Confused

[zoesav]

I have lived with type 2 insulin dependent for 15 years,my sugars are always late teens to early 20s we have tried all sorts of meds and injections to bring this down.Well last night i had a major hypo for no reason, i had lots of sugar but my bloods keep dropping back down,i am with a new partner and am wandering if being pregnant could do this,i have no explanation for this at all it was out of the blue and my sugars are still low,for me,any advice would be gratefully appreciated xxx

 

[Inka]

Hi @zoesav Sorry to hear about your big hypo. I hope you’ve been ok today. Test lots and even set an alarm to get up in the night and test. Is it possible you caught a muscle with your injection? Could you have injected twice or the wrong amount?

Yes, pregnancy can cause hypos, usually after around 8 weeks. They can be fierce and sudden. I had to reduce both my basal and bolus insulins early on.

What insulin(s) do you take?

 

[zoesav]

Im on toujeo and nova rapid, i definetly didnt double dose or hit a muscle, i really appreciate ur help,like i said i have never had a hypo before and it was out of the blue so i am now a little scared.My sugars have always been high so never had to worry about this before xxxx

 

[Inka]

How are your blood sugars today @zoesav ? It’s absolutely understandable that you’re scared. Hypos can be scary, especially if they’re sudden. Was the hypo actually during the night when you were asleep, or was it earlier in the evening? When did you inject your insulins and what time was the hypo?

 

[zoesav]

I inject in the morning and thr hypo was in the afternoon about 4 but lasted ages my bloods would go up then start going down again,i just have no idea why this has suddenly happened after 15 years of highs xxx

 

[Inka]

So do you only take the Novorapid with your evening meal?

 

[Lucyr]

Im on toujeo and nova rapid, i definetly didnt double dose or hit a muscle, i really appreciate ur help,like i said i have never had a hypo before and it was out of the blue so i am now a little scared.My sugars have always been high so never had to worry about this before xxxx

Did you mix your insulins up and take the wrong one maybe?

 

[zoesav]

Every meal, so 3 times a day xxx and toujeo once in the morning xx

 

[zoesav]

Did you mix your insulins up and take the wrong one maybe?

No its impossible they r different colour pens xxx

 

[Lucyr]

No its impossible they r different colour pens xxx

If being different colour pens made it impossible there wouldn’t be regular occurrences of people mixing them up!!

 

[zoesav]

I've been doing it for nearly 15 years i wouldnt make a mistake like that and never have xxx

 

[Lucyr]

I've been doing it for nearly 15 years i wouldnt make a mistake like that and never have xxx

I’ve been doing it for 15 years and have mixed them up. I’ve known people doing it for 50 years mix them up. When you’ve done something for so long you can do it without thinking.

I’m not saying you definitely did mix them up but you should consider the possibility. You are human.

 

[Inka]

Every meal, so 3 times a day xxx and toujeo once in the morning xx

So had you taken your Novorapid at lunch time? Just trying to work out how far away from an insulin injection your hypo was.

The fact you stayed low suggests something has ‘gone wrong’. Even if you just nick a muscle, that can cause an unexpected low. I’ve done it myself. Did you inject in a new body area? That can cause hypos too because the insulin can be better absorbed. Occasionally, insulin can form pockets under the skin and those can also cause hypos.

 

[zoesav]

I only did the nova rapid in the morning sweetheart,i injected in my mummy hangover lol at the bottom of my tummy xxxx

 

[zoesav]

I only did the nova rapid in the morning sweetheart,i injected in my mummy hangover lol at the bottom of my tummy xxxx

I didnt have luch that day so didnt need to do lunchtime one xxx

 

[Inka]

I only did the nova rapid in the morning sweetheart,i injected in my mummy hangover lol at the bottom of my tummy xxxx

Hmm, sounds like it was your basal then. Very strange. I do find that occasionally certain areas seem to work ‘too well’ for injections. I know that some basal insulins like Lantus can also occasionally release all at once rather than over hours. It might be worth mentioning to your nurse to see if she’s heard of something similar happening before.

There are also a few rare conditions that can cause unpredictable hypos, so I’d definitely get some medical input just for reassurance.

 

[rebrascora]

I have lived with type 2 insulin dependent for 15 years,my sugars are always late teens to early 20s we have tried all sorts of meds and injections to bring this down.Well last night i had a major hypo for no reason, i had lots of sugar but my bloods keep dropping back down,i am with a new partner and am wandering if being pregnant could do this,i have no explanation for this at all it was out of the blue and my sugars are still low,for me,any advice would be gratefully appreciated xxx

Hi and welcome to the forum.

Firstly I am really concerned that your diabetes is so poorly managed if your levels are regularly in the 20s and I wonder who is supporting you with your diabetes management and why they have not managed to help you bring those levels down. Is it a nurse at your GP practice or a highly qualified specialist nurse at a diabetes clinic. Long term levels that high are putting you at increased risk on diabetic complications and if you are pregnant, then they are putting your baby at risk.... which brings me onto my next question....

From the wording of your post it isn't clear if you are definitely pregnant or are just wondering if you might be and that might explain your hypo. If you are definitely pregnant, how far along are you and are you getting support from a specialist clinic to bring those high levels down?

As regards the hypo, I see you are using Toujeo, which is a brand of Glargine. From what I understand the action of Glargine is that it crystalizes on injection and then the crystals slowly dissolve and release the insulin. Very occasionally the crystals get trapped in a pocket of tissue and don't release when they are supposed to but can release weeks or months later causing a massive hypo. I believe @trophywench had some very dangerous hypos which were believed to be as a result of that when she was using Lantus which is another brand of Glargine.

Why have your insulin doses not been increased in order to bring your levels down. Do you adjust your insulin doses yourself or are you reliant on your nurse to set your doses? When was the last time they were increased to tackle those high levels. Are you on really high doses and if so, have they considered giving you a more concentrated insulin, so that you are injecting less?
Do you rotate your injection sites regularly or do you inject into the same area with all your insulin?

I should say that I am not in any way being critical of you but just don't understand how a health care professional would leave you for long periods of time with such high levels, so trying to understand the issues and suggest things that you can ask about to improve your diabetes management and reduce those risks of complications. After all you are still relatively young at 44yrs, so this really needs sorting promptly and even more so if you are pregnant.

How and when do you check your BG levels? I am guessing finger pricks and a BG meter but perhaps you have a Libre arm sensor?

 

[Inka]

Some information on Lantus hypos in my post here @zoesav :

https://forum.diabetes.org.uk/boards/threads/severe-hypo-after-lantus.92983/

I’d never take it, personally. If you think it is a similar problem that caused your hypo, you could ask to change to a different basal insulin eg Levemir or Tresiba.