I’d be grateful for a quick bit of advice. I am a late onset type 1 diagnosed in June. For the last 18 hours ish I’ve had repeated sudden drops in blood sugar - worst of all being that I was woken up four times in the night by the alarm. Normal amounts of sugar haven’t been sufficient to correct - in fact I had a litre of juice all told in the night. I assume my body has suddenly decided to produce some insulin itself (since I would be surprised if my dosing was that wrong during the day). What should I do now? Reduce both the Levemir and NovoRapid a bit today? Leave the doses as normal and just see?
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Advice re repeated sudden drops in blood sugar
- Thread starter MollyBolt
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Inka
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Are you fingerpricking to check the lows @MollyBolt ? Could you be ill? Sometimes colds initially put my blood sugar down. If you’re going low, reduce your insulin eg have less for your meals than you normally would. You might need to reduce your basal too.
Keep a close eye on things and speak to your team if needed.
Keep a close eye on things and speak to your team if needed.
If these show as sudden drops on Libre graphs overnight, they are more likely to be compression lows - false low readings resulting from pressure applied to sensors when you lie on your arm. The pressure blocks the flow of interstitial fluid to the filament.
This is one of the reasons why it is recommended to check lows with finger pricks before treating.
This is one of the reasons why it is recommended to check lows with finger pricks before treating.
So disappointingly i don’t think it is compression lows - both because it’s happening during the day and because I checked once in the night and it least on that occasion it wasn’t. I’ve reduced my Levemir by 1u and also my NovoRapid at breakfast. I am now soaring so let’s see…
Really appreciate the speedy thoughts.
Really appreciate the speedy thoughts.
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After struggling with overnight hypos for many years a pump was the first piece of the puzzle that really helped me.
But occasionally I’d still wake up low.
Then I got an early chance to trial Libre 1 just as it was launching at EASD, and I could finally see what was happening overnight, and the duration and extent of some of the low BGs I was sleeping through.
More tweaks and adjustments…
But actually it was only the MM640G with predictive low glucose suspend that really helped. Because what I could eventually see was that on about 10% of nights (2-3 nights a month), my body would suddenly decide, without warning or any apparent precipitating cause, that it needed pretty much no basal insulin that night.The pump was auto-suspending almost the whole night. But I’d go back to ‘normal’ basal needs the following night.
I wrote this, and posted a little video, when trialling the MM640G
64 Days with the Medtronic 640G: Ep 7 Overnight Hypoglycaemia
How does SmartGuard on the MM640G help with overnight hypoglycaemia?
No idea if this is what is happening to you, but you have my sympathies.
On MDI all I could do was wind down my basal, and hope to catch them when they happened.
Which sensors are you using? Can you set a different overnight low level for an earlier alert?
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Is this happening every day or are there any patterns?
For example, exercise can increase insulin sensitivity for up to 48 hours. I was advised to reduce my basal by about 20% for a day after exercise. I then increase it again if/when I do less exercise.
Alcohol can also reduce the glucose dumped by the liver. So again, I reduce my basal after a night out.
You mention you have reduced your Levemir by 1 unit. Do you have a half unit pen so you can meet it in the middle?
If not, I highly recommend it. These are the reusable NovoPens which are far better than the flimsy single use pens.
This is the first time it’s happened, so perhaps I have reacted too vigorously to it! But it was just so awful being woken so much... Tbf, this morning has been reasonably quiet from a BG perspective.
How do I get a reusable NovoPen? I am still on the single use, and have no access to half units...
How do I get a reusable NovoPen? I am still on the single use, and have no access to half units...
If it's a one-off for me it's either exercise related (so I should realise!), sudden removal of stress (I should again realise), or I'm about to come down with something. The day or so before I start feeling a bit rubbish I'll run low all day/night. If I fiddle I then end up running even higher than I otherwise would once the lurgie settles in and my BG flips to running high during the illness.
Hope you manage to work out what it was!
Hope you manage to work out what it was!
Eternal422
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Just ask your GP to prescribe one for you (or two, one for Levemir and one for the Novorapid, but get different colours to distinguish them!). My GP was more than happy to prescribe them for me and it makes much more sense to get them than the single use pens. You will also need the insulin supplied in the 3ml cartridges that go into the Novopens.
mashedupmatt
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I would also highly recommend Novopen Echos which you can use for Levemir and Novorapid - the half unit dose is very useful for minor tweaks to your routine (Not a Novopen 6 which only does whole units) - There are a number of reasons why you could be suddenly dropping - if you are still in the (dreadfully named) "Honeymoon Period" then occasionally your Pancreas will decide to start working again momentarily adding your own insulin to the amount you have injected which is very unpredictable and annoying (I speak from experience!) - also have you had your injection sites checked? If you do have any signs of Lipohypertrophy (which is where over-injecting in the same spot could result in thickened fatty tissue under the skin, meaning the insulin you are injecting may be absorbed more slowly or quickly)?
Just ask your DSN
To be honest, I have no idea why the default seems to be the single use pens when the reusable ones are much better.
I recommend asking for 3 - one for Levemir, one for NovoRapid and one spare. It is a good idea to get different colours.
You will also need to change your prescription to cartridges
Bruce Stephens
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Unfortunately they only make two colours so your spare has to be the same colour as one of the others. (Unless you mix Novopen 6 and Novopen Echo Plus because they have 2 colours each.)
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