I think it's important that we say what works for us, rather than make blanket statement about what is "good" or "bad" treatment. We're all different.
I would start by changing your basal. I am on three different modes during the day and have three different sets depending on my activity level. I am sorry you are gaving so many horrible lows. Another thing is keep a snack of nuts handy, the protein will help with stabilizing your BG.
I do not see or missed what the meal boluses or basils doses you are running and I assume you are pumping.
Some other thoughts:
a) make sure you do not have giardia/amoeba in your gut, they steal sugar like bandits and can drive you nuts.
b) you have to watch out falling asleep before meal is digetsed or the gut shuts down and glucose production shuts off and if insulin still live in blood; you will get nasty low.
c) watch out you are not using insulin with huge time to live like 70/30 or 75/25 as well as large basil doses that can creep up on you.
d)maybe pancreas working wobbly and kicking into full production doubling up on the external doses.
I am not expert but just some thoughts.
Here's my take and a couple of questions. Questions first, was there any alcohol involved with dinner? Were you running on the low side the day before/any unusual activity?
I think you probably counted correctly, but still had the the insulin arriving before the glucose.
The first clue is the buttermilk pancakes. For me, I find that buttermilk and sourdough products take FOREVER to impact my blood sugar, frequently in the 3 - 5 hour range. So if I bolus, even square wave, I am routinely fighting lows. My current solution is to mostly avoid these products; when I do indulge, I bolus very conservatively around 30% of what I would normally take and then test frequently until I see the BG rising, then square wave the other 70% over 2 hours.
For the dinner, I think you had a similar delayed digestion. Again for me, meals with a lot of protein and/or fat really slow the carbs from getting into the bloodstream. Lots of post meal testing required.
Finally, I really feel like yelling when I read these posts of treating with skittles or juice, etc. When you are that low, always treat with glucose tabs or gel first - speed is critically important. It doesn't matter if they don't taste good or are chalky or anything else! Skittles and juice take longer to treat your lows.
One glass of wine with the meal. Had been running a little low--80-90 all morning.
I use buttermilk all the time in cooking and actually like to drink it ocassionally. I have not had any problems like this before after eating it.
The hostess of the Thanksgiving meal is vegetarian and everything is organic. There was a turkey that had been cooked on the grill, but I only ate 5-6 small bites. As far as the fat part, the meal was exceptionally healthy--even most of the desserts were gluten free--but not all. I had a bite of my husbands pumpkin pie, and one rugelah (because I made them.) Veggies were all roasted.
I only had skittles available in the car, which is why I used them. And, as I said earlier, juice works really fast for me, and I have had 50 years as a diabetic to try everything. I know what works, as Zoe said above, we are all different. Paramedics are trained to treat lows with OJ, usually with sugar added, if the patient is able to drink it.
A vegetarian host who served Turkey? Wouldn't happen in this vegetarian's house!! But that is neither here nor there. So my question is...how are things going now?
Yes. She is a vegetarian, but her husband is not. As a result, he can eat meat, as long as it is not cooked in the house. However, meat of any kind is not the norm in the household.
Better. I tried some of the suggestions provided (THANKS!)and backed the basal rates down a bit. I was still 54 at noon today, however, so will back off a bit more, at least on the 7am to 12pm basal rate. Still running a little low, but it takes a while to make effective changes.
Thanks for asking!
Yes, we are all different, but some things are universal in terms of standards of care/best practices.
Just because the paramedics use OJ doesn't mean it's right! OJ has a glycemic index of around 52, table sugar is 60, while dextrose (found in glucose tabs) is 100. FWIW, Skittles are 70. I have glucose tabs everywhere and get a bit panicky when I get down to my last container of 50. For me, when I get that wonky, low feeling coupled with an idea that I might be going lower ... give me the speed!
Sorry for ranting ...
Another quirk with my diabetes (YDMV, of course) comes on big event days like Thanksgiving/Xmas/Performance reviews/Job Interviews, etc. Sometimes the little adrenaline push that typically raises my BG will do the opposite and push it down dramatically. I know I have had a few interviews that I must have sounded nearly incoherent while fighting a low, even though I was a bit high going in - ugh!
Good, I'm glad it is coming into line, whatever the cause!
Given you've been stomped several times CUT BACK on the insulin, period. Does not matter whether you've got the carbs correctly counted, you are getting crushed again and again. Does the origin matter per se, or just preventing it?
Sounds like you could have a potential pattern with the dinner/late afternoon coverage. Cut back your background first. Then look at your dosing for lunch/mid afternoon. Consider cutting that back too.
