BS dropping after eating during the day


#41

Just so you know… LADA can also present without detectable antibodies at time of diagnosis, and it can (rarely) present without detectable antibodies ever. This latter category is called “Type 1b, or idiopathic diabetes.”

There are also a lot of folks that get diagnosed as Type 2, usually in middle age, and then show insulin deficiency and antibody presence years later. They are often (but not always) re-diagnosed as Type 1. Type 1b is strongly correlated with genetic factors, and is poorly (if at all) understood.

I think it is both safe and fair to say at this point that the whole “Type 1 or 2 diabetes” split is a total myth. There are far, far more types of diabetes under the sun than most people (including doctors) realize or understand. It’s probably why there is such variation in presentation, treatment, and responses even within “the same” diagnosis group.


#42

Today my experience was much different than yesterday. Apple for breakfast then a fairly normal lunch (meatloaf, snap peas and Lima beans). Okay - maybe a little more carby than I should have but not too bad.

Quick spike and quick drop that leveled out around 70mg/dL. I ate something at this point but I do think I would have rebounded back up.


#43

Yes, but I but control is still difficult mainly because I go from
being physically active as a fisherman and cane farmer to doing my own
book work. My HbA1c is always just below 7.0. I have just changed
insulin to Ryzodeg 70/30, 70% Degludec 30% Aspart with NovoRapid top
ups.
This new insulin has evened out my hyper spikes.


#44

Just an update. I have tapered down to 5u of bass at this point - still having abrupt drops sometimes. And pretty much always seem to drift lowish in the afternoon.

I hear people praise the honeymoon. Question is it supposed to be this unpredictable and erratic? I swear today I dropped from 150 to 67 in 45 minutes for no reason.


#45

Also yesterday I had a lot of excercise (about 6 hours of on and off intensive excercise). Which I believe may be causing some erratic behavior also. I haven’t excercise lately


#46

Exercise will F up your system - Depending on the type of exercise and depending on you. By intense, you mean intense aerobic or intense strength based, like weight lifting? Expect a lot of variability associated with exercise after the honeymoon. But, of course, that doesn’t mean you should do it, just that you should be aware of its effect.

6 hours might be long enough to to deplete your liver of glucagon (sugar it releases) and produce severe lows many hours later (perhaps a day later, or 2 days later).

Answer: Yes, its supposed to be like that. I would not call your data “unpredictable.” After honeymooning ends, it will become more “unpredictable.” The younger you are, the more “unpredictable,” it is likely to be. Females, generally have more variability than males. As you age, you might expect variability to decrease. Technological tools sometimes help decrease variability (but, sometimes they make it worse).

Some people have additional conditions that make for high unpredictability, like gasteoparesis. Or, see the addison’s disease post. Managing Type-1b Diabetes with Addison's


#47

My excercise was 6 hours of paintball. High adrenaline, sprints, lots of movement.

And damn. I was hoping that after honeymoon would be easier. Because right now with my pancreas doing whatever it wants when it wants gas been friggin hard. Sudden drops for no reason then highs that won’t come down.


#48

Some of this is in your control and some of it isn’t. Dont take the data personally. You aren’t experiencing anything bad from the data, are you? Your just playing more of a game with numbers. ??? If you scroll out from the data, I bet it looks more flatline, if that makes you feel better. Everything is relative. Scale changes things.

Paintball is hard to predict. If you are running uphill under high adrenaline, I would guess it raises your BG, until you burn up all the glycogen, then it is more likely to drop rapidly. It will depend on your body. Also, temperature can make a big difference. Were you playing outdoors in the winter?

I’m a back country skier and for some reason, when I’m really enjoying myself, it runs high. But, there can be huge oscillations, and rapid ones, over a six hour period. My numbers might run any of the following. Depends on the mountain. Depends on the year. But, in general I’ll tend to run low, like in the 3rd pic, if its just typical, groomed big mountain skiing. But, if there is terrain, and I’m jumping around and really working (like in the back country), and enjoying myself, its more likely to be the first two pictures. But, you might be different.

