Glucose tablets not working!

[Dory]

Hi guys,

I've been fiddling with my insulin levels recently and have (unsurprisingly) had a few hypos along the way.

My problem is that the dextro tablets i munch on don't seem to be working! I've had two occasions where my reading inteh low 3's, have taken the suggested doze of tabs (as directed by my pump meter which has the formuila for what a 'normal' reading for me is) - tested 15 minutes later and it's around the same level (ie mid to high 3's) - for those that are slightly elevated I check again 15 minutes later and it's gone back down to low 3's!!

Anyone have any suggestions why the glucose tablets aren't working any more??

 

[Caroline]

How old are the tablets and how were they stored? That might have an effect, or you need something that will get into your system more quickly. Lots of people find a fizzy drink is pretty quick...

 

[everydayupsanddowns]

Is it possible that your basal needs might have slightly dropped recently (mine have). Post hypo, after the glucose has done its work any IOB and or slight basal over-run might be pulling you back down again(this was, I think, the original logic behind the follow-up starchy carbs)

I'm another that finds carbonated drinks the fastest acting.

 

[Pumper_Sue]

Hi Dory,
if you are needing that amount of carbs then you need to look at your basal big time. Some testing is in order me thinks 🙂

 

[AlisonF]

Yep, for me untreatable hypos are nearly always a sign that my basals are too high (or I've massively over-bolused for a meal and have far too much insulin on board, but that tends to be more of a one off problem)

 

[Dory]

yes I agree that it must be too much insulin but it's just odd that after 3 years of the same basal rate with no problems correcting a hypo it's suddenly gone weird.

the tablets are about a week old and kept in my bedside drawer, so it's not them.

I've tried lucozade before and have had to drink over half a litre for that to have any effect - which is why I've always sworn by the tablets (and they have previoulsy bene good for me)

these occurrences are in the middle of the night, so no food (or more importantly bolus) left in me - so it can't be that. readings as follows:

23.10 - 4.5
23.27 - 3.7 (12g CHO via dextro tabs)
23.42 - 3.9 (15g CHO via dextro tabs)
23.53 - 4.3
00.34 - 3.7 (12g CHO via dextro tabs)
00.49 - 3.3 (at this point i got very angry, got up and wolfed down a large handful of dried apricots and had a bowl of muesli as I really wanted to get some sleep!)

basal rate at the point of hypo is 0.43u/h which surely can't cause the readings to go low.

So it must be the ratio I have (which leaves a silly amount of IOB as EDUAD suggests).

 

[Pumper_Sue]

basal rate at the point of hypo is 0.43u/h which surely can't cause the readings to go low.

So it must be the ratio I have (which leaves a silly amount of IOB as EDUAD suggests).

Test your basal is the first port of call.
I have 0.025u delivered for 4 hours and can still hypo on that.

The fact you are saying you have had to drink 1/2 a ltr of yuckie aid and it had no affect still indicates a basal to high. Either that or you have gastric emptying problems. My monies on your basal though 😛
Look in the pump forum on how to basal test and have fun.
I'm also very suprised you have had exactly the same basal for 3 yrs. I've never heard of anyone ever managing that.

 

[Dory]

oh no, that yucky aid-testing was waaaay back when i was still on pen! (as in, about 5 yars ago)

all this ironically has come as a result of basal testing!

it's not the basal/why i'm going low that i'm questioning here though, it's why the tablets have suddenly stopped working when before they worked fine before

 

[Pumper_Sue]

all this ironically has come as a result of basal testing!

it's not the basal/why i'm going low that i'm questioning here though, it's why the tablets have suddenly stopped working when before they worked fine before

The tablets are working. It just they have to much insulin to work on. Thus you need alot more glucose to treat the hypo.

 

[Dory]

i am on no more basal (in fact i am on less) than i was before, when the tablets worked.

the only thing i can think is that i'm eating a lot less on the whole than I used to so maybe the reduced 'background' food in my body is having an effect.

interesting as that suggests that insulin ratios depend not only on when you're eating and what you're eating but also how much of whatever you're eating (ie a huge plate of rice might see you needing 1:8 ratio but a small plate of rice might see you needing only 1:10 ratio). weird!

 

[MaryPlain]

i am on no more basal (in fact i am on less) than i was before, when the tablets worked.

the only thing i can think is that i'm eating a lot less on the whole than I used to so maybe the reduced 'background' food in my body is having an effect.

interesting as that suggests that insulin ratios depend not only on when you're eating and what you're eating but also how much of whatever you're eating (ie a huge plate of rice might see you needing 1:8 ratio but a small plate of rice might see you needing only 1:10 ratio). weird!

I have noticed that my basal requirements are hugely influenced by my overall carb intake. The way I think of it is that my liver has glucose burning holes in its pockets that it wants to spend by topping up my blood sugar! When I've been on a weight reduction plan I've reduced my basal by quite a lot. I would agree that it's not the tablets, it's the basal that's the problem, if this is consistent and not just a one-off.

 

[megga]

Just a thought, are you doing anything physically more??? I find that a good workout, gardening ect can have an affect on my b/s even the day after.

