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Cargillr

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My husband is a type one diabetic, diagnosed 2 years ago. He is a runner and is training for 2 marathons in April.

He was slightly poorly, viral maybe, stomach upset last week. Since then, he cannot raise his blood sugars. He is taking absolutely no rapid insulin and only a couple of units of background.
He can live a normal day to day but he cannot exercise without having a hypo. He has eaten carbs, sugary foods, sport gels, drinks etc… nothing will raise them up.
His diabetic nurse sent him for tests which have all come back as normal (still waiting on the celiac test) but she just keep telling him he’s an ‘anomaly’ which doesn’t really help his situation.
I’m looking for advice from anyone who has suffered the same or is into exercising everyday and what might be the causes? Because at the moment he is so so deflated because his positivity comes from exercise.

Any advice welcome - newbies to the whole type 1 arena.
 
Hello, is your husband using a sensor? If so. Is your husband checking the sensor reading with a BG meter reading?
Sensors like a Libre 2 can lag regarding a rise from a hypo.
Also what insulins does your husband use?
 
He uses a sensor and a pin prick but both always say very similar. He eat loads and loads of food and then bloods never raise above 9 but come straight back down. And if he starts exercising they drop dangerously low. His insulin Abasaglar for background and novorapid
 
I have some similar experiences to your husband although not as extreme. Then again I don't exercise every day and am not in training! However, when I do exercise, it is quite intensive and I hardly need any insulin on those days or even the morning after. So what I used to do is cut the insulin right back and have no long acting at all the night after the exercise day. I say "used to" because I'm now on a HCL pump and it automatically cuts off the insulin at night when it detects I don't need any or puts it back on if I do (which is great for me!). So my suggestion is that he stops insulin altogether for a day or two and see what happens to his readings. If they still dont go up then try exercise at that point because any long acting insulin should be through his system by then, hopefully eliminating the hypo risk. (Abasaglar states it operates for 24 hours post injection). During this trial do keep a very close eye on the sensor readings and keep the alarms on just in case!
The other thing I've just thought of is that, with continuous exercise and training, there is a good chance that his body has become very insulin sensitive meaning that even a small amount will have a big impact - even more reason to do the trial above.
Finally I must say that I'm not medically trained so this suggestion is born of almost 40 years of living with this retched condition and my own trial and error, not necessarily best medical practice. Clearly you have to be comfortable and confident enough to try new things which I understand is not always easy.
Hope this helps.
 
Hi and welcome.

Sorry to hear your husband is finding he is unable to exercise due to hypos despite reducing his insulin.
Can you tell us a bit about his diagnosis and how that came about? I appreciate it was 2 years ago. Have his insulin doses gradually dwindled since diagnosis or has this just happened since this slight illness ie. What were his doses when he was first diagnosed?
Has the illness fully resolved. ie no more upset tummy, or is he still suffering some symptoms of that, however slight?
Is he noticeably losing (or gaining) weight?.... especially if he is unable to exercise? Just wondering if that might point towards coeliac. Do you know what other tests he had done?.... You say they all came back negative, but it is helpful to know what has been ruled out.
You mention his nurse, but has he seen or spoken to the consultant about this problem?
How would your husband feel about having a pump. If he is needing tiny doses of insulin intermittently, and struggling to deal with hypos that are not responding then that

Was he managing to exercise OK before this recent illness? Are his levels dropping very low

We do have one member of the forum, the previous forum administrator no less (also considered an anomaly by medical professionals I believe 🙄 ) who no longer needs basal insulin and interestingly he is also a keen marathon runner. He does however need meal time, bolus insulin. I believe he has not been using basal insulin for several years now. I wonder if Alan (@Northerner) can offer anything from his experience which might be helpful to your husband.
 
I particularly agree with @rebrascora regarding the pump idea - your husband would appear to be the ideal candidate. I've never looked back and managing exercise is a piece of cake now! (Pun intended)
 
I would check what tests he has had done and whether they include a cpeptide which is a measure of how much insulin he is producing. If he really is going low whilst taking only 2u of background insulin and no mealtime insulin then perhaps his pancreas is making some insulin and he has a different type of diabetes not type 1?
 
Lucyr said:
I would check what tests he has had done and whether they include a cpeptide which is a measure of how much insulin he is producing. If he really is going low whilst taking only 2u of background insulin and no mealtime insulin then perhaps his pancreas is making some insulin and he has a different type of diabetes not type 1?
Click to expand...
Yes, I was also wondering about that and maybe even his own pancreas over producing insulin, so a C-peptide test would be interesting.
It just seems strange that the problem has arisen since this tummy upset.... if I am reading the information correctly in the opening post.
 
