Hello I have had type 1 for 44 years and even though I know a lot about Type 1 I am always learning more so need some advice at the moment I have just had a triple heart by pass 3 weeks ago and I am starting to have low blood sugars during the night even though I ensure as I have always done my levels are adequate before going to bed, I have reduced my base insulin which has seen no difference, please advise, many thanks
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Heart surgery
- Thread starter Ron62
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trophywench
Well-Known Member
- Relationship to Diabetes
- Type 1
Hi Ron. Hope all heals OK and all that jazz. How is your diabetes actually treated, (pump, MDI, what?) and do you currently have Libre or any other type of CGM ?
trophywench
Well-Known Member
- Relationship to Diabetes
- Type 1
Have you asked whoever leads your diabetes treatment if you can have one? You see, you can then see what's happening to your BG before it gets too bad to treat, if you see what I mean. The overnight lows, though it's natural for BG to drop in the early hours, you'd be able to indentify from the graph the next day, what time it starts plummeting and then ask for advice what to do about it.
I know our hospital the diabetes nurses still do ward rounds cos obviously diabetes patients can be in hospital for some other reason rather than D itself. I broke my kneecap a couple of years ago and it needed opening up, the jigsaw put together again then pinned and wired - I was right as ninepence but my BG wasn't (it was mega high) and I was in a different hospital, not 'at home' so the ward sister asked me if I wanted to see a DSN for advice on what to do with my basal insulin dose - Oh yes please! So I did see them and landed up on 3 times the basal dose I'd started with, which then took months to reduce since I couldn't walk anywhere much for ages, but being on crutches even getting out of the house and into the car took much more effort than ever hitherto. It gobsmacked me how much all of it affected my BG, but didn't surprise any of the diabetes team either in that hospital or my own, but anyway by the time I needed to see my team again, everything was back to normal anyway. I'd had really good advice what to do when, so hadn't had to bother 'my lot'.
But anyway - ring your team - and tell them you need help, asap, please !
I know our hospital the diabetes nurses still do ward rounds cos obviously diabetes patients can be in hospital for some other reason rather than D itself. I broke my kneecap a couple of years ago and it needed opening up, the jigsaw put together again then pinned and wired - I was right as ninepence but my BG wasn't (it was mega high) and I was in a different hospital, not 'at home' so the ward sister asked me if I wanted to see a DSN for advice on what to do with my basal insulin dose - Oh yes please! So I did see them and landed up on 3 times the basal dose I'd started with, which then took months to reduce since I couldn't walk anywhere much for ages, but being on crutches even getting out of the house and into the car took much more effort than ever hitherto. It gobsmacked me how much all of it affected my BG, but didn't surprise any of the diabetes team either in that hospital or my own, but anyway by the time I needed to see my team again, everything was back to normal anyway. I'd had really good advice what to do when, so hadn't had to bother 'my lot'.
But anyway - ring your team - and tell them you need help, asap, please !
rebrascora
Well-Known Member
- Relationship to Diabetes
- Type 1
- Pronouns
- She/Her
Hi
Hope you are healing well and continue to do so and that the surgery enables you to get back to full fitness in due course.
Just to clarify, as a Type 1 diabetic you should now be offered the Freestyle Libre monitoring system without any other qualification necessary. The system is wonderful for being able to see what happens to your levels between finger pricks and particularly through the night enabling you to adjust your basal insulin dose or perhaps even just the timing of it to prevent lows..... Just wondering if you are in hospital if perhaps your routine with your basal insulin has changed timing wise and this is causing a problem. I know sometimes in hospitals they insist on taking people's insulin off them and then administering it as and when they get around to it. If they have brought your evening basal dose forward a bit ,it could simply be that the peak of activity of that insulin is hitting your system right at the point when your liver is at it's quietest, rather than when it is gearing up for the day ahead a few hours later. Not sure if that makes sense but most insulins have a peak of activity, particularly the twice daily ones and taking them at a time that ensured the peak coincides with when you need it most is really helpful. Morning time particularly when our liver is splurging out more glucose due to Dawn Phenomenon for instance, but between 2am and 4am we usually need very little insulin because the liver is just trickling out a small amount. Of course everyone is different and some people need more at night and less through the day. Libre enables you to see much more clearly what your body is doing and make adjustments to your doses and timing accordingly.
