help with sudden falling BG levels

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Cosmic

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Relationship to Diabetes
Type 3c
Help please anyone know why BG levels suddenly drop
Hubby has type 3C diabetes and all of a sudden his levels drop without any reason e.g. today at about 5pm reading was 8.1 by 5.40pm dropped to 4.9, no insulin injected he is just sitting watching the TV but is feeling quite unwell and very anxious as it says still going down
Can contact clinic in morning if necessary
Thanks
 
When had he last injected insulin @Cosmic Insulin can carry on working for some hours. What insulins does he take?

And, importantly, has he treated the impending hypo?
 
Thanks he last had 2 units of Novorapid with food about 11.00am, he had a small sandwich at 2.00pm and a coffee made with milk at 4.00pm, now just had a custard tart and BG gone up to 6.6!!!!
Have no idea what is going on totally all over the place
He had necrotic pancreatitis in July 2021 but not diagnosed with Type 3C until May this year so we are still learning
 
@Cosmic Did he have any Novorapid with his 2pm sandwich? Is he taking Creon (I’m wondering if he’s digesting all the carbs properly)?
 
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No he didn't take any insulin with the sandwich, he should be on Creon 25000 but we cant get any!
At moment he is taking Nutrizym but that is also out until at least August, have tried about 20 pharmacies to get any supplies, but rural Norfolk much around.
So when current supply runs out its Pancrex he is not looking forward to that as told 16 tablets per meal
 
What background/slow insulin is he taking? If he’s having too much of that, that could cause unexpected lows during the day.

Is he carb counting and adjusting his Novorapid according to the carbs he’s about to eat (ie does he know how much insulin to take for different amounts of carbs?)?

If he’s unable to get Creon or similar, he might not be digesting his food properly and that could cause low sugars.
 
Oh gee thanks
the background Insulin is 6 units Abasaglar which he injects at around 9.00pm
Haven't been told about carb counting and adjusting insulin, appointment at clinic said they would go though that next time, have asked for an appointment with dietician as last hospital admission (yes he has had quite a few due to the pancreatitis) said Colitis as a result of pancreatitis, all caused by a gallstone!
Diets for diabetes and colitis are completely opposite
 
Can you/he speak to his team? It might be his Abasaglar needs adjusting. They might also have advice about the lack of Creon and substitutes in relation to his insulin and food.

Here’s an intro to carb counting:

The nuts and bolts of carb counting

When you live with type 1 diabetes, carb counting is a great way of managing your blood sugar or glucose levels. It can give you more freedom and flexibility in what you eat when you're preparing meals at home, grabbing food on the go or eating out. Carb counting does take some time and effort...
www.diabetes.org.uk www.diabetes.org.uk
 
Thank you so much all this is very difficult to understand, we are both in our 70's Tony is coming up 76 and to suddenly having to cope with everything ugh! The Libra and smart phone is difficult enough, I need a teenager to explain it all
I will try and ring his diabetic team in the morning
You have been so helpful many thanks
 
Cosmic said:
Thank you so much all this is very difficult to understand, we are both in our 70's Tony is coming up 76 and to suddenly having to cope with everything ugh! The Libra and smart phone is difficult enough, I need a teenager to explain it all
I will try and ring his diabetic team in the morning
You have been so helpful many thanks
Click to expand...
Hi Cosmic,
Sorry to hear about Tony’s difficulties but he is still very early in his journey and it will get better in time.
I was diagnosed last August again caused by gallstone related necrotic pancreatitis.
One thing you may not be aware of is a type 3c not only affects the Beta cells( these produce insulin) but also the Alpha Cells ( which regulate Glucagon which normally helps slow down any BG fall) hence your diabetes can be more brittle so more volatile.
I would not worry too much about the ups and downs of BG control even if it changes quickly but the feeling unwell is a different matter which does need attention.
It sounds like you both may be getting quite anxious about some of the things happening and you may feel you are not in control and that can affect BG levels as well.
I really hope you get your Creon soon as that can pay an important part in managing your conditions but it will improve in time as you both become more comfortable and confident in managing the diabetes as you gain more experience.
VBW
 
Thank you yes we are both getting very anxious about it all but it is so brilliant to be able to ask questions and get really good advice here on this forum from your experiences. I will try and contact his team tomorrow morning just hope we can sleep tonight as have had some very bad nights lately with alarms going off as we are both in our 70's its a huge learning curve
Going to use less insulin tonight as would prefer a slightly higher BG rather than low alarm going off in middle of night
Thanks to everyone
 
Hi Cosmic and fully understand the anxiety following a diabetes diagnosis for both of you as you need to support each other.
The “ stabilisation” period when you are trying to get glycemic control is probably the most difficult as the diagnosis and the need to change your lifestyle etc is overwhelming and a lot to take on board.
It takes time to understand how Tony’s body responds to the insulin regime and what effects specific foods and exercise have in terms of response and whilst you may feel very anxious when you see the BG levels rise and fall ( particularly if you are constantly using your CGM and do you understand the limitations of say Dexcom or Libre).
You will overreact when your low or high alarm goes off but in time Tony will get better at reacting.
For eg if my Libre level dropped from 8.1to 4.9 quickly and as long as I was not driving or feeling unwell then I would wait and see if it corrected itself ( then possibly check with a Finger Prick) and see if it bottomed out which it has done before.
I would take into account my hypo awareness symptoms as part of my judgement but at first I would have reacted by taking some Dextrose( my chosen hypo treatment) at the first drop below 5.
You would probably benefit if you have your alert set higher to forewarn you of an incoming trend but once you gain experience etc and confidence you will find you can make better and more timely judgments
 
Has it been warm where you live? Sometimes insulin works quicker when it is warm, that could have an impact, but it is likely as others have suggested that his dosages need amending.
Hopefully you can speak to his team soon about this.
Take care, both of you.
 
Hope you and your husband are able to get some practical support and advice about using and adjusting insulin around meals @Cosmic

But just to offer a little reassurance… 4.9mmol/L, 6.6mmol/L and 8.9mmol/L are all in-range levels that are just part of the ebb and flow of glucose levels.

For T1 (and I think, by extension T3c) levels are recommended to be 5-7 before breakfast, 4-7 before other meals, and no higher than 9.0 by 2hrs after meals.
 
Thanks to everyone, he seems better today and had a decent nights sleep without alarms going off!
We reduced the Abasaglar from 6 to 5 last night and he was much more stable, we have managed to get an appointment with the diabetic dietitian for Monday afternoon and then with the senior nurse/dr on 2/7/24
Initially he was told to try and keep levels between 6 and 12, think a bit higher because of his age, at the moment it is averaging around 7-8ish
 
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