Unpredictability of blood sugar level movement

[Artville]

I’ve been Type 2 since 1983, most of the time on insulin of various types.

I’ve been on Humulin I for a few weeks now, taking 24 units in the morning and 10 before bed. I see a diabetes nurse regularly.

Last night my before bed sugar was 14.4. At 6:15 this morning it was 2.4 [!!!]. How can such a plunge happen? And this is not the first time such a thing has happened

 

[Toucan]

Hello and welcome to the forum.
It's good to know that you are seeing the diabetes nurse regularly. is she/he aware of the big fluctuations in readings that you are getting?
I have no experience of using Humulin, but there is a wealth of knowledge on the forum, so there may be someone else that knows more about this.
Has the nurse given you any guidance on what's best to eat? Many of us on the forum find that changes in this can help reduce blood sugar levels.
We can give you more information about this if it will help.

 

[everydayupsanddowns]

Humulin I is an ‘intermediate’ acting insulin. It has an onset time (before it starts working at full strength) of about half an hour, then a peak action up to about 12 hours after injection. After that it gradually fades and will have stopped working by about 24 hours after injection. These are taken from Diabetes UK’s ‘Meds and Kit’ and will be an average for most users. Individual timings and durations may vary.

So it looks like your injections are intended to boost the background level of insulin, rather than tackle meal carbs specifically (though your bigger daytime dose will probably need to you eat fairly regular lmeals to keep it ‘fed’.

It also looks like the profile of the insulin means that your doses are overlapping to some extent, so that as one tails off, the other is reaching full strength.

it may be that this was working well for you, but it’s not a very flexible insulin replacement system, and as you can see, occasionally, overnight to don’t need anything like that amount of circulating insulin. This might be just changes through the year, it might be the effect of exercise, activity, or even alcohol.

in general terms you would want your night time dose to hold you level though the night (and possibly deal with any small amount of evening meal carbs still being digested, but the 12 hour peak is going to take that injection right though the 3am period where cortisol / glucose output from the liver generally dips.

I would recommend setting an overnight alarm for the next few nights, and slightly reducing your evening dose if you feel comfortable to do so.

Certainly if you hadn’t started in the teens, you could have got yourself in bother!

Keep yourself safe, and let us know how you get on 🙂

 

[Artville]

Hello and welcome to the forum.
It's good to know that you are seeing the diabetes nurse regularly. is she/he aware of the big fluctuations in readings that you are getting?
I have no experience of using Humulin, but there is a wealth of knowledge on the forum, so there may be someone else that knows more about this.
Has the nurse given you any guidance on what's best to eat? Many of us on the forum find that changes in this can help reduce blood sugar levels.
We can give you more information about this if it will help.

Thanks for your input, Mike.

I keep a detailed spreadsheet showing all insulin doses and food eaten since I last saw the nurse. As a sweet tooth (I love cake, biscuits, and chocolate), so I’m my own worst enemy. The nurse has steered me away from having fruit juice and dried fruit, but hasn’t given me any general advice on what to eat.

One good thing I do is to favour porridge for breakfast, which as you will know, because of its fibre content slows down sugar absorption.

I’ll try, as you suggest, reducing the before-bed dose a bit

Thanks again,

Arthur

 

[trophywench]

But oats however good they are at other things - have as many carbs as all other breakfast cereals !

 

[Artville]

But oats however good they are at other things - have as many carbs as all other breakfast cereals !

I know, Jenny, but I don’t eat it with dried fruit, as I once did!

 

[rebrascora]

Yes I too used to eat porridge for breakfast with dried fruit, sugar and blueberries.... pre diagnosis.
Then after diagnosis I ate an omelette with salad for breakfast which I found kept me full until tea time and was almost carb free.
Currently (the hens have been off lay due to moult and I absolutely refuse to buy eggs when I have chickens) I eat "Eat Natural" Low Sugar Granola which only has 34g carbs per 100g which is almost half what porridge oats contain. I measure out 45 g and have that with a few berries (rasps and strawbs) and mixed seeds and a couple of good spoonfuls of Creamy Greek Natural Yoghurt and it comes in at just under 30g carbs for that serving and is very satisfying and slow release.

 

[Jha19]

Do you take it at set times ? I take my humulin I at twelve hour intervals (as best I can).
I've never had a crash that big though (I take my bigger dose at night), but have dropped from bgs of 10 to a 4 in the night depending on exercise...