Hey all, i am writing this post after just having my lowest low so far( newly diagnosed) so 2.4 is a big deal for me....anyway i was told about a thing called the 'honeymoon period' where your body starts to produce insulin again thus meaning that you don't need as much manually. my dinner tonight was a small bit of steak, salad, and two bits of bread. I gave myself 3 units of insulin via shot ands 12 units of lantus as well. Before dinner i hav 6.9 and within 45mins i felt dizzy ad confused so i checked again and was 2.4....What, usually i take 6 units of insulin before break, lunch and dinner, but because i have being having si many lows i have modified my doses. Someone please help, why am i going so low..is it because I'm not eating enough carbs or is my lantus affecting me straight awaw, even though it barely peaks over 24hrs. what do i do????
Adele, so sorry to hear that you are having these lows!
The honeymoon period just means that your pancreas is still producing some insulin, but not enough on its own to handle the food you are eating. It isn't starting to produce it again.
From your description, I would suggest discussing either reducing your mealtime insulin with your doctor, or taking the insulin a bit closer to the meal. This is because for some of us (like me!), a meal with a lot of protein (like steak!) can slow the digestion of food which results in the insulin getting into your bloodstream before the glucose from your meal does. The result? Low, low, low readings.
I would also wonder about taking 6 units with every meal, since your fast-acting dose needs to be tailored to the amount of carbohydrate in each meal. Unless you are eating the same carbs with every single meal, that sounds like a good path to a low, or high, depending on the meal.
Adele,
Are you using a set amount of insulin at each meal, on a sliding scale or are you using an insulin to carb ratio? If you are using a set amount then you need to also eat the amount of carbs your endo/CDE set you up for. If you are carb counting and using an I:C ratio then you ratio is off. Either way you need to decrease your rapid for now and get a hold of your endo team about how to adjust. You might also need to reduce your lantus as well.
Do you have a copy of Think Like a Pancreas by Gary Scheiner? It will help you understand what is going on so you have a better feel for the questions you need to ask your team.
The honeymoon period is when a newly diagnosed T1 has a decrease in insulin requirements shortly after starting treatment. The high BGs can actually cause some pancreas toxicity, and when you get your numbers down may recover a bit and be able to help out a little. It does not mean your cured, just that you will need less then needed at first. It does not stop the autoimmune attack on the pancreas so you will always need insulin.
Thankyou Mike, yeah i was a bit unsure myself of what happens to the pancreas during the honeymoon period, but now it makes more sense. I think now i will try to count my carbs and experiment a little bit with dosages and meal types.
Yeah i am on a set amount of insulin because i couldn't understand the carb counting. However my team wanted me to start using portion control, and understanding how much is a cup of particular foods like pasta and rice, they also said that i could change the amount of insulin i give depending on the carb load. Unfortunately i cannot contact my educator at the moment because its a sunday, and i don't have another team apt until the end of january, and I'm working all day monday but hopefully i will get some time to call her during lunch break.
As for the book, i really really want it so my mum is getting it for my christmas present. Thankyou 2hobbit
For carb counting take look at sites like calorieking or myfitnesspal. They can help you see the nutrition of foods you eat. Then you need a food scale that can measure in grams as well as ounces. A set of food measuring cups and spoons.
There are food scales that will give carbs of foods some thing like this can help. Know there are several brands out there.
Personally I don't bother with scales. I just use the carb counts from packages, calorieking and a list I have; one less thing to bother with or translate. If I lose anything in accuracy it gets absorbed by a tweaked I:C. We each do what works for us.
I don't use one now as I have gotten comfortable with eyeballing portions, but for a total newbie to carb counting having a way to reinforce what a portion really is makes the learning curve a lot easier.
Does not need to be a scale that gives you the food nutrition on the scale, but having a gram scale to measure/relate to food labels is a big help.
Personally I would find that very confusing having to translate weight to carb count and there is way too much math already for a newbie to think about, but as I said we are all different.
