A low happened without insulin

This is just getting very frustrating. Yesterday I woke up with a fasting of 158 and left it that way. A few hours later before work I checked and it was still 154. I drank my coffee with milk as I always do every morning. I went to work and worked very vigorously for three hours. When I got back home I felt weird and checked my blood sugar and it was 86. I ate my meal and took 40 units and BG was 103 at the three hour mark. I don’t know how high it spiked in between eating and the insulin kicking in though. I had no other issues. This morning I skipped checking the BG level and only took my metformin like yesterday. I will be checking again when I get home from work. I wonder if this is just the normal process for my current stage of disease. Perhaps this high and then dip will happen with or without insulin and taking the insulin is just making it more pronounced. Now when I say I felt weird, it wasn’t a hypo at all. I just felt my sugar went under 100. I was not weak nor would I have had any trouble driving. I feel much better without my BP meds and without the morning insulin. I had much more energy at work and was able to work faster. I’m gonna be looking into more dietary changes soon. I’m tired of this up and down game. Any how, no more insulin in the mornings for me.

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Have you ever been tested for being a type 1?

Hi,you are your meal? How many carbs ? Type insulin? Just trying to hel0 figure out your puzzle. Have you ever worn a cgm? Nancy50

Its always going to go up and down.

I’m not sure if I’m following you. I read it twice, but I’m confused about what the problem is, speifically. Maybe I missed something. There might be a typo - 40 units?

40 units was for the meal I ate last night after the low. Last night I had the low feeling and just rode it out while cooking my meal and took the 40 units for said meal. After three hours before bed BG was 104. All under control and no more lows. Before the low, I had no insulin all day yesterday. Just 158 upon waking and then 153 4 hours before work. Then it was 86 when I felt the low 3 more hours after the 153 reading. Sorry if it is confusing. I posted one last post on this. I had a really bad low today with no insulin again, but this time I was dropping things and had to sit down for 20 mins. I corrected with 4 packets of granulated sugar and then was ok for 1 hour. Then I felt low again while on the way home and checked and BG was 90. I felt horrible. Just ate a meal with 40 units fast acting and hopefully will be all good in 2 hours and then no more meals till tomorrow night.

No, I have never been tested for type 1. I used to get these lows way back in 2009 before I even knew what they were. It had happened a few times and I thought it was the heat. They seem to happen more in the hot weather too for some reason. Maybe it is slow moving type 1?

My average meal is three small hamburgers and some fries. One is two bologna sandwiches and a small bowl of soup. Another is steak and 1 large baked potato. Twice a month it is a medium sized pizza all by itself. Although haven’t done that since Covid started. I know the burgers are not good for type 2, but they are small burgers and a handful of fries. It is what makes me feel satisfied and not cheated. I usually eat no more than 2000 calories a day. I am still heavy though. I only eat it all at one meal because that is the only way I feel sated and do not crave food for the rest of the time. If I eat too small a meal many times a day, I just stay hungry all the time. For the pizza day I use between 60 and 80 units. It changes sometimes 60 is enough, sometimes 80 is a tiny bit too much. I do not eat any candy, cake, sweets, ice cream, noting but regular food. Most of the time I would only eat the hamburgers with no fries. I only added fries because I make such small burgers. I know I need to change food choices though. Cutting out all the sweets was the easy part. The foods like the burgers and pizza 2 times a month are much harder for me. So, if you take out the 2 pizzas a month, I mostly use between 30 and 40 units for my one meal a day. It also depends on what the meal is. I do not need more than 20 units for the steak and large baked potato. One day I was feeling low and shaking and BG was 70, so I ate two small TV dinners of pork chops with mashed potatoes and know that for mashed potatoes, I need less insulin. So, I knew not to take it, and 2 hours later BG was 109. That meal corrected the low and did not need insulin and BG remained good for the rest of the night. Those tv dinners combined that night were 1400 calories. I remain just as fat as I used to be when I was eating three large meals a day, candies, cakes, sodas, and everything in between. I really need to figure all this out sooner than later.

I used to have at least 10 salad and wing days a month too before Covid started. I would eat one huge salad with chopped ham in it, bacos, and blue cheese dressing. Then I would eat 10 naked hot wings. Naked means no breading and no carbs in the wings. I would sometimes still need 15 units of insulin, because even this very low carb meal would cause my BG to rise to 150 and stay high for a long time. I am not eating any salad until this Covid thing is over. That is why I am back to the burgers more days than I used to because I can freeze the paddies and the bread and they are quick to make from frozen.

I would get tested if you can. They used to say upwards of 8 years for a honeymoon phase, but on another site I ran across a couple of people that had been “misdiagnosed” for over 10 years before it started causing some more major issues. This of course can only happen when you were put on insulin which is virtually what would happen if you were diagnosed as a type 1 as it keeps you alive. But if you are a type 1 insulin is used a little differently as it becomes a requirement. And sometimes in the honeymoon phase people still attempt to make insulin. Hard labor/exercise really cuts down on potential insulin needs and that can last days. There is a soccer player that when he is at practice all day he is on a small basal dose but can eat a huge plate of food for lunch and takes no insulin for it.

But if you are insulin resistant and not making insulin efficiently anymore along with that it can cause issues too. High fat meals can slow down absorption of carbs for a long time in people so it would shoot up your BG’s later, sometimes a lot later. Or you aren’t utilizing your insulin well and it’s kicking in hours later. All those things can throw off just taking insulin for what you eat at the time.

