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Advice for three consecutive lows

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Jane Rooney

New Member
Relationship to Diabetes
Parent of person with diabetes
My daughter was diagnosed with type 1 about a month ago and has resumed her rowing training for the first time this morning. Since lunch she has had three consecutive lows and although she feels fine should i be concerned that she may dip further during the night and should she have a further carb boost before bed ?
 
That's a good plan. Until you have exercised a few times its hard to know how much to reduce insulin by so topping up with carbs before bed should help prevent further lows
Good luck.
 
Hi Jane, welcome to the forum 🙂 Sorry to hear about your daughter's diagnosis and the lows she has been experiencing. What insulin regime is she on? When returning to sport after a diagnosis it's very important to take things slowly at first whilst you work out how the exercise affects you. I had been a runner, and due to run a marathon the week I was diagnosed, so it was frustrating trying to get back into my running whilst working out what insulin and food I needed, and when. Regular testing is the key so you can build up a pattern over time. There are some general rules, but people's experiences can vary enormously, so you need to work out how you personally are affected.

Many people reduce insulin doses before exercising, and have a snack afterwards - or in between if levels are falling low, of course. She will have become more sensitive to her insulin, so it may also be necessary to lower the basal insulin (if on basal/bolus) in order to prevent a nighttime low. My sensitivity is increased for up to 40 hours after sustained exercise, so it can go way beyond the session itself.

Personally, depending on her bedtime level, I would have a snack of something like peanut butter on bread, which should digest slowly and keep levels up overnight. It's worth doing a test during the night also - 3am is a (un)popular time to test!

You may be able to find more information at runsweet. Also, I would recommend the Diabetic Athlete's Handbook which explains how to deal with a variety of sports and explains the science behind exercising on insulin 🙂
 
Thanks for your prompt response. She's currently on MDI -novo rapid and lanctus in the evening- 0.5 breakfast and lunch and 1 at tea usually but today 0.25 at breakfast which got her through the session without a hitch but she's had the hypos since. You gave me the reassurance i needed with regard to this evenings carb intake and ill definitely check her throughout the night. Thanks for your help.
 
Increasing carbs is probably not the way to go, long term, although it should definitely be your course of action tonight.

As i said though, it's not a good permanent strategy. Increasing carbs just means you are feeding the insulin. This is extremely bad. Firstly, it promotes weight gain. Secondly, excess insulin has some major negative effects - it raises blood pressure, promotes cholesterol production and increases vascular inflammation. Part the reason people with diabetes can get complications is because they have too much insulin circulating!

Therefore in the event of many hypos, you should definitely look to reduce the insulin, not increase the carbs. It may be harder to do but it is much better for long-term health.
 
Reduce the previous night's Lantus too probably, if not the night after cos the effects of exercise last up to 48 hours!

May be better off on Levemir, it tends to be out of the system a bit quicker TBH and because you normally need two jabs of it daily instead of just the one, you have more chances of reducing it in an 'emergency' situation.

How old is your daughter?
 
Thanks for your prompt response. She's currently on MDI -novo rapid and lanctus in the evening- 0.5 breakfast and lunch and 1 at tea usually but today 0.25 at breakfast which got her through the session without a hitch but she's had the hypos since. You gave me the reassurance i needed with regard to this evenings carb intake and ill definitely check her throughout the night. Thanks for your help.
Click to expand...
Am I reading that right? She is on only half a unit at breakfast or today a quarter of a unit? I don't know any pen that delivers a quarter unit. Or is she on a pump?
 
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