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Getting fed up of hypos already! I need more help treating them

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This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.
merrymunky

merrymunky

Well-Known Member
Relationship to Diabetes
Type 2
Hi all,

So I have entered brand new territory over the last few weeks. Rather than experiencing levels that are too high I am finding myself going too low. I’ve experienced a few readings in the 3.9 area, one of 2.8 and that terrifying hypo of 1.8 the other night.

I had tea today which had quite a few new potatoes in it so I injected novorapid (12 units) prior to the meal. I didn’t think that would be enough as potatoes are my worst enemy.

However I’ve just done a post tea test and got a reading of 3.2. The diabetic consultant has never told me what the ratio of carbs to insulin should be. Only ever that I should just experiment with it. Obviously this usually works but lately it is going wonky.

I’ve just drunk some lucozade but again I don’t know how much I should be drinking initially to get the levels back up. I’ve been reading that the glucose content has changed over the last year or so. My husband bought me a 6 pack of the 380 on bottles. How much of a bottle should I be drinking?

I’m so confused and starting to get stressed that I’m going to damage this pregnancy. I’ve read that hypos don’t affect baby, just mum but it worries me so much. I’m sat here in tears terrified that I’m going to keep experiencing these hypos and I have no idea what I’m doing.
 
Well if you were Type 1 the place we are all told to start, is 1u of fast acting to each 10g or carb. You had about 4x that, if not more! Think you need to have a BIG rethink just at the moment.

To treat a hypo, I reckon about 150ml of 'new' Lucozade - roughly half a bottle - Not more.
 
merrymunky said:
However I’ve just done a post tea test and got a reading of 3.2. The diabetic consultant has never told me what the ratio of carbs to insulin should be. Only ever that I should just experiment with it. Obviously this usually works but lately it is going wonky.
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Contact your DSN about advice on adjusting amounts, but obviously if you're having hypos then you're taking too much insulin so reduce it a bit.

The usual rule is 15g of quick acting carbohydrate and wait for 15 minutes. (Because 15g is enough to help but not too much, but mostly because it's easy to remember, I suspect. 15 minutes is significant because you won't see any change in blood glucose for about 15 minutes after eating.)

google suggests 100ml now contains 8.9g (and used to contain 17g, so they've almost exactly halved it). So presuming you've got the new formulation around half of one of those 380ml bottles would be about the recommended 15g. (But don't worry about the exact quantities. If you find you can't face lucozade, don't rule out the popular favourite of 3 or 4 jelly babies (preferably with some water or something).)

(That's assuming 15g is also recommended for you. It may be that your DSNs would recommend something different.)
 
trophywench said:
Well if you were Type 1 the place we are all told to start, is 1u of fast acting to each 10g or carb. You had about 4x that, if not more! Think you need to have a BIG rethink just at the moment.

To treat a hypo, I reckon about 150ml of 'new' Lucozade - roughly half a bottle - Not more.
Click to expand...
I just wish they had actually coached me on what do do other than just telling me to try some and adjust if needed.

When I’ve had similar meals I’ve needed way more insulin to keep me in target. I don’t know what’s going on at the moment. The maths of it all befuddles me.
 
Hello! OK so I inject 1 unit per 10g of carbs as a starting point so thats about three and a half for one of my potato portions. But I'm a T1!!!. Yours will be different anyway. You can get really good visual guides of how many carbs in different portions - e.g. the book carbs and cals (also available as an app), which takes half the guess-work out of it. For me, the trick is to write down what I've eaten, how many carbs, what insulin I guessed and then what happened a few hours later. I have a few standards meals where I've worked out by trial and error how much insulin they need and repeat them a lot. Your local firnedly diabetes nurse should be helping with this! I seem to remember it changing (it being the inslin : carb ratio, the Units of insulin per 10g of carbs) a lot throughout pregnancy though, and having to reevaluate all the time based on levels 3 hours after eating.

Treating hypos, I find jelly sweets are cheaply available in supermarkets and buy them by the bucket load. the temptation is to eat the whole packet because your body is mega-hungry, so try a rule like: 5 sweets, wait ten minutes, retest. Or buy the little, kiddy-sized packets with a sensible portion in, not a big bag. More expensive though. Afraid I don't know how that equates to lucozade? I might start wih 1/4r 250ml bottle then see ten minutes later? Someone else might have a better number. I always got told not to correct rebound highs, but thts tricky when you're pregnant and worried about the baby's BG.