So the antibody test would tell you if it’s a yes, then a definite yes on type 1. If no you could still be one of the rarer type 1’s not making insulin they don’t know why people. But also a C-Peptide test which would tell you if you are making insulin. The C-peptide test if you are low or low normal is a sign of type 1, but high or high normal is a sign of type 2. That would tell you your status of making insulin.

It just might give you more information to help figure out things a little better.

It sounds like you have several things going on. Your eating life style and your insulin use. Is there a chance you can see an endocrinologist? Have you considered an a different eating plan? You mentioned you are heavy. Have you considered taking a diabetes education class, even if it is a refresher? I hope you can seek medical care that can help. I believe education is key. Eating to what your meter says is important. Knowing what you eat for carbs is important also. If you are extremely obese would Overeaters Anonymous be something that might help you? Good luck in trying to solve your lows. Nancy50

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I don’t overeat. O only eat up to 2000 calories a day. I used to eat 6000 calories a day sometimes and I am just as heavy as I was when I was overeating.

Look up “reactive hypoglycemia.” You probably still have functioning beta cells in your pancreas. Your high carb diet causes a late over-release of insulin.

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Just to give you some info about myself, I have never, in my life, taken 40 units for a meal. So, I’m trying to get a handle on how you work - its a bit different than me. I’m a really big eater, but I try not to take more than 15 units for a meal (160 lbs female). There’s something “suspicious” about 40 units. It feels like something is out of balance here.

I’m guessing that you just take insulin for meals, not any background insulin.

Your bloodsugar numbers seem good to me, but I’m still trying to get a sense of you.
What are your blood sugar goals? What is the target range that makes you happy?

40 units seems like a very, very high dose. Is that what the doc recommended? Whats your insulin to carb ratio? Like, how many units do you take per 15 grams of carb?

Summary:

Daily metformin
Roughly 40 units of bolus for meals (hamburgers, fries)
Feeling lows & frusterated by them
Distress from alternating between 85 and 150

Could be long-acting, like Lantus, which is often what T2 are prescribed when the start on insulin. Though in general T2s have to take a lot more insulin for the same effect as T1s because it’s an absorption problem not a production one.

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This is not an uncommon dose for someone with T2. It is meaningless to compare the insulin doses of someone with type 2 vs type 1

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I have heard of some T2’s taking hundreds of units a day of insulin. It happens because they just don’t use it well at all. A T1 can end up with that as well. An awful combo.

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So here’s the thing: with insulin resistance the more carbs you eat the more insulin you need to take. The more insulin you take, the higher the chance a slight miscalculation can turn into a high or a low.

If you weren’t having any issues I’d have nothing to say, but since you are, I would suggest the following (after speaking with your doctor):

  1. Eat a low carb diet. Especially if you are going to eat only one meal a day, it needs to be low in carbs so you can reduce the amount of insulin you take. Fries, mashed potatoes, bread…those things are killers.

  2. Get a CGM. Then there is no more guessing and powering through; you will know right away what your BG really is, and you can treat immediately if it goes low.

  3. 70 is on the verge of low. 86 and 90 are not. If you’ve been high for a long time they probably feel low, but as you get used to normal BGs you’ll start feeling better when you’re in range.

Once you’ve removed the large amounts of carbs you can start making smaller adjustments; for instance, fat makes highs last longer, and protein may cause higher BGs, too. Learning how to account for this with insulin will take a while, but it will be worth it.

Another vote for reducing your insulin dose by reducing carbs: you may lose weight. High amounts of insulin tend to cause weight gain, or make it very hard to lose weight. Ask me how I know. :slight_smile:

For reference, I have LADA, which is a form of Type 1. I also have insulin resistance. Essentially I can’t make insulin and I can’t use it. :joy:

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Jules it isn’t true that the more carbs you eat the greater your insulin resistance. A plant based very low fat diet reduces insulin resistance. I now eat almost 10 times the amount of carbs I ate when very low carbing and use only about 3 more units of insulin. So I now eat close to 300 carbs a day while taking about 22 or 23 total units of insulin. Although I am a type 1, this woe works very well for type 2’s.

Healthy carbs can be eaten, but fat is the killer in this diet. Both low carb and plant based low fat diets work well for insulin resistance.

Yesterday I had 2 bologna sandwiches with white bread and a bowl of soup. I was 90 blood sugar when I ate the meal and took the 40 units. About three hours later I was 92 and did not feel too bad. I then went to bed. I have not checked sugars yet today. So, the 40 units fixed the spike from the meal that fixed the low feeling and all was done. I don’t think a normal person can take 40 units and not have an issues. So, perhaps my resistance is really high? I would say I do not use insulin ratios anymore as my resistance can often change. But I have 5 sets of meals, all the same carbs, all the same that I cycle through. I know what units I need to use for each set of meals. I did this by trial and error. I do not take background insulin because I am usually well controlled in between meals. I think using fast acting with my meal helps my pancreas from over-working itself and then makes it easier to regulate blood sugar in between meals.

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Willow, It could be reactive hypoglycemia, but it is not from eating. I eat my one meal a day at 9 PM every night. I use my insulin with said meal and am most always back to 90-110 BG at the three hour mark. I go to bed every day at 5 AM. I wake up at 12 noon and do not eat anything all day until 9 PM again. I only get hungry once a day now. I do have three large iced coffee with some Splenda and also a little but of milk in them. That is all. The coffee wards off hunger all day long and gives me energy.