SO the past 2 weeks I have been having lows right around 3-4ish in the afternoon. the weird thing is,is that they are not that low, mid 60's but I feel awful... confused, sweaty, anxious. On top of it, I have a hard time pulling myself (BGS) up. I am STARVING...I call it my 4:00 famine,thats how I feel. I tried eliminating my morning walk/jogg it did not help. I decreased my morning NPH...Nothing. Today I ate 45 grams for lunch (my usual 20-33) and decreased my ratio by one. Here is my day today:
fasting 109
After breakfast 159
Before lunch 82
After lunch 140
3:15 64
so I ate a greek yogurt 30 mins 70.
I new this would not carry me through weight lifting and cardio so I drank a Capri Sun.....90
ok good enough to lift weights, but not enough to allow me to do cardio at the end od weights I was back into the 70's.
Now My Bg's are sky rocketing, and I am a CRABBY girl.
I was having a similar situation for after lunch lows. But I take Lantus for my basal insulin, not NPH, and found that just reducing the morning basal by a couple of units took care of the lows. I don't know if I would choose Greek Yogurt to pull me up from a low though, for me it would not be enough to get ready for exercise. I would try something with more concentrated glucose to bring up BGS. Then maybe your blood sugar would not be skyrocketing afterwards. Just my guess.
I didn't know it when I was taking it but when I got my pump the doc/ sales nurse explained that NPH onlly had a 53% chance of peaking when it's supposed to. In your scenario, the the 82 seems ok, but may be as much the breakfast shot covering breakfast and having a light "tail" w/ the NPH not even really going? If the lunch then gets you to 140, a reasonable post-meal number, it may be more the short-term covering that and then lso having a "tail" which then piles on the NPH "peak" which I'd suspect may be delayed until after this (I'm guessing lunch to have been sort of early, w/ post-lunch test and then 64 by 3:15?) hitting to pound it down. If lunch is at 11, the 4 hour duration of whateverlog would perhaps still be lurking around too so you've got a bit of stacking maybe? The fact that the yogurt only gave you a very slight "bump" might also substantiate that. Since you said this is happening a lot, maybe try cutting back the dose 5-10%? That's what I'd do w/ basal rates on my pump in that sitution but I think there's more of a slot machine aspect to the NPH?
This is normal for long acting insulin to have a spike at some point during the day. First suggestion, consider a pump. You can fine tune each point during the day to your needs. It's just increadable the difference the control you'll have.
I think it's a normal insulin spike due to the hunger. Insulin's "side affect" is mainly hunger. It's a normal thing for non-diabetics how their body tells them it's time to eat. Their body's push just enough insulin in to create the hunger to make them want to eat. You may need to adjust your long acting timing, not just amount to keep the spikes lower, or change around a few other things.
Do consider a pump.
I am being really stubborn with the whole pump...well not stubborn more like selfish and immature. I do not want to be attached to it all the time :0( My CGM ruins enough outfits, but Scott I have a feeling this might be in my near future.
Acid rock, I eat lunch at a scheduled time everyday, I am a teacher and petty much finish my last bit by 12:50... my low happens 2 hrs and 10 minutes after.
today I ate a bigger meal and later 1:50 I was done it helped???My CGM says 77 and I feel good.
i agree with Scott. i have had D for 25+yrs. NPH or Lente (do they even make that anymore??) was too unpredictable. i also use to crash into my 40s in the mid afternoon. now i have been on the pump for 11yrs and it has totally changed my life. it is amazing how much you can program it to meet your specific needs. i recommend it highly. check it out!!! good luck