Honeymoon Period & Low BG - Type 1

D

Drumbowie

Member
Relationship to Diabetes
Type 1
I am a recent Type 1 diagnosis and in the Honeymoon Period. I currently take no Bolus or Basal injections and experience very few highs (>10). The downside is that I keep going low (<3.9) even when I have been at 9.0+. If I exercise to any extent it accelerates the drop and I can end up in a yo-yo of eating Fast & Long Carbs and then going low again. I eat well and regularly and find this frustrating. The honeymoon period has become a real rollercoaster and I think I experience insulin sensitivity which is continuously pushing down my BG. Does this mirror anybody else’s experience?
 
@Drumbowie Yes,I had similar soon after diagnosis. My consultant said it was a sign of a failing pancreas behaving erratically and pumping out insulin too late and often too much. How low are you actually going and do you confirm the lows with a fingerprick? My consultant told me it was best to take insulin to help out my failing beta cells and preserve them longer, so I did.
 
Thank you for your reply, I always finger prick confirm my Libre 2 low alerts. I have gone as low as 3.0 mmol/L but am around 3.8 when I intervene. I am to see my Consultant in the next week or so and will discuss this and other stuff. I will try not exercising for a couple of days and see what this does to my BG.
 
What do you eat in an average day @Drumbowie ? And what’s your Libre Low alert set at? I’d set it at around 5 then you have time to ward off any lows.
 
My BG Alarm is set at 4.5mmol/L but can drop quite quickly from there. There is a lag on BG level with CGMs and it can give ‘false’ lows too and I can otherwise manage really well.
 
You could try setting it at 5 @Drumbowie I used to set my Libre at 5.6 because of the lag. That gave me plenty of warning and I could then decide what to do (if anything).
 
Are you basing these lows on L:ibre readings or finger prick checks. I find that Libre usually reads about 1 mmol lower than a finger prick for me particularly at low levels and it also exaggerates drops, so I might be at 7 and my levels drop and the Libre will say I am down to 3.6 but half an hour later my levels are fine and there is no sign of that "dip into the red" on my graph and I might have only gone down to 4.5. I can't be bothered to finger prick every time now, because I know the pattern and don't panic when it shows me low after a meal and I know I have carbs in my system releasing glucose but the Libre just hasn't caught on yet that levels have changed direction.

If they are genuine lows without insulin then I would wonder if you might have some abnormality in your pancreas causing the lows rather than Type 1 as hypos are generally caused by an excess of injected insulin, but clearly you are not injecting any to cause hypos. Type 2 diabetics sometimes experience hypos without insulin or other hypo causing drugs because the visceral fat around their pancreas and liver prevent the correct regulation of BG levels and the pancreas doesn't get the message to release glucose when food is first eaten and then when levels go high, it releases too much insulin too late and levels plummet back down. I think it would be unusual for Type 1s to experience this sort of disregulation. Did they do antibody tests as well as C-peptide to establish that you are Type 1?
 
Also bare in mind blood sugars can naturally go below 4 in a 'normal' person. It's just when a type 1 is on insulin we treat 4 as a hypo to give a safety margin.
Hypos are normally an insulin thing, not a diabetes thing.
The dafne course now treats 4-3.6 as out of target range, requiring a nudge with some glucose, and 3.5 or less as a hypo requiring 15g of glucose.
Also, early after my diagnosis i found my levels plummeted with excercise. Part of yhat was genuine, part libre being a drama queen. It got better over time. Excercise was the thing that took longest to manage, but you'll get there.
I'd have a word with your consultant
 
I started insulin, both basal and bolus, when I was having random lows like this. DSN said it was a sign of my pancreas failing and having high bgs then it overreacting and responding too much too late. The insulin helped with it.
 
Exercise can cause some head scratching @Drumbowie , especially in the honeymoon period (what a ridiculous name for it). Well worth having an earlier warning (raise the level) a bit to help you head off lows.

Let us know how you get on with your next appointment.
 
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