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Type 1 struggle

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DaniL

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Hey everyone I’ve never posted on anywhere like this. I’m type 1 have been for 27 years. Last Monday it was like I wasn’t diabetic I didn’t need insulin all day really. I was eating, bolusing very little but still dropping. In the evening I had a 40g carb dinner gave 2 units instead and levels were 6 when I had dinner. 2 hours later bloods are 4.1 and dropping. I panicked badly and called an ambulance because I was certain I was about to die. I chugged apple juice and full fat coke. My bloods came up to 7 about an hour later. But then hit 21 at midnight 3 hours later. Since then I’ve reduced my background of tresiba down from 27 to 25 and I’ve been above 13 every day now for a week. I am so scared I’m going to die from a hypo :(
 
Welcome @DaniL 🙂 Hypos themselves are scary, and the fear of them can be overwhelming sometimes, especially if your diabetes is doing weird things. A good thing to do, I’ve found, is to split your bolus - ie inject half what you need, then wait and watch your blood sugar and inject any more insulin you need. This might mean you run a bit high but it helps you feel in control and reduces the fear.

Do you have a CGM? If so, set your Low Alarm at 5.6 minimum. You then have good warning that your blood sugar is dropping. Could you have been ill? That can cause lower sugars. Have you had a recent coeliac screen? Has this happened before?

Another thing to do is to change your bolus insulin cartridge just in case it’s not acting as it should. Also, think about where you’re injecting. Don’t use your tummy as that’s a fast area. The buttocks are slowest.
 
I’ve tried researching split bolus but it all seemed very technical. It’s happened once before when I was at uni. Nothing was different that day. I hadn’t eaten a lot of carb heavy meals the days leading up to it as I’m scared to do lots of insulin. ( like you say split dose could be explored )
I came on my period 2 days ago and I haven’t thought of celiac. It just confused me so much why it acted that way. I double checked on my meter as well. I have my alarms set to 5.6 yes but I’m still scared. I never used to be like this. I’ve got an appointment with my diabetes nurse at QA hospital on the 18th and I’m documenting everything in the app that I do and eat.
Just now I’m 100% above 13.3 last 7 days. I’m not too concerned as this won’t be a long term thing/
Thanks for listening to my worry’s
 
Has this happened to you before? Did you do anything different that day or the day(s) before. Things that do this to me might include:
Hormones - being on the first few days of my period generally makes me really low
Exercise - not just on the day but if I go for a long walk on Saturday, I might be lower for the next day or two.
Generally feeling happier than usual - if I've been stressed for a long period of time and then have a really good day, I might find my blood sugars go low for that day
Change in diet - if I'm trying to loose weight I know I need less insulin (not just with meals but basal too)
A previous dodgy injection/ infusion site - sometimes an injection or infusion site can become lumpy and insulin isn't absorbed properly. It stays under the skin and can be absorbed randomly which can cause unexpected hypos.

Not sure if any of that helps?

Edit to add: just seen your reply above! The period may explain the really low day.

Definitely speak to your DSN about your fears. I am the opposite of you and I'm probably not bothered enough about low blood sugars. Have you had a bad experience during a hypo that has caused your fear? Your diabetes team might be able to offer psychological support - clinical psychology might be a possibility.
 
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I’ve never had a bad experience in my life. I’ve never even passed out or actually needed proper medical intervention. Lowest I’ve been is 1.3 and I was sat chatting with paramedics with my jam sandwich haha!

I have no idea where this fear has stemmed from. I accident gave 6 units in September instead of 2 and didn’t realise until my bloods were 3 and dropping but I went up to 24 a few hours later because I treated it. Before I was so outgoing and I’d have a few drinks with friends. But now I’m scared to go walking, drinking, eating a meal above 40g carbs.everything has changed and it’s so annoying because the episode in December and what happened last Monday didn’t even turn into significant events. :( x
 
DaniL said:
I’ve tried researching split bolus but it all seemed very technical.
Click to expand...
The principle is simple enough. If, after giving yourself a bolus and eating a meal, you find yourself going low and an hour or two later high, then taking some of the bolus later (likely after eating) might help that. Some meals (pizza springs to mind) seem to take a while to digest.
 
I don’t eat pizza but I do understand the principle it’s just all a lot to take on board. But I thought after 27 years I’d be a pro. But I live in fear constantly that it will kill me x
 
DaniL said:
I’ve tried researching split bolus but it all seemed very technical. It’s happened once before when I was at uni. Nothing was different that day. I hadn’t eaten a lot of carb heavy meals the days leading up to it as I’m scared to do lots of insulin. ( like you say split dose could be explored )
I came on my period 2 days ago and I haven’t thought of celiac. It just confused me so much why it acted that way. I double checked on my meter as well. I have my alarms set to 5.6 yes but I’m still scared. I never used to be like this. I’ve got an appointment with my diabetes nurse at QA hospital on the 18th and I’m documenting everything in the app that I do and eat.
Just now I’m 100% above 13.3 last 7 days. I’m not too concerned as this won’t be a long term thing/
Thanks for listening to my worry’s
Click to expand...

