Solostar disposable pens. The Optipens are rotten

Gary