Sugars keep going low

[Clarelryxx]

Hi I’m newly diagnosed type 1 LADA I’ve been on new insulin dose after a telephone call from my consultant I do t see diabetic nurse until Dec 9th at the moment im on 8 units if lantus and a fixed 5units if novo rapid breakfast lunch tea I keep going low when I am nearing my next meal around 2hrs 30 mins to 3 hours after I’ve eaten the last couple of days I have increased my carbs at each meal but tonight before my evening meal I was 9.6 I went low so had to have something to treat my low as my bloods have been ranging from 4.6 to 6.6 so after my pre evening meal bloods of 9.6 I had plenty of carbs on my plate even though im not counting them yet as on fixed dose till I see diabetic team 2hrs after meal I went down to 3.8 I felt hot and shaky my sugars before bed are usually around 8 and same on a morning when I wake so im guessing from what I’ve read my background lantus is about right I think so im just wondering if I should tweak my insulin to 4 units instead of 5 as I feel like im constantly eating any advice would be appreciated as I’ve 3 weeks till I have my call with nurse and im constantly worried about going low

 

[Inka]

@Clarelryxx If you keep going low, you’re having too much insulin or not enough carbs. We can’t advise you on doses, but if I was injecting for a meal and going low I’d reduce my pre-meal insulin and monitor closely.

 

[Inka]

If your blood sugars are ok after your meal but then are too low before your next meal, you could also try a carby snack to ward off the low eg a digestive biscuit or two, an apple, etc

On one of your other threads, you were advised to count the amount of carbs you were eating, partly for practise but also so you could see how the 5 units was working for you. Are you doing that?

 

[Clarelryxx]

That’s what I was thinking as from what I’ve read up on 10 grams of carbs = 1unit so I definitely had more than 50 grams of carbs so I don’t think I’d be doing major damage if I reduced insulin by 1 unit to see if it makes a difference I can only try it and check my blood s thanks I’m sure I’ll get there it’s just feels like I’m constantly snacking in between meals to keep my levels up

 

[Clarelryxx]

If your blood sugars are ok after your meal but then are too low before your next meal, you could also try a carby snack to ward off the low eg a digestive biscuit or two, an apple, etc

On one of your other threads, you were advised to count the amount of carbs you were eating, partly for practise but also so you could see how the 5 units was working for you. Are you doing that?

Yeah I’ve been snacking I’ve started to try and gage my carb intake at mealtimes to give idea but tonight I had more than plenty carbs for 5 units if my calculations are correct but still dropped to 3.8 after 2 hrs had jelly babies and 2digestive biscuits and then 1 weetabix with milk and that got them up again I will test again before bed but feel sure good will keep me going

 

[Inka]

1 unit of insulin to 10g carbs is just a very rough starting point that’s sometimes used. You might need 1 unit to 20g carbs (1:20g) or 1:30g or 1:12g - it can be any number. You’ll also probably need a different ratio for different meals - ie breakfast, lunch and evening meal.

If you’re spending a lot of your day snacking and eating extra carbs to keep your blood sugar up, then reducing your insulin makes sense. Never make big changes. Make small, cautious changes and give it a few days to see how it works.

 

[Inka]

Yeah I’ve been snacking I’ve started to try and gage my carb intake at mealtimes to give idea but tonight I had more than plenty carbs for 5 units if my calculations are correct but still dropped to 3.8 after 2 hrs had jelly babies and 2digestive biscuits and then 1 weetabix with milk and that got them up again I will test again before bed but feel sure good will keep me going

Read my post above. Do not use the 1:10g calculation! You have no idea yet whether that’s right for you. Many newly diagnosed Type 1/LADAs start on 1:20g or 1:30g or 1:15g.

You had to eat a fair bit to get your blood sugar up so that strongly suggests you had too much insulin for the meal you ate.

 

[Clarelryxx]

I will try adjusting it by 1 unit per meal to 4 instead of 5 but leave my lantus at 8 units and see how I go I suppose my levels can only go high and if so I will revert back to 5unit s

 

[Clarelryxx]

Read my post above. Do not use the 1:10g calculation! You have no idea yet whether that’s right for you. Many newly diagnosed Type 1/LADAs start on 1:20g or 1:30g or 1:15g.

You had to eat a fair bit to get your blood sugar up so that strongly suggests you had too much insulin for the meal you ate.

I will try adjusting it by 1 unit per meal to 4 instead of 5 but leave my lantus at 8 units and see how I go I suppose my levels can only go high and if so I will revert back to 5unit s

I will try adjusting it by 1 unit per meal to 4 instead of 5 but leave my lantus at 8 units and see how I go I suppose my levels can only go high and if so I will revert back to 5unit s

I appreciate any advice as I’m muddling my way through this change of life just wish I could get to speak to diabetic team earlier than having to plod on with only this forum to reassure me and give me advice

 

[Inka]

I will try adjusting it by 1 unit per meal to 4 instead of 5 but leave my lantus at 8 units and see how I go I suppose my levels can only go high and if so I will revert back to 5unit s

And you might have to lower that even more (do you have a half unit pen?) Obviously you don’t want your blood sugar to be very high, but you really do want to avoid hypos, and it does sound like you’re having too much insulin.

Just to say - my exclamation mark above wasn’t shouting or telling you off. Just drawing attention to that important point about meal ratios because I was worried that you were dropping low and had to eat that much to bring yourself up.

 

[Leadinglights]

They should really be giving you better support in these early stages following diagnosis, you could try contacting them saying you need some advice now.

 

[Bruce Stephens]

With such low doses if you don't have a half unit pen it's probably worth asking for one (or three).

 

[Clarelryxx]

And you might have to lower that even more (do you have a half unit pen?) Obviously you don’t want your blood sugar to be very high, but you really do want to avoid hypos, and it does sound like you’re having too much insulin.

Just to say - my exclamation mark above wasn’t shouting or telling you off. Just drawing attention to that important point about meal ratios because I was worried that you were dropping low and had to eat that much to bring yourself up.

I don’t have a half unit pen just checked i can eat a big meal and check blood and if it’s low I feel stuffed having to eating More I’ll burst at this rate

 

[Clarelryxx]

With such low doses if you don't have a half unit pen it's probably worth asking for one (or three).

I will mention when I speak to team in 9th Dec I’m counting the days till I can get to speak to somebody

 

[Clarelryxx]

They should really be giving you better support in these early stages following diagnosis, you could try contacting them saying you need some advice now.

I have no contact for them I’ve tried ringing to get earlier appointment but nothing till 9th Dec I do have my practice nurse but she only knows basic type 1 information as she only deals with type 2 but she gave me her personal number incase I need any advice and she would try and help I spoke to her on Friday and she suggested eating more snacks yo keep me going till my next meal and is trying to chase up hospital

 

[Inka]

I will mention when I speak to team in 9th Dec I’m counting the days till I can get to speak to somebody

That’s understandable. It must be stressful. All I can say is to use your common sense and avoid hypos as much as possible.

My half unit pen was prescribed by my GP at my request. As you’re in contact with your nurse, I’d ask them for a half unit pen for your meal time insulin at least. You’ll find it very helpful.

 

[everydayupsanddowns]

Sorry to hear you are wrestling with hypos @Clarelryxx

And i can understand how stressful it must be having so many weeks before you can get an appointment for more input.

Sounds like you are right to be considering careful and cautious reductions in your insulin doses with the regular hypos you’ve been having.

Keep us posted with how things are going, and perhaps call NHS111 if you are concerned.