I also wonder if it is quite hot in the hospital and the increased ambient temp is causing you to hypo.
Anyway, definitely ask for Freestyle Libre sensors on prescription and in your situation, I would continue to adjust the evening basal dose if your first reduction hasn't resolved the problem yet and you have given it time to take effect. If you use Levemir, then usually just one day is enough. I am not sure if Lantus needs a bit longer to see the full effect of a dose change.
Hope you get it fixed soon and do let us know how you get on and what works.
Hope you are healing well and continue to do so and that the surgery enables you to get back to full fitness in due course.
Just to clarify, as a Type 1 diabetic you should now be offered the Freestyle Libre monitoring system without any other qualification necessary. The system is wonderful for being able to see what happens to your levels between finger pricks and particularly through the night enabling you to adjust your basal insulin dose or perhaps even just the timing of it to prevent lows..... Just wondering if you are in hospital if perhaps your routine with your basal insulin has changed timing wise and this is causing a problem. I know sometimes in hospitals they insist on taking people's insulin off them and then administering it as and when they get around to it. If they have brought your evening basal dose forward a bit ,it could simply be that the peak of activity of that insulin is hitting your system right at the point when your liver is at it's quietest, rather than when it is gearing up for the day ahead a few hours later. Not sure if that makes sense but most insulins have a peak of activity, particularly the twice daily ones and taking them at a time that ensured the peak coincides with when you need it most is really helpful. Morning time particularly when our liver is splurging out more glucose due to Dawn Phenomenon for instance, but between 2am and 4am we usually need very little insulin because the liver is just trickling out a small amount. Of course everyone is different and some people need more at night and less through the day. Libre enables you to see much more clearly what your body is doing and make adjustments to your doses and timing accordingly.
I also wonder if it is quite hot in the hospital and the increased ambient temp is causing you to hypo.
Anyway, definitely ask for Freestyle Libre sensors on prescription and in your situation, I would continue to adjust the evening basal dose if your first reduction hasn't resolved the problem yet and you have given it time to take effect. If you use Levemir, then usually just one day is enough. I am not sure if Lantus needs a bit longer to see the full effect of a dose change.
Hope you get it fixed soon and do let us know how you get on and what works.
- Relationship to Diabetes
- Type 1
- Pronouns
- He/Him
SB2015
Well-Known Member
- Relationship to Diabetes
- Type 1
Hi @Ron62 i hope that things are settling down now. I echo what @trophywench has said talk to your team. If you are getting hypos in the night it might be worth asking about a pump. This is such a good bit of kit enabling you to adjust the basal insulin hour by hour. It doesnt suit everyone but may be worth considering.
Hi many thanks for your help, I am out of hospital now but in hospital they insisted in administering my insulin which sent my levels out of control until the 4th day when a doc told staff to let me self medicate to which I had my levels back to normal within a day and they have been fine since then it has only been the last few days where they have been a bit low I'm tending to think it could be some of the heart medication that is causing this
trophywench
Well-Known Member
- Relationship to Diabetes
- Type 1
Worst nightmare, someone other than 'me' doing my jabs - it was very stressful I expect - and that affects our BG...
Bit ironic when you think about it - save a bloke's life then slap him on medication that potentially could cause his demise anyway - the saving grace for you is the obvious fact by now that you're by no means daft and are unlikely to let that happen. What's your plan re this - have you got easy contact for both sides of the equation - both cardiac and diabetes advice?
Perhaps it's likely that not every Type 1's body would react the same way to the drug but of course, until any one of us needs to try it we'd never know.
Bit ironic when you think about it - save a bloke's life then slap him on medication that potentially could cause his demise anyway - the saving grace for you is the obvious fact by now that you're by no means daft and are unlikely to let that happen. What's your plan re this - have you got easy contact for both sides of the equation - both cardiac and diabetes advice?
Perhaps it's likely that not every Type 1's body would react the same way to the drug but of course, until any one of us needs to try it we'd never know.
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