Cargillr said:
My husband is a type one diabetic, diagnosed 2 years ago. He is a runner and is training for 2 marathons in April.

He was slightly poorly, viral maybe, stomach upset last week. Since then, he cannot raise his blood sugars. He is taking absolutely no rapid insulin and only a couple of units of background.
He can live a normal day to day but he cannot exercise without having a hypo. He has eaten carbs, sugary foods, sport gels, drinks etc… nothing will raise them up.
His diabetic nurse sent him for tests which have all come back as normal (still waiting on the celiac test) but she just keep telling him he’s an ‘anomaly’ which doesn’t really help his situation.
I’m looking for advice from anyone who has suffered the same or is into exercising everyday and what might be the causes? Because at the moment he is so so deflated because his positivity comes from exercise.

Any advice welcome - newbies to the whole type 1 arena.
Click to expand...

Did they test for Addison’s @Cargillr ? I had similar when I had a stomach virus. I could eat lots of carbs with a tiny amount of insulin (I’m on a pump). Occam’s Razor would suggest the stomach virus is the most likely cause.
 
I forgot to add that mine started to improve after two or three weeks as my digestion recovered. I reduced my basal insulin too. But I’ve had Type 1 30yrs. With your husband being quite recently diagnosed, it’s possible he only needs minimal insulin at the moment due to the effect of the virus on his digestive system.
 
rebrascora said:
Hi and welcome.

Sorry to hear your husband is finding he is unable to exercise due to hypos despite reducing his insulin.
Can you tell us a bit about his diagnosis and how that came about? I appreciate it was 2 years ago. Have his insulin doses gradually dwindled since diagnosis or has this just happened since this slight illness ie. What were his doses when he was first diagnosed?
Has the illness fully resolved. ie no more upset tummy, or is he still suffering some symptoms of that, however slight?
Is he noticeably losing (or gaining) weight?.... especially if he is unable to exercise? Just wondering if that might point towards coeliac. Do you know what other tests he had done?.... You say they all came back negative, but it is helpful to know what has been ruled out.
You mention his nurse, but has he seen or spoken to the consultant about this problem?
How would your husband feel about having a pump. If he is needing tiny doses of insulin intermittently, and struggling to deal with hypos that are not responding then that

Was he managing to exercise OK before this recent illness? Are his levels dropping very low

We do have one member of the forum, the previous forum administrator no less (also considered an anomaly by medical professionals I believe 🙄 ) who no longer needs basal insulin and interestingly he is also a keen marathon runner. He does however need meal time, bolus insulin. I believe he has not been using basal insulin for several years now. I wonder if Alan (@Northerner) can offer anything from his experience which might be helpful to your husband.
Click to expand...
Hi and thanks for welcoming myself and Will. So he was playing rugby professionally and when he retired he had surgery on his bicep to reattach it. He woke up from surgery and for 6 days basically showed all the typical symptoms, thirst, fatigue, weeing more and lost a tonne of weight. So went to the doctors and they diagnosed him diabetic.

they had him on LOADS of insulin to begin with. But I would say for about 3 months he was having multiple hypos everyday until we just decided to stop taking insulin for a while. This was classed as his ‘honeymoon’ period. So but since then he’s gradually overtime increased his insulin. From maybe 2 units of background to about 8 units was the highest it’s got to. And he only needs rapid for evening meal because he exercises after breakfast and lunch.

He was diagnosed as type 1.5 for a while but they then said no it was definitely type 1.

Before this spate of illness he was fine, he would eat a high carb meal and go for a run no problems. But now it’s changed drastically.

He still feels a bit poorly but it’s been nearly 2 weeks now of no exercise and no insulin with meals. And we just don’t understand.

He hasn’t seen a consultant but I was planning on contacting our private health centre near to us tomorrow because he wants to get himself right again.

He’s running both the Manchester and the London marathons on April to raise fund for Diabetes UK so we really want him training as he wants to better his times from last year whilst raising money.

Sorry I know this is probably all a bit jumbled but we’re pretty new to this world and it’s crazy how things change day to day.
 
