HI
@Tdm,
I remember particularly well experiencing this sort of problem - both before I got Libre 2 and subsequently.
Snacks aren't the answer - my levels drop too dramatically when excercising on novorapid. Even if I took dextrose, it wouldn't work quick enough to keep my levels
Firstly I suggest that you need to accept that snacks have to be the answer either when you've already gone hypo, or ideally before getting to hypo. My diabetes is extremely brittle - when my BG is truly falling (and sometimes the Libre trend arrow misleads) it plummets. I have my alarm set at the top limit of 5.6 and once that has sounded I repeatedly scan and watch what is happening, ready to respond if appropriate. In this warmer weather I often just drink Lucozade or high carb orange juice, which helps my hydration as well as more promptly reducing the plunge!
steady/counteract the fall. Several times I have been stuck in the greenhouse on my allotment, after an illadvised trip to water my thirsty tomatoes, waiting for the dextrose to kick in so I can walk home (mind you, i saw a fox last time, so even that has its advantages).
If I jog the fall is even more dramatic - a quick round the block brings high blood sugars down fast, though now I have done my ankle in so that's off the table.
Yes, modest exercise is my solution to reducing highs and it doesn't need to be as demanding as jogging; just being active rather than sedentary works pretty well for me. As you try different things you will steadily build a better understanding of what works for you; but it's not simple and has taken me time to recognise what is appropriate on any one occasion.
In case you weren't aware, strenuous (anaerobic) exercise elevates one's BG initially. Your body is responding to an innate 'fight or flight' assumption and extra glucose is released from your liver thanks to adrenaline or even cortisol (the stress hormone). That extra glucose has to be corrected, either by insulin or activity.
And the rebound is a real phenomena, not just libre 2, as its confirmed by fingerstick tests.
Again, I well remember the rebounds! I did find that as I reduced the hypos or near hypos then the rebounds became less excessive. Initially, I had great difficulty in getting off the low/high/low rollercoaster. One bit of technology that helped me was with the diabox app on my android phone, providing me with Continuous Glucose Monitoring (CGM); not only could I get better immediate visibility of what was happening, without the delay of scanning, but Diabox has 2 x low (and high) alarms with a better upper limit of 6.8 (ie more warning time that change is happening) and what I used as an Urgent low alarm set for me at 4.5. The alarm sounds are varied and distinctive. The trend arrows are accompanied with a numerical indication of severity, from 0.5 to 7 mmol/L/min (at least). Another app is Nightscout in conjunction with xdrip; I haven't used this, but know that
@helli does.
As for my own insulin kicking in a couple of hours after eating, I don't think that explains it, as the fall of my blood sugars with excercise wears off over time, as you would expect if it was due to the novorapid, rather than coming on after a few hours. I doubt i produce much of my own insulin now - they did start me on gycaside +metformin but even on the max dose my blood sugars were too high. Plus, the rise and fall of my blood sugars correlates exactly with my excercise, so I don't think there is a need to bring in external factors to explain it.
Regrettably, external factors play a big part in managing one's DM, eg the weather, your mood, injection sites, timing and your natural variations of insulun resistance. Have you come across the 42 factors that affect BG? Most of these are subjective, not definable numerically and accounting for them is an art not a science. Be cautious about simply dismissing the bigger picture. Also, exercise (or any activity) can leave consequences for up to 3 days after the event.
It's not the basal insulin, otherwise i would experience the issue when excercising at all times (on 24 hr basal). It only happens with novorapid is active in my system. The diabetes nurses thought it was basal insulin, reduced my basal insulin dose (to be honest, it probably needed to be reduced). It made no difference to my issue with novorapid and walking. I can't really reduce my basal insulin further as I am on 2 units a day. I tried 1 unit, it was too low, and the clinic says they don't do half unit pens for my basal insulin. (They started me on 10 units, which was fun...)
About basal or background insulin: I'm on Tresiba 1x daily which lasts well over 24 hrs, perhaps up to 40 hrs; your Abasglar, also 1x daily is intended to last across the full 24 hrs. Both have very even performance profiles. Whereas a basal such as Levermir is shorter lasting, hence taken 2x daily - and not necessarily split evenly between am and pm. But your body's background need (regardless of food) is not an even or flat line! It is remarkably varied across the 24 hrs.
So your 1x daily basal can't be optimised for meeting the different hourly needs and I steadily optimised my Tresiba to keep me very steady during the night; I try very hard to not bolus after 8pm, so by midnight most of my NovaRapid has dissipated and my only remaining insulin on board is my basal; unless I'm highish as I go to bed when I will take a correction around midnight. On good nights (not always - my DM is not perfectly managed!) I will see either a flat 7 or 8 hrs or a definite fall over 4 hrs, then a flat line for the rest of the night; lows during the night are now rare and my target is now to be at 6mmol/L during the night (it was 8, then 7). Getting your basal correct, is a fundamental first action: otherwise your rapid/ bolus is trying to compensate for an errant basal and playing havoc with your presumptions about carb/insulin or correction ratios.
BUT this means with basal optimised for nighttime my bolus has to pick up any problems during the day and, now, I will make corrections between meals if needed. But I take great care to not 'unknowingly' stack insulin on board. Of course when low I have to 'feed the insulin' ie snack! Or stack up carbs before getting busy and letting the activity prevent the high spike.
If it sounds as if I've got this sorted: I haven't! I still,
always, have a mix of snacks (from very high GI such as lucozade and jelly babies, highish such as cookies at 60-70% carbs and to medium GI such as KitKats; even quite low GI but high protein, such as KIND bars).
Libre makes this possible, finger pricking alone doesn't.
Anyway, thank you for your answers, its confirmed my thoughts that this is a general thing that happens to everyone, but seems to happen more so with me.
I suspect its only happening more to you because you are still learning about what works well for you; also you might still be in the honeymoon period - difficult for you to know for sure (I know for sure, because I had a total pancreatectomy, so I've been spared that aspect).
In a way, its useful, as it's a good way to bring my blood sugars down (A1c 40 mmol/mol - hurrah!), but it does come at a cost.
As for gaining weight, its not really that easy. I think its because, a low carb diet is, effectively the same as a keto diet or atkins - ie a weight loss diet. I've upped my carbs and hopefully that will work. Again, I know a low carb diet works long term for a lot of people, but it doesn't seem to work for me.
Because you have to take insulin (as a T1 that is absolutely unavoidable) I believe no point in even getting involved with avoiding carbs. Gary Scheiner, in his book 'Think Like a Pancreas', points out that our bodies need glucose; if that isn't provided by carbs then we convert proteins and even fats into glucose - but the conversion isn't as efficient and takes longer; if a meal has more than 30gms carbs then the potential conversion of proteins and fats is generally not needed, so doesn't occur.
All of that just adds to the complexity of bolus ratios and timings - so I don't avoid carbs, but do make sure I also have plenty of protein and fats within my overall intake. But I am fortunate enough to have no real weight issues.
As you have said to someone else, somewhere else: It does get easier with time. And perfection is not possible. Good luck.
