I’ve never had an evening HYPO event until last night.
Felt a little dizzy on the stairs coming home at 9:30pm.
That was very unusual for an evening thing. Wondered about it. Used the 14 stairs again to take out some garbage. Definitely felt dizzy again and started getting sweaty. I recognized those symptoms so I took my reading: 65! So I drank a few ounces of gatorade, ate a peach and an orange a few bites of chicken. Don’t like eating right before bed because, and sure enough, 1 am, acid reflux! Oh well. Stayed up an hour and then slept fine through the night.
My guess is that the additional stress of the day caused the glucose to get consumed much quicker than usual. Still, I’ve not noticed stress having that much impact for me. It does for my partner who is type 1 on an insulin pump and CGM (dexcom6), so I txted her and asked if stress uses up her insulin faster and she said yes it does. We’d had some discouraging news about my partner’s cancer situation the day before and I had been depressed about it all morning and cried a few times. Then I got a flat tire out in the country. That was not that big a deal but still a little stressful. AAA took care of it, but I still felt nervous driving home on a smaller spare tire.
I don’t usually eat snacks in the evening and never have hypo events in the evening. I am one of those who wakes up with a 120 or so reading and don’t need to eat until a few hours after waking up. I don’t even take a reading in the mornings anymore. I woke up today and took a reading just to see. It was 121.
My dinner last night around 5 pm: a small serving of mashed potatoes, one corn-cob, and two chicken thighs.
I’ve been diagnosed and taking metformin and glimepiride for maybe 6 years. My A1C has gone up and down with my weight. Highest ever was maybe 8.1 or less several years ago. Jan 2020 it was 6.1. July 2020 it was 7.2 (with an increase of weight - 10lbs. Jan 2021 it was lower again: 6.5
(The weight gain last year in Summer was because my partner had been in the hospital for 3 weeks and lost her insulin function due to her immune system attacking it after Immunotherapy treatments for about a year (Keytruda). That’s when she became type 1. Recovery from pancreatitis had taken 4 -5 months. Pretty tough time. I ate too much).
I don’t know what else to add so just ask if you need more information.
What is my question? Is my diabetes changing in some way to cause this hypo event in the evening when I’ve never had one before?
@4theBIRDS Welcome, this is a really good site for any and all types of diabetics. Your weight gain is certainly a factor in your HbA1c going up. The closer I am at my proper weight the easier it is for me to have more stable blood glucose levels.
When I was first diagnosed 28 years ago I was put on another sulfonylurea drug, Micronase. If I remember correctly sulfonylureas increase insulin sensitivity as well as stimulating insulin secretion. Metformin suppresses the release of glucose from the liver and does increase insulin sensitivity.
Because you lost some of that anxiety weight may have increased insulin sensitivity along with the Glimepiride. Having a hypo with your drug regime I think is more positive than negative. Type 2 DM does change, it progresses as the beta cells get worn out, but it sounds like that’s not the case for you.
I would suggest getting a jar of glucose tablets for treating any future hypos rather than juice and two fruits. I’ll bet your BG spiked pretty high. With the tablets you can be more careful about metering the grams and it works faster is faster. With a reading of 65mg/dl I would use 1 at most 2 tablets. That’s 4 grams and 8 grams total carbs.
Thank you Luis! Your information is very helpful/useful. Yes as I’ve dropped about 7 of those ten lbs, about every two lbs makes a difference in my body response to the Metformin and amaryl. I was taking 3 mets - one each meal for a month or two then only 2 - brkfst and dnnr in recent months. I lowered the amaryl from 3 per day to two per day about two weeks ago, so you are absolutely right about the changes in sensitivity. I had to do that because several days a week my partner and I climb steep hills in the late morning - about the equivalent of 10-15 floors of stairs over the course of an hour or so. Amaryl really drops the glucose fast after exercise so I was having crashes before I ate my lunch.
Reduced the amaryl to 1 at brkfst instead of 2. That has been working well.
I’m glad you think my hypo might be a good sign rather than a bad one at this point. Maybe soon I will have to decrease to 1/2 amaryl at dinner.
You wrote: “With a reading of 65mg/dl I would use 1 at most 2 tablets. That’s 4 grams and 8 grams total carbs.” That’s what I know the least about so this is very helpful.
I didn’t know it took so little to get out of trouble.
