Struggling to keep levels up

[Abner55]

Hi all
My wife was diagnosed with Type 1 five months ago and for the last month her insulin regime has been 1 unit of Novorapid with breakfast, lunch and dinner and 6 units of Abasaglar at 9pm
This seems to have been ok, and has helped with spikes at mealtimes, but for the past 4 days her levels have been continuously dropping and it is a struggle to raise them above 7mmo/L
This sounds fine! But in practice, means that the levels are dropping quickly towards 4.5 to 5.0 and if she does not act quickly will drop even further
This has become quite stressful as she is constantly having to snack or take glucose tablets to try and raise her levels again as she was when first diagnosed
She has just had 3 ‘Lift’ glucose tablets and 30 minutes later it has only raised her levels by 1.1mmo/L
If anyone has any suggestions as to why this happening, they would be gratefully received
One more question…. After taking Lift tablets or their equivalent, how soon do you need to eat a snack etc.?
Thanks in advance
Abner 55

 

[SimonP]

Talk to your healthcare team. I would reduce basal and potentially reduce bolus too (does she have a half-unit pen.)

This may be the pancreas trying to up its game during the honeymoon period, or it could be the effect of warmer weather (no-one is quite sure why some people have to reduce dosage in the summer - might be hormonal, could be because one is more active in general, could be better absorption due to higher blood flow to peripheral tissues as it's warmer, etc.)

 

[Inka]

I’d reduce my basal in those circumstances too and, depending on the timing of the hypos, possibly my boluses too. She could also try taking more glucose tablets, and eating a carby snack after to keep her blood sugar up.

 

[Abner55]

Talk to your healthcare team. I would reduce basal and potentially reduce bolus too (does she have a half-unit pen.)

This may be the pancreas trying to up its game during the honeymoon period, or it could be the effect of warmer weather (no-one is quite sure why some people have to reduce dosage in the summer - might be hormonal, could be because one is more active in general, could be better absorption due to higher blood flow to peripheral tissues as it's warmer, etc.)

Thank you

 

[Abner55]

I’d reduce my basal in those circumstances too and, depending on the timing of the hypos, possibly my boluses too. She could also try taking more glucose tablets, and eating a carby snack after to keep her blood sugar up.

Thank you

 

[mashedupmatt]

I understand your concern but as stated above you do need to speak to your healthcare team - dropping to 4.5-5.0 is definitely not the end of the world and I certainly wouldn't be taking fast acting carbs too soon as it will cause more of a rollercoaster - totally agree that you may need to adjust your basal and bolus too but take advice first - I am just about coming to the end of my honeymoon period and it is very difficult, so I understand - good luck

 

[Abner55]

I understand your concern but as stated above you do need to speak to your healthcare team - dropping to 4.5-5.0 is definitely not the end of the world and I certainly wouldn't be taking fast acting carbs too soon as it will cause more of a rollercoaster - totally agree that you may need to adjust your basal and bolus too but take advice first - I am just about coming to the end of my honeymoon period and it is very difficult, so I understand - good luck

Thank you

 

[Duncan23]

As others have said, the basal dose may be too high. I’ve had type 1 since January ( well that’s when I got the correct diagnosis). I take 5 or 6 basal units depending on how active I am. If I’ve been busy doing outside manual work I need 5. Of I’ve been working in the office I take 6. I take it in the morning- so have to guess what kind of day I’m going to have to some extent.
I don’t know about the honeymoon period so will have to look into that.

 

[Abner55]

As others have said, the basal dose may be too high. I’ve had type 1 since January ( well that’s when I got the correct diagnosis). I take 5 or 6 basal units depending on how active I am. If I’ve been busy doing outside manual work I need 5. Of I’ve been working in the office I take 6. I take it in the morning- so have to guess what kind of day I’m going to have to some extent.
I don’t know about the honeymoon period so will have to look into that.

Thank you

 

[everydayupsanddowns]

I generally find I need less basal insulin in the longer days and warmer months.

It’s not very precise, predictable, or consistent, but I tend to be on the lookout for doses slightly ‘overrunning’ as the spring progresses towards summer, and I consider a modest tweak if I generally seem to be drifting downwards.

 

[Abner55]

I generally find I need less basal insulin in the longer days and warmer months.

It’s not very precise, predictable, or consistent, but I tend to be on the lookout for doses slightly ‘overrunning’ as the spring progresses towards summer, and I consider a modest tweak if I generally seem to be drifting downwards.

Thank you