NEVER EVER cover with skittles. severe problems there. Always, soda, or gels. Anything you have to count, or can miss putting in your mouth, ie little candies, a BAAAAAAAD idea. Anything with chocolate on it cuts down the breakdown/absorption rate. You want straight sugar in the most rapid form possible
Hello Mike,
Choked on too many of those dried, chalk gigantic horse pills... never been a fan.
IMHV if its texture can cause issues, much batter methods need to be used...
Stuart:
Great shot - I love it.
Been there , done that too.
Have a great day!
OK UPDATE If you want to shout...
I have reduced all basals and I/C ratios by 20%. Additionally, I am under reporting my carb count when estimating a bolus; I input a carb count of 30 when I figure it is more like 50. Oh, and after all the reductions, I was 43 at dinner. I had eaten (I will not say what I ate. Am feeling a little bullied..)about 3:30 when I tested at 48.
I know everyone thinks I am taking too much insulin, but this is all VERY new. Before last Thursday, I was tightly controlled, not not really low this consistently. I am beginning to think that after 50 years as a Type 1, my pancreas is rearing its ugly head. Correction foods aside, this is really scary. I have lowered all ratios considerably from 1 week ago, am not stressed (EXCEPT FOR THIS!!!) am not getting sick, have not changed my life patterns.
Overwhelming, while trying to maintain normal family patterns. Husband is aware of the problem, but I am trying hard not to create a lot of drama around it. Refer to puppy dog eyes in my first post.
Am actually considering suspending basals and just living on bolus for a while....
Sorry you're feeling bullied, Spock. People do seem a tad more opinionated than lately - maybe it's Black Friday making people edgy.
Just to commiserate, I took nearly two months about six weeks to make enough changes to stabilize my (high) blood sugars, just because I was trying to make sense of why all of a sudden I needed significantly more insulin. I guess it's just human nature to both be cautious and to try and understand things first.
If I have any "theories" for myself it's that my pancreas finally gave out the little bit it was producing, but that's easier to believe after 5 years than after 50 (the opposite, that yours decided to spurt a bit at this late date!). Anyway, I think you're going about it in the way and at the pace that feels right for you! Hope it stabilizes soon. (for me, I think it's my new normal...for now!)
Thanks, Zoe. I often wonder if there is ever a normal with Type 1.
I don't think there is. I make changes all the time. I'm sorry too that you're feeling bullied and hope I didn't contribute to that, although sometimes I try to be obnoxious about stuff. I'm glad that cutting back didn't send you skyrocketing so maybe a little more will do the trick. I dunno if some other issue, maybe a thyroid thing or something, might be able to do that to BG. I'm sort of in the same boat as I had my old (failed) pump cranked up, I think to counteract the failing motor (which produced slightly and variably elevated BG for a few weeks before I got the MOTOR ERROR and got a new pump) as it seems as if the settings are cranked up but I'm relying on the giant bag of halloween county I gave the person who sits next to me at work during the day, and more eating at home. Which I need to cut back on. I don't feel like going back and forth. I just want to take a "blood test" that will figure out my settings, not all this fiddling around with numbers all the time.
Re all the different suggestions for snacks and the "you should eat ____ not _____" stuff, which is always entertaining. I think the most important thing for hypo treatments is that they are easy to eat, which is pretty subjective. I don't mind little things myself (and am currently favoring Smartie [dextrose] and jelly beans [HFCS]...) but avoid Skittles as I drool a lot if I eat them while I'm running. I know you're a "pro" and have been around the diabetes block long enough to know that stuff.
I've given up on thinking, "as soon as I fix x, y and z it will all be perfect" but still keep expecting stability and looking for causes when it eludes me. If you are still wondering that with your 50 year diaversary coming up, that kind of says it doesn't really exist! I just looked and can't believe your diaversary date! That's just not fair! Mine was such a non-event that I had to go through my checkbook records to remember the day. "oh yeah, so I have Diabetes? I figured I did." I'm sure yours was more dramatic (in part by being so much younger). I don't think I'd be here today if I was diagnosed when you were (not because of D)
Acidrock threw out the idea that this is about something else such as thyroid.
One idea that hasn’t been mentioned yet is that adrenal insuffuciency (Addison’s Disease) can result in hypoglycemia because of lowered cortisol production. Addison’s is another one of those conditions that can be autoimmune and go along with Type 1. It’s unusual but can be very serious.
If you continue to have unexplained hypoglycemia, I think that you should contact your endo.
Aha! I knew there was someone smart around here!
Here again, staring at the final product - glucose production a good start, we have here a complex chemical plant and multi hormones that figuring out who burped and threw plant off; really needs looking at the key hormones and plant overall operation factors and key organs.