I have a few dextrose tabs in my purse that my partner gave me. I’ll pick up a jar of those. Yesterday my flat tire caught me late for my afternoon snack. I no longer keep things in my car because a rat took up residence in my glove box last Summer. Trapped him out, but UGH! I remembered those tabs and ate a tab every 20 minutes or so as I was around 3 hrs after eating lunch. Again, didn’t know how much to use. I usually drop around 3 to 3-1/2 hours after lunch if I don’t snack on something. Everything worked out. When I got home from the outing/flat tire, my reading was 101 -at 4pm. I decided to eat dinner a little early.
Glad to be of help- about how I would treat a 65mg/dl hypo just remember we’re all different in how our body’s respond to whatever. I mean from one day to the next can be different. Keep walking those hills and get your partner to join this forum if they will. A lot of good stuff from a lot of good people here.
We don’t have anything that my Connecticut wife would call hills, But let me tell you, cranking a bicycle up what we have and u-turn and back for 8 or 10 repeats will wind you. Yeah, I’m a spandex wearing road bicycle rider.
65 is fine for me. I won’t feel a low until I’m in the 40s. And with cgm I never get that low anymore.
Before cgm I would never go to bed with a 65. Now I will knowing it will recover with no issues.if I ate to correct that, I would be up and down all night.
Everyone has different tolerance and different satisfaction with lows and highs.
When I hit 200 I get very sick to my stomach, and my muscles ache,but some don’t even notice it when they re 400.
I think taht when you get used to a certain range , then lower it, even normal glucose might feel low.
You might eat a snack before bed just to be on the safe side tonight incase these night time lows are a persistent problem. Having one might suggest that there’s another one coming and you might be on the look out.
You might keep some snacks by your bedside and consider setting an alarm to do a check in the middle of the night. Be certain to check before bed.
A juice box might keep fine in the car - mice won’t be interested in that.
So are you suggesting that having symptoms like dizziness and sweating only means that I have less “tolerance” for lower blood sugar levels? Are you suggesting that it is my not having “satisfaction” with these symptoms at a glucose level of 65 that needs to change? So should I then ignore those symptoms and see if I can learn to tolerate more extreme symptoms and be more “satisfied” with being able to tolerate them? Please re-read your post and see if you wrote what you meant to say.
I appreciate your suggestions about snacks and having something available at bedside. Thank you for taking my concerns seriously. Some of the men who have replied seem more interested in bragging about their ability to tolerate lows rather than giving intelligent, safe advice.
In these 5 or 6 years I’ve never had concerns about low night-time levels until this event.
If I have more evening lows I will try reducing the metformin with dinner to 1/2 tablet and same with the amaryl. That will probably take care of it. Until that gets settled, I will have to take your suggestion and take readings for a while at bedtime or even in the middle of the night to keep an eye on it.
The juice box won’t work for the car. It was a RAT that was in my glovebox and roamed the car interior at night (but only for two nights before I put a trap in the glovebox and took him out. And it consumed an entire quart of chicken stock from one of those cardboard box containers. So apparently they can either smell through containers or they just bite holes in anything to see what’s inside.
So I should not be alarmed about a 65? What about the dizziness and sweating? Should I ignore those too? Should I be trying to train myself to tolerate more severe symptoms so I can be more like you?
“Unless I am heading lower” - You wear a Dexcom - so you know the current trend. In my case, I don’t have a CGM, but I think I could assume that my glucose wasn’t going to start rising again on its own at 10pm since it had obviously been dropping for a while already and I hadn’t eaten anything since dinner.
I do not consider your reply to be helpful or even safe advice. Where are the moderators? It seems you are more interested in bragging and minimizing the dangers of hypoglycemic events than in giving sound, safe, helpful advice.
No, I’m merely suggesting 65 is nothing to panic over, especially if you’re not on insulin. Studies have shown healthy peoples glucose levels fluctuate anywhere from 59 to 168. Sorry your disagreeable nature took this as some type of attack.
Minimum and maximum interstitial glucose values, observed under everyday life conditions, were 59 and 168 mg/dl, respectively. The percentage of time spent in different glucose ranges is shown in Figure 3
I don’t know if we have rats here. The mice keep getting into MY car. I don’t know what I would do if I had to face a real life rat. That is quite the combatant.
I’m guessing this might have happened because you lost some weight. That, at least, tends to happen to me.
Some of us have more lows than others, so we get kinda used to them. You would get used to them, too, if your control was not as tight - like, if you keep running these night time lows for weeks or months. But if this is unusual for you, it will hit you really hard and could be dangerous. If a normal person (who is not diabetic) gets BG = 65, they will just pass right out, or run around naked in the street. It can hit people really hard, which some of us forget about.
