Hypo morning insulin

[Filignano]

After travelling (flying) I experienced a hypo early morning, actually two. Had usual hypo meds and carbs however after a hour in bed I had another hypo. Repeated hypo meds again then ok. Guess I never had enough carbs? Now very high and not sure if I should take usual morning insulin dose or less/ usual.

 

[everydayupsanddowns]

Sorry to hear about your nasty hypo @Filignano

I would take your morning dose as advised, but just keep an extra close eye on things this morning.

Hopefully it was just a blip.

Do you count your carbs in meals/snacks to ensure you are eating a regular amount to balance with your insulin doses.

I found that essential when I was on mixed insulin. Both the carb count of various meals/snacks, and also their timing. Of course that’s not always all that easy when travelling/flying.

For me that was one of the most difficult things about mixed insulin. It has its own schedule, and expects you to live your life around it. Whereas my life is often more chaotic than that!

 

[Filignano]

Sorry to hear about your nasty hypo @Filignano

I would take your morning dose as advised, but just keep an extra close eye on things this morning.

Hopefully it was just a blip.

Do you count your carbs in meals/snacks to ensure you are eating a regular amount to balance with your insulin doses.

I found that essential when I was on mixed insulin. Both the carb count of various meals/snacks, and also their timing. Of course that’s not always all that easy when travelling/flying.

For me that was one of the most difficult things about mixed insulin. It has its own schedule, and expects you to live your life around it. Whereas my life is often more chaotic than that!

Thank you for your reply much appreciated. I am type 2 and insulin however I do not count carbs only monitor what I eat and use libre2 sensor and the app on my phone.

 

[rebrascora]

Did you actually feel hypo? Libre can record false lows if you apply pressure to the sensor, for example by lying on it. We call this a compression low. All Libre readings below 4 should be double checked with a finger prick before treating unless you feel obviously hypo. It is also important to ignore Libre after taking your hypo treatment and do another finger prick 15 mins after taking your hypo treatment. Libre will almost always show your levels dropping lower 15 mins later, whereas a finger prick will almost always show it coming up. You should almost always rely on finger pricks once Libre says you are below 4 or over 10 as it is not reliable below or above range. It could also be that if you stayed in bed to recover from the hypo, you laid on the sensor again and possibly caused another compression low.

I wonder if either it was a compression low in the first place or a genuine hypo but then because Libre doesn't respond quickly enough when levels are changing direction, that you were lulled into treating it a second time when it didn't actually need it, leading to your levels ending up too high. If you rely on Libre when recovering from a hypo, it will almost always cause you to over treat them, because of the algorithm used to compensate for it reading interstitial fluid instead of blood. The advice is to finger prick when Libre shows you low or high and then decide what action is needed.

What do you use to treat hypos and how much do you take? It is very easy to over treat hypos because they sometimes make you feel ravenous and you have to learn to be very disciplined in your routine of treating them. The standard advice is 15g of fast acting carbs which is 3 jelly babies or 4-5 glucose tablets or about 150mls of orange juice. The advice is then to follow uop with 10-15g of slow acting carbs once your levels recover. If I followed that advice I would be high after every hypo and I never have follow up carbs and usually just 1 or 2 jelly babies to treat a hypo. Again, that is something that you learn with experience.

 

[Filignano]

Thank you for your words of wisdom. I am guilty of using Libre to much and what you say is great advice especially the part about pressure on the sensor while in bed. I will definitely start using the finger prick more often from now on. I am always high after every hypo and in the morning sometimes off the scale for hours. Br Ronnie