Inka said:
Did they test for Addison’s @Cargillr ? I had similar when I had a stomach virus. I could eat lots of carbs with a tiny amount of insulin (I’m on a pump). Occam’s Razor would suggest the stomach virus is the most likely cause.
Click to expand...
No I don’t believe so but I’ll research addisons now and get back to you. Thank you
 
The Addison’s test tests cortisol, I think @Cargillr It’s a (rare) cause of hypos for no reason. Worth ruling out if they persist over weeks but I honestly think it’s connected to his stomach virus.
 
Inka said:
The Addison’s test tests cortisol, I think @Cargillr It’s a (rare) cause of hypos for no reason. Worth ruling out if they persist over weeks but I honestly think it’s connected to his stomach virus.
Click to expand...
Will do thank you, yes we definitely think it’s connected because it all started when he got ill. This is why they are testing for celiacs disease too. But we just can’t figure out why and if there’s anything we can be doing to get better or is it something that will maybe run its course? Sorry I know this isn’t helpful at al I’m just getting nowhere with the nurses because they just keep saying he’s an anomaly but with no solutions. X
 
Only time helped mine @Cargillr At first I basically needed no mealtime insulin at all, then that changed to maybe a quarter of what I’d normally take for that meal, then a third (that was the longest stage, I think), then half, then two thirds, then back to normal. At the time I googled a lot and found out that some viruses ‘paralyse’/affect/temporarily damage your digestion so you can’t extract nutrition or glucose from your food properly. This totally fitted with my symptoms and made sense. The stomach virus I had was far from the worst I’ve ever had, but it was clearly a specific type that caused this as I’d never had something as extreme as that before - ie affecting my insulin doses so much.
 
Personally I think your husband should rest and only take light exercise (ie a short walk). He might also need to reduce his basal insulin further or even stop it temporarily if needed.

One thing I did do was eat bland, gentle foods so as to allow my digestion to recover. I also avoided alcohol.
 
Inka said:
Only time helped mine @Cargillr At first I basically needed no mealtime insulin at all, then that changed to maybe a quarter of what I’d normally take for that meal, then a third (that was the longest stage, I think), then half, then two thirds, then back to normal. At the time I googled a lot and found out that some viruses ‘paralyse’/affect/temporarily damage your digestion so you can’t extract nutrition or glucose from your food properly. This totally fitted with my symptoms and made sense. The stomach virus I had was far from the worst I’ve ever had, but it was clearly a specific type that caused this as I’d never had something as extreme as that before - ie affecting my insulin doses so much.
Click to expand...
Yes this sounds so so similar. This is not the worst stomach virus he’s ever had but it’s affected his insulin so much. Yes he’s only resting at the moment but it’s a bit of a ticking time bomb because exercise is his life and his outlet so having downtime isn’t really his forte.
He rarely drinks alcohol now maybe a beer with a meal once or twice in a month but nothing more than that.
He is still able to do some short ish walks because we have a dog so he takes the dog out regularly.
It’s good to know that other people have had the same or similar things happen and gives me hope for him.

When you were going through the stomach virus/insulin dosage problem, did you eat lots of food(carbs etc) and still not really raising your bloods? And would they come straight back down again?
 
If the nurse is at the GP surgery I suspect they have not got enough experience to deal with something unusual so he really need to be seen by a specialist diabetic centre at the hospital where they ought to have more knowledge about what may be going on.
They could then do the additional tests c-peptide and Antibodies tests if he has not already had those.
 
Leadinglights said:
If the nurse is at the GP surgery I suspect they have not got enough experience to deal with something unusual so he really need to be seen by a specialist diabetic centre at the hospital where they ought to have more knowledge about what may be going on.
They could then do the additional tests c-peptide and Antibodies tests if he has not already had those.
Click to expand...
Thank you I will make some calls tomorrow
 
Cargillr said:
Yes this sounds so so similar. This is not the worst stomach virus he’s ever had but it’s affected his insulin so much. Yes he’s only resting at the moment but it’s a bit of a ticking time bomb because exercise is his life and his outlet so having downtime isn’t really his forte.
He rarely drinks alcohol now maybe a beer with a meal once or twice in a month but nothing more than that.
He is still able to do some short ish walks because we have a dog so he takes the dog out regularly.
It’s good to know that other people have had the same or similar things happen and gives me hope for him.

When you were going through the stomach virus/insulin dosage problem, did you eat lots of food(carbs etc) and still not really raising your bloods? And would they come straight back down again?
Click to expand...

@Cargillr Yes, I ate lots of carbs and was able to eat something like a piece of cake or a chocolate flapjack without insulin if I was at all active. Any rise from that was minimal. It was almost like being cured.
 
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