Unexplained Rapid Onset Major Hypo

[AliTired]

Had an unwelcome rapid onset and unexplained hypo today that's destroyed my confidence.

Woke this morning with high BS after a late-treated hypo at bedtime. Expected to wake-up OK this morning but BS up to 16.3.

Had breakfast and added extra units to bring BS down. Post-breakfast 1.5hours after breakfast was 19.6.

1 hour after this and before lunch my BS had dropped off a cliff and was 1.4.

I can't find a reason why my BS dumped big time. No exercise, carb counting fine.

Any ideas?

 

[Northerner]

Hmm...what may have happened is that the night hypo caused your liver to dump its stores of glucose into your blood to raise you from the hypo (even though you treated it). The rise after breakfast wasn't actually that high, given that you were 16+ beforehand and your breakfast insulin would only just have begun peaking at 90 mins. Then it's possible that your liver, having previously dumped glucose tried to replenish its stores, as the breakfast insulin peaked and everything plummeted

That's just one scenario, of course. You may also have had one of those rare occasions where your insulin suddenly got rapidly absorbed and caused yo to drop like a stone. I've actually had hypos half an hour after injecting lantus and rapid absorbtion was the only possible explanation - very confusing to say the least!

Someone else may have some better ideas - hope it was a one-off and you levels stabilise! 🙂

 

[Robster65]

I can't really think of anything other than what Northerner's suggested. The pre-bed hypo, followed by the morning high does suggest a night-time hypo and a liver dump. Or an over treat for the hypo possibly that lasted all night

The absorption scenario could be injecting into the same place too often and getting fatty lumps causing erratic absorption. Not much insulin, then a sudden splurge of it. Would explain the rapid drop.

Rob

 

[trophywench]

Oh Yuk.

It becomes a seesaw if you aren't careful. Next time you get a hellish high, try correcting it in 2 goes. Half now and half later. Yes it does mean you stay higher than you want to be for longer, but it also stops sudden plummets like you had today.

What's a few hours in a whole lifetime?

Plus - you don't perchance over-correct your hypos do you? What's your actual routine for treating them? (Rule of 15's - 15g of fast carb, wait 15 mins, test. If not where you want to be, 15g more, wait 15 mins, test ... If you aren't going to have a main meal within the next hour, you also need some slower acting carb, but NOT if your meal is due)

 

[AliTired]

Thanks for replies - maybe I'll not be able to work this one out and have to roll with it. Was at work today & it is so not an inclusive environment for T1s.

Injection sites are rotated every month so I don't think hypo was an insulin surge. Unless... this has got me thinking now... I'm on x2 basal doses a day at 10:00 & 22:00 in front thigh (always painful & bruise easily) so maybe not a good idea. Had surges years ago on mixed x2 injections a day & front thigh injections.

Liver BS uptake idea is a new one for me - thought it was a background process rather than a BS-grabbing leech-style thing. This reason has so made me smile - thank-you.

I so hate the risk management aspects of managing T1.

 

[AliTired]

Hypo treatment is OK - I use BS to determine how much glucose to take & meal timings to add low-GI snack or not. Find the timing of when I become aware of hypo is the main factor in managing them effectively. Early is Easy, Late is Long time to feel guilty - aaarrrggggghhhhhh.

 

[PattiEvans]

I'd go with the liver snatching back it's glucose. Been there done that and got the T shirt. I call it the rollercoaster. Hope stuff has levelled out for you now.

 

[Caroline]

Sounds horrible, I hope you are feeling better.