Insulin - hypo or something else?

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Hughes87

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Type 1.5 LADA
Hiya! Following my last post, I spoke with a nurse who said I should start insulin before my meals, due to my size she suggested start on 1:20 ratio. I have done two which were find although my legs went jelly like immediately.

This morning I thought I would try a pot of oats, scanned my libre which said bg was 7. Did two clicks as the oats are 40g. My legs went immediately weak, I felt a bit queasy and dizzy so I sat down for a min or two. Then I felt like I was going to pass out. I managed to get upstairs and had 5 glucose tablets and some water. I’m a bit confused as to whether that was a hypo as insulin doesn’t work for 15 mins? My other hypos haven’t been the same either
 
I wonder if you are suffering from anxiety about using the insulin because it really can't drop you that quickly and you say you have Libre so you will be able to see if your levels dropped or not??
Also, it is really important to have hypo treatments to hand wherever you are and you certainly do not want to be negotiating the stairs either up or down when you feel like that and you might be hypo. A couple of spoons of jam or honey from the kitchen will do the job if you are down stairs and have nothing else, but please make sure you have stashes of hypo treatments all over the house, in coat pockets and bags and in the car if you have one. I even keep some in the bathroom because a hot bath or shower, particularly after exercise, can drop your levels fast.
 
Well nobody will have the slightest clue I'm afraid - the BIG rule for when anyone using insulin is feeling weird is ALWAYS test your BG right there and then. And to carry whatever your hypo treatment is about your person wherever you happen to be, too. If you had been hypo - you could have passed out and fallen down the stairs and broken your flippin neck!

What does the Libre graph now show that your BG was doing at that time - going down, then up again right after the glucose, or what?
 
You need to fingerprick before treating a hypo. That will tell you whether you’re low or just panicking.
 
Where did you inject the insulin @Hughes87 ? Some areas eg stomach, can be absorbed fast. Also, if you catch a muscle, then the insulin will be absorbed super-fast, which is very unpleasant.

Great advice above to keep hypo treatments everywhere close at hand. I was told to treat before I tested if I thought I was hypo ie get the glucose in, then test.

Not relevant really, but just to note, it’s best to say your dose in units not clicks because a click can be 1 unit on one type of pen, half a unit on another type, or even two units on some pens. So your dose was 2 units 🙂 If this happens again, try eating the same but reducing your insulin. It sounds
Ike you don’t have a half unit pen - do ask for one. They’re crucial if you’re small/sensitive to insulin.
 
Did your Libre show a drop in glucose values when you felt a bit squiffy @Hughes87 ?

And did you cross-check with a fingerstick meter (which won’t have the ‘lag’ of sensor glucose)?

If the sensations continue you might experiment with taking the dose after the meal - it’s not usually recommended because as you say the insulin usually takes a while to get going... but if you’re getting confirmed BG drops soon after taking your dose it may help to give the food a bit of a head start? 🙂
 
Thanks everyone. My libre wasn’t showing a dip. I was so anxious last night that I injected myself without loading up the insulin 3 times and the 4th still seeped after I removed the needle from my belly tonight I tried in my thigh and it worked much better

Think I’ve taken some learnings from this so appreciate all your replies
 
Do you mean you injected 4x the insulin dose you needed? Or you injected 0u three times first - if that way, why? You should dial the dose before you inject and just inject each dose once.
 
The nurse told me to do a test of 4 units before I inject myself and I think because I was so anxious after this mornings dose, I put the needle into my skin and realised I hadn’t turned the dial to add the unit
 
The air shot only needs to be 2 units not 4. That is wasting a lot of insulin. There is usually a slight seep of a small droplet on the end of the needle after I inject pretty much every time and I always inject and count to 10 before withdrawing the needle. My guess is that it is the heat from my body causing a slight expansion of the insulin in the pen/cartridge and doesn't affect the dose. You can dial up the dose with the needle in you if you forgot to dial it up before inserting the needle into your skin. I just count the clicks rather than look at the dial on the pen.

You clearly are extremely anxious about the whole procedure but practice makes perfect and you will eventually be able to do it with your eyes closed. Is it just the meal time insulin which makes you nervous? Are you OK injecting your basal/slow release insulin?
 
I’ve not got to basal yet. I’m just having one/two a day at the minute. I don’t particularly like needles (who does) but Sunday mornings issue really did throw me. Hopefully things will get easier with injecting as you said
 
Hughes87 said:
I’ve not got to basal yet. I’m just having one/two a day at the minute. I don’t particularly like needles (who does) but Sunday mornings issue really did throw me. Hopefully things will get easier with injecting as you said
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Does that mean you are only taking bolus insulin for your meals and not the once or twice a day basal insulin.
What is the name of the insulin you are taking as that might help people suggest what is the problem with your funny feeling.
 
Needles are a funny thing. I’m pretty sure you’re suffering from anxiety around that even if it’s subconsciously. It’s funny because I can stab myself all day long, for this reason my daughter called upon me to give her some daily injections for blood clot prevention. I’m like eww no! She’s had to have lots of blood test recently and even though she feels fine about them, her veins instantly collapse as soon as they come near her. Keep going you will get there using all the practical advise above
 
Leadinglights said:
Does that mean you are only taking bolus insulin for your meals and not the once or twice a day basal insulin.
What is the name of the insulin you are taking as that might help people suggest what is the problem with your funny feeling.
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It’s novorapid that I’m having, just with higher carb meals
 
I wonder if the name itself might be making you more anxious. If it helps, many people here on the forum refer to it as NovoSluggish or Novo(not so)Rapid. Insulin absorption times do vary from person to person and at different times of day but to give you an idea of how "not Rapid" NR is for some of us, I had to inject 75 mins before my meal at breakfast time to give it time to get going before I ate breakfast and I could spend some of that time walking and doing exercises to try to get it going a bit quicker. Most other times of the day, it took about 30 mins but unless you are injecting it into a blood vessel it will not bring you down immediately.

Getting confident with how your insulin works in your body and how quickly you can absorb carbs to counteract it is an important part of diabetes management. I would urge you to ask for a half unit pen (NovoPen Echo) and get your prescription changed to cartridges because the pen is reusable. There are more advantages to this that just the half unit option. The pen has a timer on the end which shows when your last dose was and how much.... just in case you have a momentary lapse in concentration and can't remember whether you did or didn't inject. The cartridges take uop less space in the fridge and there is less impact to the environment from the disposable plastic pens. You could also start experimenting on yourself by injecting a unit of insulin when your levels are reasonably stable and about 6 or above and then watch your Libre to see when your levels start to drop. Have some Jelly Babies to hand and when you see the Libre numbers start to reduce, eat a jelly baby and then keep watching the Libre and it will go back up. When it starts to drop again, eat another JB. 2 or 4 jelly babies should be enough to soak up that insulin over a 4 hour period. Hopefully experimenting like this will give you confidence that it isn't going to drop your levels like a stone and that your chosen hypo treatment be that JBs or Dextrose/Glucose tablets will work much quicker than the insulin.

It is important to understand that NovoRapid works over about 4-5 hours, so even if it got going immediately, which it doesn't, only about a third to a half of it will be released in the first hour and the rest gradually after that. It really is a much more gradual process than you might think and most of us get frustrated with NR because it is so slow, rather than worrying about it being too fast.
 
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