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Constantly dropping glucose levels

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emmah456

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Parent of person with diabetes
Hello, my 19 year old son was diagnosed with type 1 ,3 months ago after being very unwell with DKA. He is now much better and back to work. However, he works away during the week with quite a physical job as an engineer. These past few weeks his glucose levels are constantly falling under 4 with his CGM alarming regularly. He has spoken to his diabetes team as he is eating so much sugar to increase his insulin levels. He is worried about his levels but also the amount of sugar he's eating. Apart from his long acting insulin, he has had nothing in the past few days.
I'm wondering if this is common after diagnosis, the honeymoon period and if his levels will rise. Or if it is to do with his activity levels. And if not, how does he control it without eating lots of sweets. Any advice would greatly be appreciated. Thank you
 
Quite likely he’s in the honeymoon period, could also be activity levels, could also be the weather, a lot of people are finding they have to reduce their insulin doses in this heat. What did his diabetes team say?
it’s not great to have to be eating sugar all the time, but you can’t ignore a hypo. If he’s not taking any bolus insulin then the only other thing he can do is reduce his basal (long acting). We can’t tell you how much to reduce it by though, he’ll have to speak to his team, especially as he is so newly diagnosed. After a while, he’ll learn how to make adjustments himself and won’t have to ask them all the time, but in the beginning it’s better to be careful!
 
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Hello thank you for your reply. He's been advised to reduce his long acting dose but at the moment doesn't seem to have made much difference. Maybe needs to reduce further. His diabetes team just say to keep treating the hypos. Hopefully it's just the weather or honeymoon period as he is getting so fed up with it. He does have a face to face appointment in a few weeks so hoping they can suggest more options.
 
That doesn’t sound terribly helpful to me, but he’d better do what they say for now. Probably he does need to reduce his dose again, diabetes can be a bit of a pain though and it’s quite likely that he’ll have to change it back again, especially if the weather gets cooler again. Maybe the medics are being cautious as it’s early days.
 
Hi @emmah456 I’ve found heat plus activity causing lots of hypos recently. I’ve had Type 1 almost 30 years so definitely not in my honeymoon period, but I’ve had to reduce my basal insulin and all my meal-time ratios too. I suspect your son is suffering similar.

What basal/long-acting insulin does he take?
 
Thank you. He's on tresiba. I'm hoping as you both say that it is the heat but just seems to get worse! I'm just worried about the longterm effects if it doesn't settle.
 
Sorry to hear your lad is having a bit of a hard time recently.

There are quite a few of us who often notice seasonal changes (needing more insulin at some times of the year, and less at others).

Warm weather can certainly have an impact for me. A few of us have been reducing our doses recently - mine are still gong down, and it won’t be long before I might have to consider tweaking my meal doses too.

A few of us were comparing notes here:
 
emmah456 said:
Thank you. He's on tresiba. I'm hoping as you both say that it is the heat but just seems to get worse! I'm just worried about the longterm effects if it doesn't settle.
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@emmah456 If he’s still going low, he needs less insulin. Better to be slightly high than risk hypos. Tresiba is a very long-acting insulin, so if he makes a change, it will take a few days to see the effect. If he’s now only taking Tresiba yet still dropping low then it sounds like he’s on a fair bit too much insulin. If he’s not comfortable reducing it himself, he should phone his team again.

Also, his Low alarm on his Libre or CGM should be set at 5.6 to give him more time to catch the drop in his blood sugar. He shouldn’t worry about the sugar. It’s fine. The only worry is that he’s dropping low so much. That really does need sorting. We can’t recommend doses, but I’d be looking at a reasonable decrease, depending on his total dose.

Also, make sure he’s eating long-acting carbs after he’s treated the hypo with glucose. Biscuits and flapjacks are good.
 
emmah456 said:
That's great thank you I've sent the link to my son. Does seem it might be weather related. Thank you for all the advice
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How are things this week @emmah456 ?

Have the adjusted doses had an impact yet? Are the hypos reducing in frequency?
 
Inka said:
@emmah456 If he’s still going low, he needs less insulin. Better to be slightly high than risk hypos. Tresiba is a very long-acting insulin, so if he makes a change, it will take a few days to see the effect. If he’s now only taking Tresiba yet still dropping low then it sounds like he’s on a fair bit too much insulin. If he’s not comfortable reducing it himself, he should phone his team again.

Also, his Low alarm on his Libre or CGM should be set at 5.6 to give him more time to catch the drop in his blood sugar. He shouldn’t worry about the sugar. It’s fine. The only worry is that he’s dropping low so much. That really does need sorting. We can’t recommend doses, but I’d be looking at a reasonable decrease, depending on his total dose.

Also, make sure he’s eating long-acting carbs after he’s treated the hypo with glucose. Biscuits and flapjacks are good.
Click to expand...
Yes I was told with Tresiba to make a change and wait 3 days ans then make another change, can take weeks to get it right again.

He / you will get the hang on it. In hot countries I need hardly any insulin and can eat what I like all day long, it’s lovely on holiday but not if working.

Hope it levels out
 
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