Hypo After Dinner

[JoeJOns]

Hi guys,

I'm looking for advice on having hypos after dinner. So I am trying to put on weight at the moment as after DKA i'm about 15 pounds underweight. So I have been having relatively large meals. My dinners require around 6 units of insulin. Most days I'm ok after dinner but there have been a few days where I have checked myself around 1 hour after dinner and I'm in a hypo! about 3.6 - 3.8. Why does this happen? Could it be my insulin ratio?

Thanks for the help!

 

[Bruce Stephens]

Could it be my insulin ratio?

Of course it could. It could also be that the activity profile of the insulin doesn't match your digestion.

That's especially likely if you're eating a lot (the more you eat, the longer it's likely to take to end up in your bloodstream). You can try delaying the insulin dose a bit (so take it closer to when you eat), or even splitting the dose (for example taking 3 when you'd normally do and then 3 when you've finished eating).

Don't worry about trying to get it exactly right, though. Probably just taking a slightly lower dose is saner. Or take your current dose and if you're hypo later then just correct it.

The fancier things (like splitting doses) are really more for things where you know it's going to be worth doing (like having a pizza out, since pizzas are big and contain quite a bit of fat, so they tend to take a while to digest). Even then it's reasonable not to worry too much, and just do simple things (and correct later).

 

[SB2015]

It could be your insulin ratio. Difficult to judge as there may be the right amount of insulin, but if your food has a high fat content the glucose won’t get into your system as quickly as the insulin gets going, but as you will have treated your hypos with some extra carbs it is hard to tell. Normally if my ratio is right but it is the content of the food I would end up dipping but be back on target before the next meal.
Right insulin, wrong profile of carb converted to glucose.
As @Bruce Stephens has said there are tricks round this by splitting your dose of insulin (whenever I tried this I forgot the second half). However you could also reduce your insulin, reduce the fat content (if that is relevant) or stick with it and treat any dips as necessary.
It is still early days for you and your pancreas may just be playing SBs and chucking some insulinout of those few remaining Beta cells, just to confuse. At present there will be a bit of firefighting until things settle. I know that doesn’t help, but it emphasises why it is difficult to control in the early days.

 

[Bruce Stephens]

why it is difficult to control in the early days

It does get easier with time (and practice), but things are never quite as straightforward as you might hope. So while these ratios and things give the impression of being nice and predictable, there's always an element of winging it.

 

[SB2015]

It does get easier with time (and practice), but things are never quite as straightforward as you might hope. So while these ratios and things give the impression of being nice and predictable, there's always an element of winging it.

And we just get better at doing this.

 

[everydayupsanddowns]

Welcome to the wacky wonderful world of T1.

It’s a lifelong learning opportunity 🙂

All we can do is just try to spot the patterns, and notice when things are starting to shift and change and adapt to the new ‘normal’ for as long as it lasts.