I hypod like crazy through both of my pregnancies - hang on in there. It's unpleasant, but you can get through. Keeping asking here (hope some of my weird ramblings help) and also pester your team like anything. You sound as if you need more support - that's awful when you're pregnant. Keep asking for it because it is TOUGH! - and difficult. We can only do out best.

PS I AM NOT A MEDIC OR IN POSITION TO GIVE YOU MEDICAL ADVICE. THIS is just to give you ideas of how people approach it. it sounds as though they should really be giving you more support, though. please ask for it - referral etc. It's ok to say 'I don't understand what to do. WHat do I do when i have my dinner tongiht? How do I work out how much?' There's no WAY you should be left to ask this sort of thing on the Internet.
 
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Thank you. I have no idea what the carb content of the potatoes is. I definitely need some sort of guide to work it out. I’m not a stupid person but when it comes to this I am completely out of my comfort zone.
 
You are definitely not stupid, it's so extremely difficult! I was spoonfed through my pregnancies and didn't appreciate this at the time; nobody should be left trying to find this stuff out on the internet, although this site is a good place to get ideas if you are. Please do pester your medical team for better instructions, and know we're all behind you.

I at least used to find it comforting that if I was hypoing, the baby was hopefully growing and stealing my blood sugar, which was a good comforting thing.

Good Luck
 
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Lizzzie said:
You are definitely not stupid. This sounds like you need a Diabetes Support Nurse to look after you. Not sure where you get that from tho ..but if you have them, it's ok to pester them first thing tomorrow (or monday) morning! .. Good Luck
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I’m seeing the diabetic consultant at maternity fortnightly at the moment and he’s just told me to keep doing what I’m doing. Obviously he hasn’t seen these hypos yet as I wasn’t in on Friday.
 
I agree with everyone else, @merrymunky - a Diabetes Specialist Nurse should be supporting you through this (consultants are all very well for theory, but DSNs are used to real people's real experiences and know a lot more about managing things in practice). Yes, you have to experiment a bit with insulin, because all our needs are different - but they should be guiding you through it, not leaving you to work everything out on your own.

This website lists the carb content of a whole range of different foods (and all the other nutritional values - ignore those, you just want to check carbs) - https://www.calorieking.com/us/en/foods/ - it's great if you're cooking from scratch and want to work out the carbs in all your ingredients. If you're not doing that but are eating fairly common meals then you might find Carbs & Cals easier to use, as there's not so much maths involved, it just has pictures of meals and their carb content.

If you type boiled potatoes into the search box in the Calorie King site and then change the measurement to the more common UK one of grams, you'll find that (for instance) 200g of boiled potatoes contain 40g of carbs - so if you ate that amount of potatoes and your insulin to carbs ratio is 1:10 you should have injected 4 units of insulin for them. Of course your insulin to carbs ratio might be 1:12 or 1:8 or 1:15, but most people start with 1:10 and then increase/decrease the insulin a bit as needed until they work out their own ratio.

I use fruit juice to treat hypos - you don't need to worry about the sugar content being reduced and it's one of your 5 a day (and, I think, tastes nicer)! I use 100g of grape juice, which is 15g of carbs (about a third of a mug).
 
200g is Half a POUND of spuds! Surely to God nobody sane who's diabetic tries to eat that much of em?

MM is Type 2, she's vegetarian - and a glass of fruit juice is absolutely NOT one of your 5 a day - because there's no fibre in it.
 
merrymunky said:
Thank you. I have no idea what the carb content of the potatoes is. I definitely need some sort of guide to work it out. I’m not a stupid person but when it comes to this I am completely out of my comfort zone.
Click to expand...
It should be on the back of the packet of potatoes what the carb content is, it completely varies on breed of potato but things like Jersey Royals, baby potatoes and new potatoes tend to be generally lower carb at about 15g carbs per 100g then its just a case of weighing yours out to find out what they weigh and working out how many carbs are in your portion xx
 
trophywench said:
and a glass of fruit juice is absolutely NOT one of your 5 a day - because there's no fibre in it.
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well the world seems to think different so maybe you ought to take it up with them - **A 200ml glass of Welch's Purple Grape Juice represents one portion of fruit or vegetable a day.
 
