What would cause this?

[gillrogers]

I had did my dinner, checked my carb count, checked my bolus calculation. Eat my dinner, gave my bolus 15 mins later (as ive gone the other way now) , then went upstair to do my levemir which was correct dose. 15 mins later im dropping fast and it took the equivalent of 1.5 units of insulin in carbs before i started to slow down. My night time basal dose look perfect over night. So i dont know what happened at all.

 

[pawprint91]

I hope you’re okay low, levels dropping fast can be scary! Others will probably have a better insight but I would ask:

• did you check with a finger prick as libre can be inaccurate sometimes
• What did you have to eat? The insulin may have hit your system before the carbs (but if you were okay for the rest of the night then not sure about this one).
• Are you sure you calculated your bolus right? Lots of food (particularly home cooked)can be a bit hard to bolus for.
• Did you do anything else other than go upstairs? Sometimes I find something as innocuous as cleaning or hanging out the washing when I have bolus on board can cause a drop that I’m not expecting.

 

[Inka]

If you catch a muscle or happen to inject in a super-absorbent spot, the insulin can act much quicker than normal. It can be frightening. One reason why the really fast insulins don’t appeal to me. The other possibility is a miscalculation. Hope you didn’t feel bad for too long x

 

[gillrogers]

Hi @Inka and @pawprint91 . I felt ok just my usual anxiety over a hypo kicked in from the speed of the drop. Yes ok just annoyed. Cos of my anxiety I double check everything. Ive asked my dsn if i can go back to ordinary lispro now as I clearly dont need the lyumjev anymore and the probkems im having witj it being too fast is impeeding me with sorting a snack ratio out.

Intrestingly this morning i didnt get my 1 -1.5 mmol from when i wake up to doing my morning basal and then breakfast an hour later. I rhink now it may have been a combination of a drop in basal and something else. My basal drop always shows in the afternoon/evening first so this level start to the day can be another indicator. When that happens i just drop half a unit off my boluses to compensate and dont prebolus or as im now doing bolus a bit later after eating.

 

[rebrascora]

What time of day was that?
Also curious to know if those mountains and valleys preceding it were compression lows during the night as they have almost identical profiles which is typical of compression lows or if you corrected but levels went back up afterwards. It looks like your evening basal may not be quite enough judging by that graph although never make a decision based on one set of results.

For the drop in question, I presume you had injected insulin? Did it bleed when you injected which would suggest you hit a small capillary? Other options would be exercising or being more active just before or after injecting insulin can make it kick in more quickly than usual. Personally I would be very happy with a rapid drop into range like that. I usually have to wait hours for levels to come down from double figures.

Being able to see the time and know what you did when (ie when you injected basal and bolus and when you ate) would give some perspective to the graph. It is odd that you went back up into double figures almost exactly where you started from and then slowly meandered down into range. Did you eat fast acting carbs to stop the drop and if so how much. Since your levels "level out" afterwards, if you ate some JBs or whatever, then it would appear that your bolus + correction was too much in the first place, especially as your levels eventually settle reasonably nicely into range afterwards, albeit a little high.

 

[gillrogers]

Oh gosh sorry Barbera this was just after dinner, started dropping around 6.45pm. All those other peaks and troughs was my breakfast, where im working out this snack and my lunch time.

 

[rebrascora]

OK That is interesting., especially with those peak profiles all being so similar.

What did you have for dinner? And did you have some fast acting carbs to stop the drop or did your levels recover on their own?

 

[Pumper_Sue]

Any chance you just nicked a blood vessel?

 

[gillrogers]

OK That is interesting., especially with those peak profiles all being so similar.

What did you have for dinner? And did you have some fast acting carbs to stop the drop or did your levels recover on their own?

Well im.told my variance is extremely good for a type 1 lol. Dont know if that's anything to do with my peaks and troughs lol. I had a small chicken leg, a load of homemade fries done in the airfryer and a bag of mixed veg. Gave ibsulin after it. Then gad my pudding half hour later with no bolusvas i was dropping then ended up polishing off 3 glucose tabs when it was obvious thevpudding wasnt working.

 

[helli]

@gillrogers
Did you test that dip with a finger prick or feel as if you were having a hypo?
Whilst it may not have been a compression low, it could be a sensor anomaly.
They happen which is why it is recommended to test highs and lows before treating.

 

[gillrogers]

Any chance you just nicked a blood vessel?

No dont think so as i didnt bleed and theres no bruise colouring today. Not sore but i did at breakfast time and it didnt happen then. Ooh i have just thought. I gave my basal within about 5 minutes of my bolus so to do that i whizzed upstairs and on the same leg for the day pinched up near where i did the bolus. I wonder if i inadvertently set of my bolus to quickly doing that. ?

 

[pawprint91]

No dont think so as i didnt bleed and theres no bruise colouring today. Not sore but i did at breakfast time and it didnt happen then. Ooh i have just thought. I gave my basal within about 5 minutes of my bolus so to do that i whizzed upstairs and on the same leg for the day pinched up near where i did the bolus. I wonder if i inadvertently set of my bolus to quickly doing that. ?

I do believe that if you inject two different insulins in the same place at the same time it can cause problems - I believe you are advised to do basal and bolus in different places - I think it was @Inka who told me this.

 

[gillrogers]

I do believe that if you inject two different insulins in the same place at the same time it can cause problems - I believe you are advised to do basal and bolus in different places - I think it was @Inka who told me this.

Yes think i may have been too close. I have alwsys used the same leg on alternate days but rotated around it. Think perhaps i ought to alternate leg and rotate during the day. So difficult tring to remember where you did last. Specially with skinny legs lol!

 

[Pumper_Sue]

I do believe that if you inject two different insulins in the same place at the same time it can cause problems - I believe you are advised to do basal and bolus in different places - I think it was @Inka who told me this.

I find that hard to believe as there are mixed insulins (basal and bolus) For many years I used a syringe and mixed varying amounts in the same syringe.

 

[pawprint91]

Yes think i may have been too close. I have alwsys used the same leg on alternate days but rotated around it. Think perhaps i ought to alternate leg and rotate during the day. So difficult tring to remember where you did last. Specially with skinny legs lol!

I can’t remember who but someone on here draws a circle on their skin so they remember where they’ve injected!

I find that hard to believe as there are mixed insulins (basal and bolus) For many years I used a syringe and mixed varying amounts in the same syringe.

Until the potential dangers were explained to me on on here I had been doing it for a few weeks and never experienced any adverse effects, but a DSN did also tell me the same thing when I asked her!

 

[gillrogers]

Think i may have uncovered the problem. Done a basal test that covers from 4.30pm to 8.30 . Anyway ive come down two mmol since 4.30 to now. Starting to hold steady. Now if i remember rightly last year i would have fluctuations at that time and some weeks my bolus would be 1:16 some weeks id be 1:12 . That was before i forced myself into finding time to basal test. Now i dont know if this wpuld be a real basal test as it covers 2 hours of the tail end of my day time dose of insulin and 2 hours start of my night time basal dose which is half a unit lesd tjan my day time dose. Now as my basal did actually seem right through breakfast and lunch and my night time level after bed is nice and flat i dont want to change them so im looking at adjusting my dinner bolus ratio down instead me thinks. And im back to that ball game lol