Hypo upon waking 2 nights running.

[Pat91]

Could having a hypo 2 nights running suggest I need less basal insulin. Bed time reading were 8.7 and woke at 1.30am with 3.8 and last night reading was 6.6 (had some biscuits before bed) and woke this morning with 3BG at 7am.

 

[helli]

Maybe.
Had you been exercising more than usual in the last 48 hours?
Or drinking?

Both can affect your blood sugars..
Definitely something to discuss with your DSN

 

[Inka]

When you tested before and mentioned it here, you were in the 4s, weren’t you, and, I think woke up in the 4s too? Yes, I think you probably need less basal, unless there’s another obvious reason eg forgetting your bedtime snack.

It’s far better and safer to be in the 6s. Nighttime hypos are a risk not worth taking.

 

[Pat91]

Maybe.
Had you been exercising more than usual in the last 48 hours?
Or drinking?

Both can affect your blood sugars..
Definitely something to discuss with your DSN

Yeah slightly more activity but no drinking. Same again today have done loads of walking, had my lunch 1hr.30 mins later I had a hypo, only took 6 units as well as I knew I was walking.

 

[Pat91]

When you tested before and mentioned it here, you were in the 4s, weren’t you, and, I think woke up in the 4s too? Yes, I think you probably need less basal, unless there’s another obvious reason eg forgetting your bedtime snack.

It’s far better and safer to be in the 6s. Nighttime hypos are a risk not worth taking.

Had done more walking, that's the only thing I have done different, have been reading, think like a pancreas and they mention in that to maybe take bolus down 10% if to high, currently on 26 so might try 24 tonight.

 

[helli]

Yeah slightly more activity but no drinking. Same again today have done loads of walking, had my lunch 1hr.30 mins later I had a hypo, only took 6 units as well as I knew I was walking.

Exercise can affect blood sugars for up to 48 hours.

My understanding is our liver releases glucose to give us energy when we exercise. This “uses up” the glucose in our liver which drips all the time. As a result, we have less background glucose so may need less background insulin.

With alcohol, our liver thinks of it as toxic so tries to sort out the poisons before it will drip glucose. As a result, there is a risk of hypos after drinking.
This does not mean you need to give up drinking but maybe a good idea to go to bed with a higher blood sugar level than usual after drinking. Or reduce basal a little,

 

[Pat91]

Exercise can affect blood sugars for up to 48 hours.

My understanding is our liver releases glucose to give us energy when we exercise. This “uses up” the glucose in our liver which drips all the time. As a result, we have less background glucose so may need less background insulin.

Oh ok, thank you that's something to remember then. Quite a lot to this diabetes isn't there.

 

[trophywench]

Errr Pat, the starting point for anyone carb counting& dose adjusting, is 1u per 10g CHO (CHO is the scientific/medical shorthand for carbohydrates) One slice of large medium sliced bread = c.15g CHO, so a 2 slice sandwich = c. 30g CHO so that = 3u bolus insulin. Plus if you have a bit too much basal insulin circulating, that would just make the 'too much insulin' problem worse.

Think Gary Tauber actually said take BASAL insulin down 10%! Anyway, max. 10% at any one time (either up or down) has always been recommended. Remember if it's glargine insulin (eg Lantus or Abasaglar brands) it can take 3 full days to be able to judge correctly whether any change of dose is right, wrong or OK.

 

[Pat91]

Errr Pat, the starting point for anyone carb counting& dose adjusting, is 1u per 10g CHO (CHO is the scientific/medical shorthand for carbohydrates) One slice of large medium sliced bread = c.15g CHO, so a 2 slice sandwich = c. 30g CHO so that = 3u bolus insulin. Plus if you have a bit too much basal insulin circulating, that would just make the 'too much insulin' problem worse.

Think Gary Tauber actually said take BASAL insulin down 10%! Anyway, max. 10% at any one time (either up or down) has always been recommended. Remember if it's glargine insulin (eg Lantus or Abasaglar brands) it can take 3 full days to be able to judge correctly whether any change of dose is right, wrong or OK.

Yeah sorry I meant basal, I did read that but was wondering why I was told 10 at first then down to 8 seems far to over the top. Do you recommend me trying the 1:10 ratio with the bolus then to see if that makes a difference.

 

[trophywench]

Only alter ONE thing at a time Pat! only then can you (and your doc) judge correctly whether it has worked or not.

 

[Pat91]

Only alter ONE thing at a time Pat! only then can you (and your doc) judge correctly whether it has worked or not.

Good point, thank you.

 

[Inka]

Had done more walking, that's the only thing I have done different, have been reading, think like a pancreas and they mention in that to maybe take bolus down 10% if to high, currently on 26 so might try 24 tonight.

Yes, I’d try dropping your basal down. As @trophywench says, don’t alter anything else and give it a few days (the basal change).

As regards your 10/8 bolus amount, I think your main ‘problem’ is that you weren’t told a carb amount to go with that. When I was diagnosed, the DSN looked at my records, went through a normal day’s food with me (ie what I ate on a normal day) then added up the carbs for each of my meals. So I knew what I was supposed to eat and could see how she’d linked the carb amount and insulin. Of course she had to estimate the insulin but it was pretty close and only needed slight adjustments.

I keep saying this and you probably think I’m a boring broken record, but slow and steady is the way. Keep things regular and, tedious as it is, that way you’ll be able to move forward quicker in the future because you’ll have built a solid base of information. Hope that makes sense! After you’ve roughly sorted your basal amount, look at each meal. Eat the same eg your 2 WB and 200ml milk, have your 8 units, see if that works.

 

[Pat91]

Yes, I’d try dropping your basal down. As @trophywench says, don’t alter anything else and give it a few days (the basal change).

As regards your 10/8 bolus amount, I think your main ‘problem’ is that you weren’t told a carb amount to go with that. When I was diagnosed, the DSN looked at my records, went through a normal day’s food with me (ie what I ate on a normal day) then added up the carbs for each of my meals. So I knew what I was supposed to eat and could see how she’d linked the carb amount and insulin. Of course she had to estimate the insulin but it was pretty close and only needed slight adjustments.

I keep saying this and you probably think I’m a boring broken record, but slow and steady is the way. Keep things regular and, tedious as it is, that way you’ll be able to move forward quicker in the future because you’ll have built a solid base of information. Hope that makes sense! After you’ve roughly sorted your basal amount, look at each meal. Eat the same eg your 2 WB and 200ml milk, have your 8 units, see if that works.

Yeah it's just because I have been having more and more hypos now I'm pretty much back to usual activities.even tho I'm eating pretty similar to before.

 

[Deleted member 25429]

Be careful of timings . I leave 3/4 of an hour after my insulin injection before I walk my dogs otherwise I go hypo

 

[everydayupsanddowns]

Hope you can get hold of your DSN for a follow-up conversation to get some pointers around where and when to make changes.

Remember the possibility of ‘honeymoon’ help from your pancreas too. So default ratios like 1:10 could be a bit strong. Best to discuss with your DSN before making any changes 🙂