Hypo help please

[Jacen017]

Hi Everyone,

I just wanted a little advice...

I've been struggling with Hypos in the last hour and a half, I've had 2 and every time I get the levels back up they drop down again.

I was supposed to take my insulin about 20 minutes ago but in light of the hypos I have left it. I can't get any medical professionals on the phone to ask if this is the right decision and was hoping that someone here might know?

Thanks in advance.

J

 

[Jacen017]

PS: I've checked levels with a finger prick also, not just relying on the Libre.

 

[rebrascora]

Hi. Sorry to see know one was available to advise you earlier. Hope you are feeling better now and you have your BG levels back under control.

Have you resolved the question about taking your insulin? If not, then more info about the hypo and when you had it would be helpful..... ie was it as a result of your breakfast fast acting insulin or did you wake up hypo and it was your long acting (basal insulin) which was causing you to drop low? Or could it have been alcohol last night which dropped you low this morning?
Generally you would still take your long acting insulin, even if that was the likely cause but you might consider reducing the dose, particularly if your waking readings have been getting a bit low recently, or increasing your bedtime BG levels by having a snack (digestive biscuit) before you go to bed.
If it was a timing issue with your breakfast bolus insulin (ie you waited too long before eating) or you gave yourself too much bolus insulin, then the important thing is to learn from that, but yes still take your basal insulin because your liver will continue to release glucose, so you need the basal insulin to cover that.

 

[Jacen017]

Hi. Sorry to see know one was available to advise you earlier. Hope you are feeling better now and you have your BG levels back under control.

Have you resolved the question about taking your insulin? If not, then more info about the hypo and when you had it would be helpful..... ie was it as a result of your breakfast fast acting insulin or did you wake up hypo and it was your long acting (basal insulin) which was causing you to drop low? Or could it have been alcohol last night which dropped you low this morning?
Generally you would still take your long acting insulin, even if that was the likely cause but you might consider reducing the dose, particularly if your waking readings have been getting a bit low recently, or increasing your bedtime BG levels by having a snack (digestive biscuit) before you go to bed.
If it was a timing issue with your breakfast bolus insulin (ie you waited too long before eating) or you gave yourself too much bolus insulin, then the important thing is to learn from that, but yes still take your basal insulin because your liver will continue to release glucose, so you need the basal insulin to cover that.

Thanks Barbara,

I've spoken with my GP but she didn't know what to do so said she would call me back.... An hour and a half ago...

I'm only using a basal insulin which I take at 0830 (26 Units) and 2030 (16 Units).

I woke up about 0630 on 5.3, an hour later it was 3.7 - Treated with Jelly Babies and got to 6.0.

30 minutes later it was back to 3.8 - Treated again and then had breakfast (Bacon, Mushroom, Egg and Wholemeal toast.) and its been slowly dropping from 4.4 since then.

I'm not in danger or anything because I'm keeping an eye on it closely, I'm just unsure about what to do with the Insulin. I'm not experienced enough with it to be confident in changing the dose or knowing how much it affects me and how quickly.

 

[Pumper_Sue]

Best thing to do is see what happens tomorrow and if the same result then you need to cut your insulin.

 

[Jacen017]

Best thing to do is see what happens tomorrow and if the same result then you need to cut your insulin.

Thanks Sue, Is the amount to cut it by determined by the Dr or is this something I should know how to do?

 

[rebrascora]

Did you take your morning basal? Is it Levemir?

To me those seem like rather high starting doses. How long have you been on those doses? Do you have Libre?

 

[Jacen017]

Did you take your morning basal? Is it Levemir?

To me those seem like rather high starting doses. How long have you been on those doses? Do you have Libre?

It's Humulin I.

They started me on 14 and 14 and then changed it to this about a week and a half ago.

Yes I'm using a Libre now. Started a few days ago.

 

[Jacen017]

Just read your original question, no I haven't taken it yet today

 

[rebrascora]

I would take it, but if it was me I would probably reduce it., particularly as you are now late with the dose. It is always best to err on the side of caution and take lass but there is a lot of difference between 26 and 0!! Generally they recommend 10% adjustment and see how that goes for a few days but since you are already late with the injection and still dropping, I would reduce it by more.

That seems like a big increase from 14 to 26. It may be that your own pancreas, having been given some support by the injected insulin, is starting to fire up again. Do you have a telephone number for your hospital diabetes clinic helpline?