That stuff is the most difficult stuff I do as a diabetic. Sometimes things get weird. I like to know the ski patrol on duty and ski at a small, challenging mountain, were everyone knows me and my malfunction.


#49

These are my graphs from the paintball day and the day after (I am still really sore and legs feel like jello).

You are right, the first hour of intense excercise my bg shot up and then plummeted like a rock. By the end of the day my sensor fell off and didn’t get another one will I got back into town.

The following day (yesterday) was the worst part of it. I was having swings so quick I couldn’t barely tel what was going on.


#50

Whats with those morning highs? Is that dawn syndrome from dropping your basal?

Yeah, my sensor fell off last time I went skiing. The hill was absolutely treacherous and I didn’t really feel safe skiing without it because I was all alone and really far from home. There was a police medic there from my home town on patrol, but he left shortly after I arrived because he had been there all week. Plus, there were a bunch of super annoying guys there who kept following me around - kept telling me stories about how they did so many drugs in Europe that they ended up in the hospital. Made me think, “Wow, who’s more disabled here - me? Or, you guys?” Seems like you might have to work pretty hard to end up in the ER in a foreign country when you dont have any underlying medical conditions. I could loose them on the mountain, but they would be waiting at base. I just ended up throwing in the towel and going home. I’ll remember extra sensors next time.


#51

Yeah I was about 3 hours from home when my sensor fell off. I had plenty of snacks for the ride home so I over endulged a bit lol.

The overnight/morning highs are probably due to me over eating in late afternoon to try and avoid evening lows.

Could be dawn phenomenon also. I talked to doc about trying a diff insulin and split basal but haven’t heard back yet.


#52

Bringing this topic back up because of some changes.
I am now only taking 4u of long acting a day. I stopped the metformin to see how it affected me. Doesn’t seem like the metformin changes much at all - so I may just continue to take it.

Anyway, at 4/5u I am running a little higher at night than I would like. However, like clockwork, between 12 noon and 6pm my BGs plummet into the low 100s. Typically now my drops are slower and easier to managafe.

Is this indicative of needing a varying basal?


#53

Could be. You could split the basal by taking 2 units at night and 2 units in the am. Then, you could increase the night time to be a better fit.

I think that the sticky low 100’s is a LADA thing. I dont know if you would be able to change that. But, I wouldn’t, even if I could. Thats a perfect number. The ultimate perfect number is 94, some would say, LOL.


#54

My basal is tresiba, supposed to not have a peak or anything. Would splitting cause any difference


#55

Its a way of allowing you to change one dosage, while keeping the other at 2u. So, it seems like you want more insulin at night. As an example, you could keep your AM dose at 2 units and change your PM dose to 3 units.

Note that there may be some overlap first thing in the morning. So, you might want to ask the Doc or another Tresbia user.

" During a period of 24 hours with once-daily treatment, the glucose-lowering effect of Tresiba, in contrast to insulin glargine, was evenly distributed between the first and second 12 hours (AUCGIR,0-12h,SS/AUCGIR,total,SS = 0.5). The duration of action of Tresiba is beyond 42 hours within the therapeutic dose range."


#56

Lol can you explain that last bit in layman’s terms? I’m a simple man.


#57

The last bit is just copied off the internet.

I dont understand it, either. Thats why someone else should explain…someone who takes Tresbia. I think it means that it lasts, in your system, for over 42 hours. And each shot does something like this…

So, the first 12 hours are simple to calculate. But, I have no idea what happens after that.


#58

My morning and overnight basal is obviously too low right now. I scaled back to try and deal with the unpredictable nature of my afternoons. You can see my basal lines are flat which is good, but that drop was from nothing. No food and no corrective insulin, ect. Just… happens. Pretty consistently too.


#59

What time of day do you take your insulin? Do you think those lows result from the tail end of the tresbia curve? Because you have multiple shots active in your system at that time? Kinda like this? Tresbia is weird. See how on the 2nd day, there might be 2 shots active at the same time?


#60

I take my insulin in the morning. I used to take it in the evenings but was having the same thing happen.