T2 getting hypos during the night, and fighting lows during the day

[Steve1122]

Hi everyone, I'm T2, not on medication, in remission with my latest HbA1c of 30. I have peripheral vascular issues, stage 1 retinopathy and maculopathy, and having already had a foot amputation am considered 'high risk'. I've had a CT scan and all's well with the pancreas.

I have no issues with controlling high BG, but lately I'm seeing lots of hypos, particularly at night. Whilst some are undoubtably Libre compression surprises 🙂, others I've confirmed with finger pricks or by feeling ill (anything 3.4 and under leaves me unwell. The lowest I seem to fall to is 3.1, perhaps because by that time I've already begun treatment and am turning it around).

This seems to have started since I had a respiratory illness in January. Surely I can't still be feeling the effects of that, can I? Previous to this I followed my regime of eating nothing after an evening meal(17:00) until breakfast the following day. This worked well for me as overnight my BG hovered around 4.5 all night.

I've tried changing this, eating a supper of something carby like 50/50 toast. All this does is stop the lows around midnight, but then we're off on the hypo rollercoaster again.

I've tried eating more carbs during the day. I was aiming for around 150g carbs as a daily total, but increasing this to nearer 200 made no difference. All it's done is made me put on a little weight (I'm not overweight).

I have a review with the Diabetes consultant next week. It's a yearly review, so not because of this, but of course I will be bringing it up.

I'm interested to know if you have any opinions of what's going on, and if there's anything in particular I need to ask next week.

Thanks for taking the time to read this, and also thanks in advance for any insight you might share.

steve

 

[Inka]

What time do you eat your evening meal @Steve1122 ? I ask because sometimes a person’s insulin response can be messed up, with the body’s own insulin kicking in a bit slowly and then over-compensating by releasing a little too much insulin and pushing blood sugar slightly low. That could be why you found your supper didn’t work and just delayed the lower sugars. It could also potentially explain why things went awry after your virus.

 

[Steve1122]

Hi Inka, we tend to eat early, 5pm ish. The first lows tend to be around 130 am. You think taking supper earlier might help - 8pm maybe? I'm willing to try anything to get a good night's sleep back!

 

[Inka]

5pm sounds a reasonable time to eat @Steve1122 I’m not sure about having supper earlier - you could try. I think it would also be worth trying different suppers - like I said, protein ones with minimal/low carbs in the hope that that will give a slow, steady slight increase to your blood sugar.

Are you able to upload your Libre graph here, so we can see what’s going on the rest of the day?

 

[everydayupsanddowns]

It does sound very unusual @Steve1122 - as you aren’t on any medication to reduce your BG levels.

Are you seeing rises with the meal on your Libre trace, and then falls later?

Definitely one to ask the Dr about!

Are you using the 15 rule for the hypos? Take 15g of fast carbs, and recheck with a fingerstick in 15 minutes. When you say you get a hypo rollercoaster, are you seeing big jumps after the hypo treatment, that then dip back down again?

 

[Steve1122]

5pm sounds a reasonable time to eat @Steve1122 I’m not sure about having supper earlier - you could try. I think it would also be worth trying different suppers - like I said, protein ones with minimal/low carbs in the hope that that will give a slow, steady slight increase to your blood sugar.

Are you able to upload your Libre graph here, so we can see what’s going on the rest of the day?

A protein rich supper is something I hadn't considered. I'll try that. I've (hopefully) added a couple of Libre graphs - before the issue started and now with my issue, The peaks after the lows are me over compensating somewhat (when feeling ill I don't have as much patience waiting for sugar to kick in).

 

[Steve1122]

It does sound very unusual @Steve1122 - as you aren’t on any medication to reduce your BG levels.

Are you seeing rises with the meal on your Libre trace, and then falls later?

Definitely one to ask the Dr about!

Are you using the 15 rule for the hypos? Take 15g of fast carbs, and recheck with a fingerstick in 15 minutes. When you say you get a hypo rollercoaster, are you seeing big jumps after the hypo treatment, that then dip back down again?

Yes, as per the graphs I've added above. I try to use the 15 rule, but find when feeling ill with it I want relief and end up over compensating.

 

[everydayupsanddowns]

Yes, as per the graphs I've added above. I try to use the 15 rule, but find when feeling ill with it I want relief and end up over compensating.

Ah yes! That blurry gnawing anxious insatiable EAT ALL THE THINGS moment - I think that’s a feeling that’s familiar to many forum folks!

 

[everydayupsanddowns]

But actually I’d be very happy with those post-hypo-treatment levels myself - you kept those rises in single figures!

Has anyone suggested a follow-up snack to you? This is mostly suggested for people on glucose-lowering meds where the possible over-reach of the meds may need something to top levels up and prevent a double-dip.

Something starchy and about 10g of carbs was the old fashioned suggestion onve hypo treatment has got you back up over 4.0. So half a slice of seedy bread, or a digestive, or something like that to even things out following the hypo recovery.