A split bolus doesn’t have to be technical - it can literally mean splitting your bolus into fractions. For example, if you worked out you needed 4 units for your meal, instead of injecting all that upfront, you could inject 2 units, then another 1 unit when you’re happy you’re not going low, and the final 1 unit 30 mins later. Note! That’s just an example. Do what works for you. You literally split the bolus into two or three smaller injections to space the insulin.
 
DaniL said:
I don’t eat pizza but I do understand the principle it’s just all a lot to take on board. But I thought after 27 years I’d be a pro. But I live in fear constantly that it will kill me x
Click to expand...

To be clear, the idea of splitting the bolus in this situation isn’t as some kind of clever blood sugar trick. It’s to reduce anxiety and the risk of hypos. Also, it means you don’t have all the insulin working at once. It’s what I did when I had similar problems and it worked well - both to stop the hypos and, importantly, to reduce the fear.
 
Hi @DaniL and welcome to the forum - sorry to hear your diabetes is not behaving - unfortunately that is the nature of the beast I'm afraid - and I think most people will have some degree of hjypo-anxiety (I certainly do, and its not nice) - hopefully your BG levels will settle down soon and I agree that splitting your bolus insulin may help and also give you less worry about hypos - wishing you all the best
 
You are all so kind and it’s so nice to talk to people who understand it. I know I’ll be back in my normal ranges soon. I did have to lower my background as I was dropping from 12 to 6 most nights. This was on 28u of tresiba. Now on 25 and needing to give it a few days to see what happens. I’m trying to be brave. Just hoping it was a blip. :( xx
 
DaniL said:
I don’t eat pizza but I do understand the principle it’s just all a lot to take on board. But I thought after 27 years I’d be a pro. But I live in fear constantly that it will kill me x
Click to expand...
There's always something to learn! Presumably you have a CGM? If not, that's worth fighting for. If you live in England it should just involve asking. That reduces the risks from errors significantly (because you can have alarms for lows and highs).
 
I have the libre 2 plus yes 🙂 it’s very inaccurate at times. One minute it’ll say 17 then 2 mins later it’ll say 15. Which makes me hesitant to start the pump. Which I’ve been approved for. But so anxious about that as well x
 
Welcome to the forum @DaniL

Sorry your diabetes has been messing you about recently, and giving you some wobbly days :(

Alongside the contribution the over-enthusiastic basal dose may have been making, one other possibility could be your sites? We have members who have has experience of doses seeming to “go missing” some days (possibly locked up in scar tissue of some sort?), only to re-emerge on another day when you least expect it. And least need it! 😱

I’m not sure if you are aware of any lumps or bumps, or any areas where doses don’t seem to absorb very reliably?

Hope your diabetes gremlins bog off, and leave you in peace, so that your levels can settle down a bit. :care:
 
Sorry to hear you have lost confidence in your diabetes management and that has manifested in a fear of hypos. Do you follow a set routine when you treat hypos? It is really important not to rely on Libre or other CGM when you are hypo because it is one of the times when it is least reliable and it will almost always tell you that your levels are lower and still dropping 15 mins after you have taken your 15g of fast acting hypo treatment, whereas a finger prick to check that that you are recovering will usually show your levels coming back up, so once you are hypo, ignore your Libre because it will just make you panic more and revert to finger pricking like you used to do.

CGMs are wonderful bits of kit provided you understand their limitations and when you can rely on them and when you can't and when you are hypo is one of the main times when you should not rely on it. I do wonder if perhaps Libre has caused this serious fear of hypos because it shows you continuing to drop after taking your hypo treatment and takes ages to show your levels rising, but then as you have found, you end up over treating because you believed that you needed extra hypo treatments when you probably didn't.

I also wonder if Tresiba is a suitable basal insulin for you if your basal needs vary with your monthly cycle. It is quite an inflexible basal insulin which is great if you don't have much variation in your basal needs, but it absolutely would not suit me as I need to adjust my evening Levemir dose on an almost nightly basis depending upon what exercise or physical work I have done over the past 2 days. The fine weather, the last 2-3 days has meant that I have been more active outside in the garden and I have reduced it by 3 units. Levemir is very responsive so I can reduce it one night and increase it again the next night or the night after if I have had a more sedentary day. Tresiba you really need to give it 3-4 days before you consider making another change because it lasts about 36hrs so each dose is topping up the previous day's dose, so it takes at least 3 days for a new dose to show it's true effect. Levemir just lasts about 16hrs so whilst I inject it night and morning by the next night any change in the previous night's dose has happened.

Anyway, I hope your change of dose works but please start finger pricking when you are hypo because Libre will make you panic more because it will show your levels continuing to drop, when a finger BG test 15 mins after treatment will usually show you recovering. I hope you are able to find your confidence again.
 
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