 

[PattiEvans]

interesting as that suggests that insulin ratios depend not only on when you're eating and what you're eating but also how much of whatever you're eating (ie a huge plate of rice might see you needing 1:8 ratio but a small plate of rice might see you needing only 1:10 ratio). weird!

Not really weird, it's the law of small numbers. Bernstein explains it well here http://www.diabetes-book.com/book/chapter7.shtml Hope this helps.

 

[trophywench]

Dory - I'd be astonished if my basal remained static for 3 months.

It literally IS at least as changeable as the weather, but these days I can't even guarantee THAT.

 

[Dory]

Megga - no it's not the exercise. I am quite a sporty person anyway so that was the first thing I looked at when I fist got fitted with my pump 🙂

Patti - that link is really helpful, thank you! It basically explains what I said! So glad I'm not a nutter (but scary that there can be that much of a margin!)

TW - do you really have change your basal that much? I only have one rate set up that the nurses make minor tweaks to. What sort of different rates do you have (ie what changes make you choose a different rate)? Maybe his is something I also need to think about.

On a separate rant, I phoned the DSNs Thursday morning at 7, desperate for help due to the 3-4 bad hypos I was having, she said she'd have a look at the diary and get back to me with an appointment but in the meantime, to switch back to a previous basal rate (which I did). Phoned Thursday afternoon, got answerphone, left message saying 'er hello, someone was meant to get back to me, please help'.....did exactly same thing Friday morning....Friday at 4.30 my phone rang, I missed it but got an answerphone message 'hi, i believe you've been trying to get in touch, i know my colleague has helped so we'll call you next week', called back the DSN less than 10 minutes later and they'd disappeared off. HOW CAN THAT BE HELPING?! They give me a suggestion, don't bother checking with me to see if that's worked (which it hadn't - was having and still having now 1 hypo a day) and now they've trotted off and left me on my own for the weekend!

Whilst typing this, I wonder - i take BP tabs at night (i don't need them, my readings are usually 125-130 over 75-80 but the doctors muttered 'preventative' and I can't be bothered to argue). Could the BP tables (which I know lower my BP hence i was advised to take them at bedtme because of this) be affecting glucose uptake?

 

[everydayupsanddowns]

Dory - I'd be astonished if my basal remained static for 3 months.

It literally IS at least as changeable as the weather, but these days I can't even guarantee THAT.

Mine too. In your shoes I'd run a basal test or two along with anything else

 

[Dory]

thanks guys. will mention this to my DSN (if and when I ever see them again)

 

[Pumper_Sue]

I only have one rate set up that the nurses make minor tweaks to. What sort of different rates do you have (ie what changes make you choose a different rate)? Maybe his is something I also need to think about.

Dory,
with respect it's your pump it's you who should be making the changes 🙂

May I suggest you do a complete basal test over 3 or four days and then post the results. With what you think should be changed.

This way we can help you.
Do yourself a huge favour by buying pumping insulin by John walsh (Amazon) It will be the best investment you ever made.

 

[trophywench]

Well Dory - if I have 2 or 3 days when my BG is unexpectedly higher.

Like say I'll test before lunch and it's usually between 5 and 7. I'm not going to care or even notice if it's up to say - 7.3. Then one day it's high 7s, next day 8.1, next day still over 7 - I go ooer, and do a basal test over lunchtime. If that doesn't give me an instant answer, then I'll do it by missing brekkie, to try and identify at what point it's rising.

And tweak it an hour or so before the increase starts.

These are not like major changes, just a tad. Say my basal was 0.37 then, well I might bung it up to 0.38 or 0.39.

Obviously if I suddenly get 10s at some time of day then more drastic action would be ncessary. I might go really drastic and stick it up to 0.41. However soon after I had my pump I fell into that trap and increased by 10% all morning or something, and paid the price in Lucozade. Oh - how Sue laughed at my misfortune! No that's a lie, she didn't but I can imagine her wanting to. I would have! She had warned me only to tweak by a gnat's whisker.

A teeny adjustment can make shedloads of difference.

If you can't be arsed to track your actual readings to that degree, you need to note any time you have to correct before a meal, before bed, when you get up etc which can't be explained by good old User error.

No way does my DSN tweak my rates! No way does she even want to - it's MY diabetes not hers. She made that clear on MDI before we ever got to this stage, Here - I'll give you the education to do the job yourself - if you get stuck, shout for help and I'll be there. (and she IS, when I do)

But she is good at noticing things (trends and stuff) that I haven't and yes she will make suggestions - but it's up to me whether to do em or not.

The first thing she asks when we download is, is this basal pattern still right or have you changed it since the last time? So she expects me to say I have sometimes and she doesn't expect it to last forever.

 

[Pumper_Sue]

- how Sue laughed at my misfortune! No that's a lie, she didn't but I can imagine her wanting to. I would have! She had warned me only to tweak by a gnat's whisker.

I'll have you know I didn't laugh once 😛 Felt like shouting at you when you told us all what you had done, was worried sick you were going to need an ambulance. 😱