Diabetes is kicking my ***!

Sorry this is long...
Had been doing really well until Thanksgiving. It is not high blood glucose causing the problems, but devastatingly lows ones and I have no idea why! Ideas? Here is what happened:

1. Thursday morning I woke at 72. Did some cooking for the big meal and made us buttermilk pancakes for a late breakfast (10 am). I calculated the carbs for each pancake (11) and took insulin for 22 carbs, but ate three pancakes with APPLE BUTTER for pete's sake. On the way to the dinner, I started feeling low (husband is driving) and I tested at 45. Had the completely disorienting kind of low where I actually seized a bit. Treated with Skittles, but it took a long while for it to go up.

2. Fast forward to the trip home. Please note: I ate reasonably well, had some pie, etc. Figured I would eat about 70 carbs and bolused for 50, square wave as it was a two hour meal. On the way home I was having a lot of trouble looking at the road; long story but I thought the problem was related to my slight double vision. Husband was driving again and thought I was sleeping. Got home and I tried to get out of the car, fell down in the front yard (neighbors probably think I was drunk. THE JOY OF BEING DIABETIC!) Tested at 41. Got into the house and my husband starts pouring juice into me. About two minutes after I drank the first juice, I got horribly ill. Eventually, he had to treat me with gel.

3. Woke up 209 on Friday, of course. Treated the high blood glucose level and got it under control by 10 am. I hovered around 100 all day. Dinner was leftover chili and I again under bolused. Woke up this morning at 40. I tested at 1 am and was still at 100. Took about two hours (ate breakfast, had some juice) to get it up to 60.

Basals have been refined lately and have been nearly perfect the last few weeks. Not sick or getting sick. No other bug changes.

All of these lows have been the very disorienting type. I get jerky, ornery, and am not the best to be around. Husband is hovering, looking at me with puppy dog eyes--he worries so. And I feel awful from all the lows.

Anybody have any thoughts on why this might be happening? Usually I would just say too much insulin, but I am pretty sure my carb counts were pretty accurate and I under bolused so much, that just does not make sense.

I find that sometimes my insulin ratios/ rates "drift", no apparent reason. I try to run my BG pretty tightly, even being off .1G/U or .025U/ hour can make a difference in my BG between ok (85ish) and low (50s, etc) and there's not that much difference between 40 and 50. I'll make a slight move, what I refer to in my head as "nudging" if I notice a low or high about the same time for a few days in a row, although by low and high, I tend to use my own definitions more than anything I get from my doctor. I dunno if you have had other changes/ exercise/ stress/ type of things that might produce changes but if you're counting and running low, I'd try a wee bit less insulin and see if it works out.

Especially when I was young (but it still happens) holidays and the associated happy emotions, would make me go low. I had real problems as a little kid looking forward to Santa. Mom would stuff me with holiday treats, lower my insulin, and I would still go low. Maybe this is what happened? You know how stress can make you go high? Being super happy can make me go low and maybe this was the cause. All sorts of hormones can have all sorts of different effects.

Ok...I feel like you would know this but I'm going to throw it out there anyways. That time of the month? Also you might do a basal check...no food and continue to check BG. Did you start taking any medications or new vitamins or anything? That's all I got. Hope it helps.

Yikes, scary! When I read about your breakfast I thought "350?" something is definitely going on, but what it is is not obvious. The suggestions above are possibilities. You also mentioned you did some basal tweaking lately; was it all up? I had to do that the last couple months (reason still unknown) and keep waiting for the click that will signal it all going the other direction!

But one thing I learned during the nearly 2 months it took me to raise my basal to the point I needed. I was being over-cautious and trying to find out "why". As Fritz Perls said, "understanding is the boobie prize." It takes what it takes is a good cliche. If you are too low, lower your basals and/or I:C until it gets normal again. I found it easier to just lower my basals and keep track of the changes rather than doing "temporary basal" and having to keep track of it expiring. If there's a "why" it will come clear in time...or it won't.

#3-how much insulin did you have on board at 1:00am? if you didnt have any insulin on board, would seem like a basil issue.

To Elizabeth:

Too old, no new anything. Basals have been checked and working fine. All good thoughts, though....

Just basal BOB. Bolus was taken at 6:00 and I am a pretty consistent 4 hour person.

Decreased. My total basal for 24 hours is 10.5 units. I also backed off my insulin to carb ratio from 1:10 to 1:15. My A1Cs come in about 5.1 and I am being told that is too low.

If you continue to have these unexplained lows, I suggest just further decreasing your basals and not worrying about why. I have always believed that doctors always say that A1C's in the 5's are "too low". If they are achieved at the cost of lots of highs and lots of lows that average out, or of just a lot of lows, then, yes, they are "too low". But if they are achieved with steady good blood sugars than they are wonderful!

I would see what happens in the next couple days and tweak accordingly.If it is some short-lived anomaly, then the worst that can happen is you start going high and change them back.

I hope I'm jumping the gun but your symptoms sounds like what I went through before I was finally dxed with Gastroparesis. It can be scary when you're experiencing the symptoms. There are tests that can determine whether that is what it is. I would suggest that you get in touch with your medical team and have them do tests.

(OK, this is TOTAL denial) I refuse to submit to Gastroparesis. I have enough problems. I am aware that in the evening, I do not digest quite as efficiently and have learned when and how to counteract this problem.

Betty, that is a good thought, so I may need to reassess my denial.....

I'm hardly an expert, but if it were gastroparesis, wouldn't you be experiencing lows soon after eating (when the insulin hit but digestion hadn't happened) and highs later when the insulin was gone but your food was finally digesting?

I find in the evening that a square wave helps for exactly that reason, although it is not the reason I used a square on T Day.

Correcting for a Severe Low?
Forget the Skittles, go to the Juice and Glucose Tabs and Over Correct .. take an extra 10 carbs.. It akes 1/2 hr to really get things Up and you can always Take a CB bout 1 hr later... Just keep tabs on how much Extra Carbs you took to take a Bolus for them later..

Have you ever done a comparision btwn How fast those Skittles Work vs Juice/Liquid?
For Minor lows they are fine, but not for Serious One's..
I keep 15 carb Juice Bottles In the Fridge and Some Juice bottles come with me in the car when I go out..

When did you last change your set? Maybe you have it somewhere with really good insulin absorption. I know it seems odd to suggest too good a site as opposed to the bad sites we are usually fighting. I know sometime I put in a new set, my BG shoots down & wont come up.

I suffered with pre-gastroparesis before actual diagnosis that's why I mentiond Gastro. When I was first tested about 4-5 years ago they said I didn't have it but just this year I was finally dxed...just something to think about..and yes you might have to reassess.

I am a juice person. It works and works quickly. We had a juice box in the car, but had lost the straw. He was driving, I was ...sort of seizing...Skittles were the available alternative. Glucose tabs are unhelpful, as they pack too low a carb count for a severe low. When I feel that way, I cannot eat as many "chalk tabs" of glucose that I would need. They just do not work well for me at all.

I am a juice user, but it seems highly unliked here. It is fast, easy to injest, and works great.

Thought about that and changed out yesterday to a new site. Equipment malfunction is always my go to defense.

I have to say this is one of the best replies I have seen on here. Good thinking.