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First Time Post. Blood Sugar dropping with no insulin.

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Antcorbs1

New Member
Relationship to Diabetes
Type 1
Hello,
I’ve been a type 1 diabetic since August 2021. Yesterday I had an odd experience where my blood sugar was continually dropping after a few hours it seemed stable. As precaution, because my hypo awareness is weak, I didn’t take any insulin with my tea, which was carb heavy and I didn’t have my tresiba either. I’ve woken up to slightly high readings with numbers around 10/11mmol but these are already dropping. What else can be causing these to drop? I’ve had no insulin at all and normally these numbers would be much higher with what I’ve eaten.
 
Tresiba is very long-acting @Antcorbs1 so that could still be acting. Can you work out why your blood sugar was continually dropping - ie did you catch a muscle, did you calculate the carbs ok, where did you inject, had you been exercising recently, etc? Sometimes certain sites can cause the insulin to absorb more quickly and/or more thoroughly. You’ll then see a noticeable drop.

When did you last do a basal test? Perhaps you’re taking too much Tresiba for your needs?

Lots of questions there but the more info you can give, the easier it will be to find a possible answer.
 
Thank you. My Tresiba is one that I take daily before bed, the only noticeable difference was that I exercised for the first time in a couple of weeks. I don’t remember catching any muscles, as I normally inject in to my more fatty areas. I’ve never done a basal test before, this is my first time hearing of it. I’m just concerned as I’ve now not had any insulin since my last Tresiba injection Thursday night and my levels are still going down. I’ve not done anything that I wouldn’t normally and have never experienced this before.
 
Tresiba lasts for more than 42 hours. It’s injected daily but the daily injections are just topping up, if you get what I mean. It could be the exercise. That can continue to have an effect after you finish exercising. Are you still taking your mealtime injections?
 
If you’ve had no insulin at all and your blood sugar is continuing to drop, I’d phone 111 for some support. There are a few rare conditions that can cause lows like this: Addisons is one. Also, some people have found the flu and Covid vaccinations can cause prolonged lows.

Do you have a Libre? If so, set the Low alarm at 5.6 so you’re alerted in good time to any drops.
 
I’ve cut out my insulin all together, as my levels aren’t increasing so I don’t want to risk hypo’s. I recently had a blood test that included kidney function so I assume, I can rule out addisons? As that has now panicked me haha. I’ve got a libre yes, I’ll do that.
 
No, Addisons needs a special test (cortisol) Don’t panic - it’s a rare condition and the test is usually done simply to rule it out.

If you’re taking no insulin and eating normally, I’d think the Tresiba must still be having an effect, probably added to by the exercise. If so, your blood glucose levels will start to rise once that runs out (probably around 3 days after your last injection, but that’s just a guess).

You might want to consider changing to a shorter-acting twice daily basal. Although it’s an extra injection, it’s more flexible and means you can reduce it for exercise.
 
Once you’ve got this sorted, here’s a link about basal testing, but personally I’d consider changing your basal to Levemir or another twice daily insulin. Levemir ‘goes away’ much more quickly than Tresiba:

www.mysugr.com

How To Successfully Test Your Basal Rate

Are you looking for basal rate information and testing instructions? Perfect! You're in the right place!
www.mysugr.com www.mysugr.com
 
I've had a couple of nights like that, when I've had prolonged lows and just eaten lots of carbs with no insulin and no rise afterwards - there's a thread here where people suggested some possible explanations - https://forum.diabetes.org.uk/boards/threads/the-mystery-of-the-late-night-plummet.104415/ (no need to read my very long initial post explaining what happened!) but I never did find out which if any of them was correct.

I've also had a prolonged low and had to eat lots of carbs with no insulin after walking round a botanical garden in the sun, but that was a lot of exercise for me, so there was a much more obvious reason that time. It could just be the unaccustomed exercise in your case too, you may find you need to reduce your doses quite a lot whenever you exercise.

As you haven't had diabetes that long, you may also still be in the honeymoon phase, ie still have a pancreas which randomly decides to work a bit occasionally - they used to say this lasted about a year but for a lot of us it seems to last a lot longer.

I think you're doing the right thing in the circumstances, not injecting - much better to risk going a bit high later than to risk going too low now.
 
Sorry to hear about your ongoing low BGs @Antcorbs1

Must be quite concerning and perplexing for you!

One other option you might explore is MODY, which is a collection of monogenic forms of diabetes (caused by one faulty gene) which can look a lot like T1, but needs different treatment.

Alternatively, you might be a bit like @Northerner who is T1, but who hasn’t needed basal insulin for several years now!
 
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