Hypos immediately after eating

[Midnightcatpatrol]

Hi all,

To summarise I was diagnosed T1 about 6 weeks ago. Severe weight loss. Osmotic symptoms and a shock trip to a&e. Blood glucose 37, hba1c 180, anti GAD 550.

I've been doing quite well on just under a 1 to 10 ratio.

However last few days have been dreadful. I've been more active than usual preparing the house for some works. Lugging stuff up stairs, moving dressers around etc.

Now I inject (50% than usual because of the exercise and it's hot again grrr) and I still hypo within 30 mins of injecting just after eating meals. Dinners seem to be the worst.

Getting very frustrated, I assumed I would get the honeymoon as I didn't at first. Was needing 8 4 8 at each respective meal. Could this be a late honeymoon? Is it the heat and exercise again?

Not sure if actually asking for advice or just venting!

 

[Thebearcametoo]

It could be the honeymoon period (not everyone has one) or it could be the exercise. You may find that you don’t need even 50% insulin if you’ve been doing more exercise especially if you tend to hypo in heat. Or it may be a timing issue and you need to bolus a little later. And of course it depends what you’re eating and how fast you’re absorbing carbs. The other thing is your basal may need adjusting down. Which one are you on?

 

[Midnightcatpatrol]

Lantus. 10 units. Hasn't been an issue until last few days

 

[PhoebeC]

What are you eating when this happens? Are you carb counting?
Are you on the Libre?

 

[Kaylz]

Unfortunately things will change no matter how long we've been diagnosed, we always need to keep an eye out for patterns and adjust things where needed, doesn't matter if you've been diagnosed 2 months or 20 years there's always going to be something whether it be ratio adjustments or basal adjustments

Many things can effect your insulin needs, whether it be the honeymoon period (mines lasted 2 years), stress, illness, outside temperature, season, hormones, exercise etc

We aren't allowed to give advice on adjusting insulin doses so it really would be best to get in touch with your diabetes team and explain it all to them with figures and doses etc and they can then suggest what action they think you should take, it takes time but you will learn and be confident to make adjustments yourself when needed

Good luck
xx

 

[Midnightcatpatrol]

What are you eating when this happens? Are you carb counting?
Are you on the Libre?

Carb counting and on libre. Eating normal healthy things, roasted fish, wholemeal pasta, green vegetables then generally some dark chocolate for afters. I'm low by the time I get to do the washing up.

 

[everydayupsanddowns]

What happens 4 hours later after a smaller dose @Midnightcatpatrol

Is it just that the insulin is acting too fast, but that the dose is right? or that the dose is simply too high?

You could try shifting your injection until after eating (not often needed long-term, but some parent’s of small children find it a useful strategy when they don’t know how much food will be eaten!)

Or take some before eating and the rest of the dose an hour or so later? (Sometimes a tactic used with carbs/meals that absorb extra slowly which can include pasta and pizza for some people)

 

[Sally71]

@everydayupsanddowns beat me to it! I was also going to say that it sounds like either your carb ratio needs an adjustment (speak to your medical team if you're unsure about doing it yourself), or that the insulin is working faster than the food, in which case try doing the injection after you eat or splitting it. Unfortunately diabetes never stays still for long, it's always a work in progress and even when you've had it for years you still have to make adjustments from time to time. It can also happen that you need different carb ratios for different times of the day, my daughter needs much bigger doses in the morning than the evening, this is because usually you become less insulin resistant as the day goes on.

 

[Inka]

It sounds like it might be all the all the exercise if it’s only happened in the last few days. Never underestimate how much some normal chores can lower your blood sugar. When I moved house even though I wasn’t doing any heavy lifting, all the jobs made me constantly low until I adjusted my insulin. It’s the same with very gentle gardening.

I’d also be checking your basal dose is still ok. I found that I needed less insulin after a few weeks of being Type 1. I presume this was the honeymoon and my own remaining beta cells being rested by the external insulin.

If it was me, I’d be reducing my evening meal ratio at least, if not other meals too. But don’t discount your basal needing a tweak too if only for these days of exercise.

 

[porll69]

You are really early on in your diagnosis, 6 weeks. I would say honeymoon period at the moment. Plus you say you are on fixed doses (8,4,8)......breakfast 80g carbs, lunch 40g carbs and tea 80g carbs based on 1:10 ratio. I do think that carb counting this early into a diagnosis is a waste of time (dont get me wrong it is a good idea to start early) due to the possibility of being in the honeymoon stage. Also exercise will effect your readings (along with 501 other things which you will get to see as you progress 🙂)

 

[Pumper_Sue]

It sounds more like a drop in basal is needed if doing extra exercise.