Can a severe hypo affect your ISF?

I am having an episode similar to one I had in September. I tested a 35 at 1:00 am the night before last (not sure why). I drank 23 g worth of apple juice and waited 20 minutes to retest. The retest was 40. So I drank another 23 g and went to bed.

My 6:00 am test was 186 - high but not shocking. I took my normal basal and corrected the bolus for the high. At 10:00 my BG was 191 - a real surprise - so I took an additional bolus over correcting with a higher dose. At noon my BG was 198! So I took a whopping bolus (cut the ISF in half) and was able to get the BG down to 143 at dinner. By bed time (19:00 PM) I had it down to98. This took massive (for me) amounts of Apidra.

Today is better but am still not back to the base ISF. Is this just one of those mysterious diabetes events or is there some mechanism that can explain it.

I did not take any Glucogon, I have not varied my diet and Apidra is usually in and out in 4 hours for me.

I've experienced the same sequence of events many times. It's my understanding that hypos < 50, especially if they last for any significant length of time, start a cascade of counter-regulatory events involving other hormones and the liver to neutralize the severe hypoglycemia. It is a life-threatening event and the body's response is dramatic.

The bottom-line effect for the counter-regulatory response to severe low blood glucose is a sustained degradation of insulin sensitivity.

Unfortunately, the body seems to sustain that metabolic brake much longer than is actually needed. It often takes me 12 hours to recover from these situations. I usually fast until dinnertime. Interestingly, if I can limit the low to 15 or 20 minutes then I can avert that long duration high BG.

Thank you. I suspect you are right about the fast as well. In my September event, it wasn't until I did that things started to get better. In September this was new to me, so I started over correcting and ended up on the old BG roller coaster for 10 days. Annoyed me because my A1c went from 6.0 to 6.5.

Yeah, even if you don't inject glucagon, the normal metabolic response to low BG is a release of glucagon from pancreatic alpha cells. Since our metabolics are all beat to hell anyway, who knows what kind of whacked out lingering affects we have after a hypo incident that's way out of the norm.

Heck, I had a hypo in the 50s the other night after dinner. I thought I corrected within a reasonable margin of error since I went to bed in the 90s, but I woke up a few hours later at 150. I corrected that, then woke up in the morning at 292. I corrected that, then spent most of the morning chasing more hypos. I probably didn't get to feeling right again until late afternoon yesterday.

I feel your pain.

Thank you, it is helpful to know that weird is normal.

Anytime I reach a very low reading, and usually wake up a little groggy but ready to go. Readings are elevated, but easy to correct. W waking up high is a whole other story, as I tend to crash, not matter how much I adjust the correction.

FHS is absolutely correct--the glucagon is released by your liver to counteract the low. Although you do not produce insulin, your liver does not know that and will react as if D was not a factor.

I have had a lot of lows like yours, and my insulin sensitivity is excellent, and my daily insulin usage is around 20 units total--basal and bolus.