How do you carb count something like an apple or baby carrots? An apple can range anywhere from 10 to 25 carbs depending on its size, and carrots (if measured by volume) can differ a lot depending how much air is in between them in the cup (more tightly packed equals more carbs).
I personally find scales extremely useful and very accurate. I even carry a tiny portable scale in my purse to use when out and about. Maybe it's because of my visual impairment, but I cannot determine a cup versus a cup and a half of pasta (or similar) just by looking, and I find using a scale much more normal-feeling and less messy than bringing out measuring cups (youc can just put food onto a plate like anyone else, and there's nothing extra to wash).
I agree that we are all different, so use whatever works for you, but I also think part of what makes things like math hard is that people go around saying it's hard, which makes it "hard" even before you try it out... Someone new could start out using a scale just to measure a serving, just like they would do with cups, without using any math. Then, when they are comfortable using a scale to measure, they could use carbohdyrate factors looking foods up on a list like this one - the math involves one multiplication calculation. Once they are comfortable with that, they could move on to calculating their own carbohydrate factors for foods that do not exist on the list, which only requires one division calculation. (This is one of the great things about carbohydrate factors - you can find your own for ANY food, even if it's not on a list, as long as you have its nutritional information; and once you calculate it and write it somewhere, you never have to go looking on Calorie King again.)
The above is how I learned, and I will never go back. And I say this as someone who needed hours of tutoring every week all through high school to pass math (once even failed high school math when I decided I didn't need tutoring that year) and who still struggles to do simple math equations without a calculator. So math is definitely not something that comes easily to me, either. :)
wow, that has made me feel way better, its so good to be talking to people who get that all this carb counting stuff can get very overwhelming especially since like Jen i am not too good with math.Although i am still going to invest in a scale and download the calorie king app.
This is a bit redundant at this point in the thread, but 3 units of fast-acting insulin is an awful lot to cover "two bits of bread." The fact that you went low within 45 minutes suggests you injected wildly too much insulin. Usually lows are a problem after two hours, because carbs are done digesting by that point, while even fast-acting insulin acts for several more hours with a long tail. The steak will raise your blood sugar for a longer period of time because the protein digests more slowly, but it doesn't need much insulin to cover it.
The other thing to keep in mind is that one data point can be unique--for example, perhaps you got a little more exercise that day, or had a cold, or were more or less stressed, or any of a number of things that might have been unusual that day, and that could throw you off. But in this case, it just sounds like you injected far too much insulin (or if you want to think of it that way, ate far too few carbs for the insulin you'd injected).
yeah, thats what i thought, but i was so use to 6 units of insulin barely getting me out of the mid 20's for weeks, so its being a real adjustment to suddenly having so many lows and using way less insulin.
What you just wrote is a bit confusing.
But one additional thought. It sounds like you may be dosing just as you start eating. Even rapid-acting insulin takes a while to start working, and food hits your blood sugars fast. So you may want to try injecting 20-30 minutes before eating, and checking your blood sugar to see if it starts dropping before you start eating. One reason you may be used to using way too much insulin is because you're not timing your insulin appropriately to your meals.
i use a scale, too. for things I typically eat daily, broccoli, etc..i eye ball it but I weigh most stuff. why not, it's simple and accurate.
I was diagnosed about 8 months back, and was on a sliding scale for about 2 weeks but found it was far to inaccurate and allowed very little flexibility in meals and timing.
You should really look into carb counting, and perhaps a half unit pen (if your not on a pump).
I was injecting min 6 units before each meal, now after starting to count carbs I rarely inject more then 4 units, and i feel as though i can eat anything I want as long as i estimate the proper amount of carbs (within 5-10g) if i go over or under i will notice on my post meal 2-hr test and either eat a bit more or inject a bit more. So far its working great!
Make sure that you properly set your basal insulin rates as well (again a half unit pen helps so much!)
Check out this video i did that explains how to set your basal rates - www.youtube.com/diamattic
When set correctly you should be able to go for many hours without eating and maintain a good stable blood sugar without a change of more then 1.5mmol/L or 27mg/DL. So you may find that your long acting insulin needs to be lowered because its pulling your sugars down too much after meals...