 

[trophywench]

Have you been diagnosed as Type 1? - if so why on earth have they stuck you on Humulin I? that hasn't been advised for Type 1 diabetes for about 35 years. I stands for 'intermediate' not 'long acting' so it ain't the best for a Type 1.

 

[Jacen017]

I would take it, but if it was me I would probably reduce it., particularly as you are now late with the dose. It is always best to err on the side of caution and take lass but there is a lot of difference between 26 and 0!! Generally they recommend 10% adjustment and see how that goes for a few days but since you are already late with the injection and still dropping, I would reduce it by more.

That seems like a big increase from 14 to 26. It may be that your own pancreas, having been given some support by the injected insulin, is starting to fire up again. Do you have a telephone number for your hospital diabetes clinic helpline?

I do have a number and I called them. It's just an answerphone that they check at 1 and call you back.

Have you been diagnosed as Type 1? - if so why on earth have they stuck you on Humulin I? that hasn't been advised for Type 1 diabetes for about 35 years. I stands for 'intermediate' not 'long acting' so it ain't the best for a Type 1.

I don't have a type yet. The GAD was inconclusive with me only showing positive for only one thing they tested for. I'm not entirely sure what the results were - they aren't on the NHS app yet for me to read.🙄

 

[Inka]

It's Humulin I.

They started me on 14 and 14 and then changed it to this about a week and a half ago.

Yes I'm using a Libre now. Started a few days ago.

If you’re Type 1, you need a bolus (fast) insulin as well as your Isophane basal insulin. To me, it looks like they’ve stuck you on too big doses of Humulin i hoping it will cover your meals.

 

[Inka]

@trophywench A bit off-topic and I’d better whisper this, but…..when I take a pump break and use pens, I use an isophane basal. I find it works well for me.

 

[Inka]

I woke up about 0630 on 5.3, an hour later it was 3.7 - Treated with Jelly Babies and got to 6.0.

30 minutes later it was back to 3.8 - Treated again and then had breakfast (Bacon, Mushroom, Egg and Wholemeal toast.) and its been slowly dropping from 4.4 since then.

Did you have some longer-acting carbs after your jelly babies? That would help keep your blood sugar up.

I would take the Humulin personally but cut the dose down. I think the problem is two-fold - you’re on too much Humulin i and you’re on the ‘wrong’ insulin regime.

 

[Jacen017]

I woke up about 0630 on 5.3, an hour later it was 3.7 - Treated with Jelly Babies and got to 6.0.

30 minutes later it was back to 3.8 - Treated again and then had breakfast (Bacon, Mushroom, Egg and Wholemeal toast.) and its been slowly dropping from 4.4 since then.

Did you have some longer-acting carbs after your jelly babies? That would help keep your blood sugar up.

I would take the Humulin personally but cut the dose down. I think the problem is two-fold - you’re on too much Humulin i and you’re on the ‘wrong’ insulin regime.

Is the toast a long acting carb? If not, what should I have?

 

[Inka]

Is the toast a long acting carb? If not, what should I have?

Yes, toast is long-acting. Other things are digestive biscuits, oatcakes, etc. How much toast did you have? You might need more if you’re using the toast as an after-hypo carb.

I’d have had the long-acting carbs pretty soon after treating the hypo and not wait until breakfast. So, I’d probably have had a digestive or two in your situation, then eaten my breakfast as normal.

 

[Jacen017]

Doctor just called back and told me to take 22 units now and then 14 tonight.

Yes, toast is long-acting. Other things are digestive biscuits, oatcakes, etc. How much toast did you have? You might need more if you’re using the toast as an after-hypo carb.

I’d have had the long-acting carbs pretty soon after treating the hypo and not wait until breakfast. So, I’d probably have had a digestive or two in your situation, then eaten my breakfast as normal.

I had 1 piece - about 14g carbs.

 

[Pumper_Sue]

Thanks Sue, Is the amount to cut it by determined by the Dr or is this something I should know how to do?

If you are confident in doing it yourself then do so 🙂 People normally decrease by a couple of units then waite and see what happens over a couple of days.

 

[Inka]

Doctor just called back and told me to take 22 units now and then 14 tonight.

I had 1 piece - about 14g carbs.

Ok, so I’d have had more toast if one slice is your usual amount otherwise you’re not having any additional long-acting carbs after your hypo.