Sudden crashes during the night

[Jimmy2202]

good morning all. Recently I’ve been noticing sudden crashes during the evening, but last night was extreme.

From 21 to 6.3 with down arrow
I had done a 1 unit correction and a .5 correction which I usually would do but am still trying to get used to fiasp but people were right it’s like water!

I had my tea about 6pm which was a usual meal - I hadnt done anything diffrent that day,

The only thing I can think of is stacking as I do have about 3 lumps in my belly, however I do remember injecting a correction in my bum instead due to this.

Very scary as I ate a low carb bread sandwich to begin with as my bread always gets my level up a bit quickly but it didn’t last night so got the jelly babies and choc biscuit out - that still didn’t work.

Levels still 5.9 which I don’t like being there at all, got orange juice and more jelly babies and finally shot up.

Had a high carb slice of bread and finally went sleep.

Leviermeir I spilt dose currently 16 at night and 17 in morning

 

[Aish]

Hello Jimmy,
I’m so sorry you experienced that but it’s a good thing your levels are back up.

 

[helli]

Sorry to read about your evening "crashes". Glad you were able to raise it to a level where you are more comfirtable,

My experience with Fiasp is not that it is like injecting water.
My experience with Fiasp is at high levels it initially seems as if I am injecting water because the activation time is long.
Like you, I am tempted to stack because nothing is happening and then suddenly all the insulin I have injected is activated at once and my BG plummets.
This is one of the reasons why I minimise the time my BG is in double figures. However, if this is common for you, maybe Fiasp is not the appropriate insulin. I found NovoRapid works faster when my BG gets that high despite its nickname of NovoSluggish.
Another thing to remember is CGMs will "over-egg" high readings. Therefore, if your 21 was taken from a CGM and not checked with a finger prick, your true BG may have been lower. I always double check any CGM readings over 10 before calculating my correction dose.

Do you know what caused your BG to get as high as 21? If it was me, I would be trying to avoid such highs. Do you carb count and pre-bolus?

I am confused by eating low carb bread to increase BG. If you want to increase your BG you need something with high carbs, preferably fast acting carbs which is why jelly babies are a good option. Chocolate biscuits are good to maintain a level but will be slow at increasing your BG because the fat in chocolate will slow down the carb absorption.

 

[rebrascora]

Hi Jimmy. Sorry to hear you are experiencing some significant crashes. Am I right in thinking you are working night shifts now or am I confusing you with someone else?

I think what I am asking is are these drops happening whilst you are sleeping or when you are awake and are you double checking them with a finger prick if they are whilst you are sleeping to rule out compression lows which are false low readings caused by lying on the sensor. Also are you relying on Libre or Dexcom to assess your recovery because it certainly takes Libre far much longer than normal to show levels stabilising or going back up, so that can cause you to eat more carbs than you need to.

Personally, if my levels are dropping hard and fast I want to stop the drop as quickly as possible, even if I am not hypo, so I start with jelly babies, because they work quickly for me. Eating low carb bread sandwich is likely going to take 2 hours to release it's glucose and show and improvement on Libre, which isn't going to give you any peace of mind, whereas one or 2 jelly babies should work in 10-15 mins on your blood glucose and take about 40mins to show results on Libre plus they are far quicker and more convenient to eat. Chewing them really well gets them working quicker too.

I am amazed that a 1unit correction with Fiasp followed by another 0.5 unit correction when you are at 20mmols would drop you down to 6, so I wonder if your Levemir doses are keeping you steady or if too much Levemir is also playing a part in this drop. Are you able to post a photo of your Libre/Dexcom graph showing how long it took to come down.

Do you know why you went up to 20 in the first place? Preventing the high can mean you don't need corrections and then you are less likely to go low.

What correction factor do you use? ie. How many mmols do you expect 1 unit of Fiasp to drop your levels?

 

[Jimmy2202]

Thanks for the replies I will respond in more detail later but for now the reason I ate a sandwich was a,) my consultant told to start eating at 5 mol which I’m not prepared to do as that’s too low for me however I am trying to get my levels lower and just to add my low carb bread I know increases my levelsin 10-15 minutes as I do it every day , but as I noticed my levels still were not increasing I got my jelly babies ect out .

 

[helli]

my consultant told to start eating at 5 mol which I’m not prepared to do as that’s too low for me

Sorry to be a pest (I know you said you would respond in more detail later), can you clarify what you mean?
Did you consultant say not to eat until your BG was at 5mmol/l or to eat something to raise your BG if it gets to 5 mmol/l.
And what the reason that you think 5 mmol/l is too low for you when hypo is less than 4 mmol/l so it still gives your body time to react? Do you feel false hypos at the higher level or are you nervous of the hypo risk? Maybe it would help to ease your BG down slowly - start getting comfortable with reacting at 6 mmol/l for a week. Then, try 5.8, then 5.5, etc.

 

[trophywench]

A level of 5 is pretty bog standard normal - hence you have said you're not happy with normal.