Kaylz said:
well the world seems to think different so maybe you ought to take it up with them - **A 200ml glass of Welch's Purple Grape Juice represents one portion of fruit or vegetable a day.
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I have heard of fruit juice counting as one (but only one) of your 5 a day - no matter how much fruit juice you have - because of the vitamins in it. But there are those who raise eyebrows and say it shouldn’t count because of the high level of sugar equivalent. 🙄
 
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Sorry to hear you are struggling @merrymunky and don’t feel you’ve been given the tools to try to unpick this. :(

My understanding from reading Alison’s Shoot Up Or Put Up diabetes blogs (T1) was that insulin sensitivity can change dramatically during different phases of pregnancy - so it’s a little disappointing that you weren’t given a bit of a warning about this. Though as someone said the other day I think it’s generally high BGs that the medics stress most about.

The 15 rule is a good starting point for treating. You may also find you need to ‘follow up’ with 15g of longer acting carbs to prevent a double-dip later on. perhaps a piece of whole meal toast or something?

As for adjusting insulin doses... we can’t offer advice, but I guess you have 2 options. One is to keep your current approach, but make a % change - so if you know you would usually need 12u for that meal then knock off 20%.

Or you could use a fairly straightforward meal (or meals) to establish your current insulin:carb ratio and adjust from there... So take a fairly easy-to-count meal (a sandwich and an apple would be just the carbs in 2 slices of bread and 15-20g for the fruit) and then divide your dose down from there.

As an example (and not using your numbers):
Sandwich and apple = 15+15+20 = 50g carbs
Your normal dose for that = 8u

Current ratio = 8u:50g carbs or (50 divided by 8) 1u:6.25g carbs

So reduce your insulin by increasing the ‘carbs’ side of the ratio - eg 1u:8g carbs

Obviously these are just example numbers to show the working... not actual numbers you should use!!

Hope that makes some kind of sense - let me know if I’ve just confused you massively and I’ll have another go!

Hope you manage to get things sorted soon!
 
merrymunky said:
I just wish they had actually coached me on what do do other than just telling me to try some and adjust if needed.

When I’ve had similar meals I’ve needed way more insulin to keep me in target. I don’t know what’s going on at the moment. The maths of it all befuddles me.
Click to expand...

You are pregnant so your hormones are constantly fluctuating making you insulin sensitive at times (so you’d need less insulin ) and insulin resistant at other times (meaning you need more ) and just to add to all the fun the resistance / sensitive changes throughout the day (so you could be resistant at lunch time and sensitive at dinner ). There’s so much going on your busy right now and your needs will be affected by this .

Do you have a good set of electronic weighing scales ? If you don’t then id strongly suggests that you get some (I don’t think eye balling is enough when you’re pregnant ) and measuring cups are good as well. Measure / weigh all carbs that you eat to you can work out how much insulin you need . There’s a good booklet on diabetes UK about carb counting . It explains it all a really simple way. Ask your DSN for advice . Type 1 pregnancy (or in your case type 2 with insulin ) is ridiculously hard becuase it’s relentless and your needs change throughout . It’s frustrating and sometimes you want to bang your head against the wall but you have to roll with it. It’s not easy but you can do it. Let us know what DSN says Good luck !
 
Lots of hugs to you merrymonkey. You have a lot to deal with - pregnancy has enough challenges, even without the complications of diabetes!
There is plenty of good advice from the forum, and I hope you can get some good support from your medical team as soon as possible. The important thing is that you get a clear plan so that you can reduce the stress and try to stay calm.
I hope it all sorts out soon.
 
I’m no medic so this could be rubbish but as a type two with, I assume insulin resistance, is it possible that by taking insulin it has given your pancreas a kick up the bum and it’s working properly? Just a thought. I hope whatever the cause it gets sorted ASAP.
 
Weigh your food and get something like carbs and cals (I prefer the book to the app but both are good) otherwise it’s all guesswork. Your hormones will change your insulin needs frequently during pregnancy so be prepared for everything to fluctuate. But if you know the amount of food you’re having and the average amount of carbs for that portion then you will have more idea about where your ratios need adjusting.

It’s really hard work and a good DSN will help loads so push to see one ASAP
 
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