Thanks for your comments/perspective. One thing I don’t understand though. A diabetic is typically - typically has more insulin resistance than a healthy person. That means their glucose has be higher just to get glucose into the cells of the body/brain. So it would seem, from that, they would have symptoms and get into danger zones at higher glucose levels than non-diabetics. There have been times even last Summer that a 120 started to bring on dizziness, foggy thinking and sweating. Right now it has to drop to about 100 before I notice anything AND I HAVE TO BE standing up or walking around the apartment to notice it. If I’m sitting down I don’t catch it until its 55 or 60. Then I stand up and WHOOSH - WHOA! Gotta get some glucose! I have read that people who have lots of lows seem to stop getting symptoms of being low. My impression is that they are still in dangerous territory but their bodies are no longer giving them the warning signs. Is that a correct understanding? Seems some guys here are saying that they tolerate lows very well so there’s “no problem”. But I think it IS a problem and they should be MORE careful rather than more casual about low glucose levels.
This forum is supposed to be a place for safe advice. If I didn’t know as much as I do already, I would be getting very confused by some of the replies some guys have written. This concerns me.
Yes seeing a RAT tail when I opened the glove box, slithering over the edge into the engine area - that was DISGUSTING! I bought an expensive “sure-thing” trap and it was dead in there the next morning. I couldn’t bring myself to take it out of the trap so I threw the whole thing into the dumpster. A few years ago we started having a serious rat problem. It was partly due to people with compost piles which were easy for rats to access. Also people are allowed to keep chickens in their yards and the chicken food makes for easy pickings also. After that, bird feeders become a source of trouble too. I live across the river from where most of the back-to-Garden-of-Eden folks live, but we still developed a rat problem here too. Very mild winters some years with no ice storms and no snow storms are part of the problem. Most years we at least get some ice or snow for a few days.
Hi 4theBIRDS. First of all I am really sorry to read about all of the awful stress that you have had to endure. I hope that your partner’s health gets better. That has to be very hard.
I want to see if I can explain this at all, and hope I don’t add to more confusion. I am a type 1 and have been for 62 yrs. I am now 70. I keep a very low a1c because I don’t want more complications and that is the only way I know to combat them. I may be overdoing it. My A1c is very low.
I feel all of my lows and have lost none of my hypoglycemia awareness. I feel a 65, but for me, because I can still do well when my glucose level is lower than that, I don’t have to do much at all to correct a 65. You are feeling a 65 because your average glucose level is higher than mine. My body is very used to lows. It takes a low in the 40’s to cause me problems. That is just the nature of the beast.
Of course you needed to treat a low of 65 and I am sure that you were not feeling well. I wouldn’t have needed to eat as much as you did to correct the low, but if you didn’t then go too high, maybe that is what your body needed. Does this make sense?
I just want to add that in my 62 yrs of living with this disease, I have very rarely needed help with a low, and I have never passed out. I never drive without testing at 80+.
Thank you, Marilyn. I apreciate your sympathy about the situation with my partner’s health. It’s not clear yet how things will go next, but having the two-year “progression-free” (PF) period coming to an end is very distressing. Two years PF was fantastic really, so we have to be grateful we’ve had that. Radiation is next and it could actually put us in a good situation again for a while. There are some “unknowns” which will remain unknown until or if they “show up” and make trouble. Otherwise we don’t even know, and cannot know if they are there. We have to continue to live with the uncertainty.
Yes, all of what you wrote was clear. One thing I mentioned in one of my replies to someone else concerns me. If someone loses some of their awareness to the symptoms of low glucose, doesn’t that put them at greater risk of getting too low without feeling it coming on? If I understand it correctly, not feeling the symptoms of low glucose doesn’t mean the low is less dangerous.
A reading of 65 in itself is not very dangerous, however even the best meters will have a variant of +/- of 15 mg. So a 65 reading could be actually be anywhere from 50 to 80 with a good meter. If your body is giving you signs then adjust.
It is really important to understand, this forum does NOT dole out any advice, only opinion from individuals that have similar experiences to those read from a poster. Advice, usually good, but not always only comes from a licensed professional. Here you will often get various opinions because diabetes does not have a one size fits all solution. We are all different and all have a large variety of experiences so it is totally up to you to pick and choose what you may agree with or would like to try.
Any of us that have spent time on this forum have benefited from the various opinions offered, however, we use it as supplemental information to what we learn from our licensed professionals, and not as a replacement.
