Hello Everyone, I was in the chat room with this question but I would like all input I can get. I have been a type 1 for 3 years (diagnosed at 46). I have some other auto immune issues that they say led to this. When I was diagnosed it was sudden and I've been on insulin since. I recently had a check up and got a dtap booster, then 2 weeks later I got the stomach flu.This was a fight with usual high glucose. Now I'm starting to feel better after 4 days and have had to stop taking my insulin because I am having very Low Lows. Has this ever happened to anybody? This is very freaky. The lows feel like normal feverish, irritable lows. Help!
Wonky control is de rigeur when sick.
What is your prescribed treatment plan from your doctor? Are you on shots or pump? Do you count carbs? Are you familiar with basal vs. bolus, and do you administer insulin for basal coverage?
Hi Dave, I take (shots) 23 units of lantus in the morning, 12 at night and 1 unit of humalog for every 20 carbs. I'm not sure about basal and bolus. I think I might need to go see an endocrinologist and not just a primary care doc. I went to see my doc today and he said well that's weird. Then he tells me let's wait and see. David in the chat room asked if I was LADA and I didn't know what that was either, but I looked it up and it seemed pretty close to why all of a sudden my pancreas would work. I'm totally exasperated! Shouldn't one of the doctors I see suggest some kind of test to find out? I just feel like I was in control of the situation then bam! Everything does a 180 on me, and it feels like I don't know what the heck I'm doing!
how were you confirmed a type 1 or diagnosed? were you losing weight rapidly, throwing ketones, were you DKA when diagnosed, did you test positive for the T1 antibodies, did you have a fasting cpeptide test? basal is your lantus, bolus is your fast acting - humalog. have you seen an endo and/or had any diabetes education? 35 units of basal - lantus is quite a big dose for a type 1 fairly newly diagnosed. are you now having fasting low, after meal lows and/or both?
What kind of low number is very Low Lows? I recently had to reduce my basal and bolus insulin amounts. It happens and sometimes we don't know the reason. Stopping insulin would not be an option for me though, so please keep a close eye on your blood glucose. Your 23 units of lantus in the morning, and 12 at night is your basal insulin; and then the 1 unit of humalog for every 20 carbs is your bolus insulin.
These sometimes need to be adjusted. Do see an endo if you can. And read the book called Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin-Completely Revised and Updated by Gary Scheiner.
Hi Sarah, I did lose 40lbs in a month and a half and had dka. So I spent a fun filled 4 days in the icu to get better. My doctor(primary care--haven't seen an endo)said they were testing me for T1. Also, the PA in the his office is their diabetes specialist so I usually see her. I don't believe I've ever had a cpeptide test, and when I went to see my doc today he said he couldn't find any tests or results from test when I was in the hospital. Yes I do get fasting lows, almost never after meal lows. This weekend with no insulin and being low was very scary. If I feel like I don't know what I'm doing I also feel like my doctors don't know what they're doing.
please, if you can...see an endo. a primary care doctor doesn't have knowledge of type 1 diabetes, usually. did an endo oversee your care in the hospital (sorry about your DKA, it's horrible..ugh!). what did the endo say at the hospital. who Rx'd your insulin and put you on your lantus? that's a large dose of lantus, just saying..but I don't know your sensitivity, true Dx, weight, size, etc...you may also be honeymooning. when you say no insulin, is that no bolus (food) insulin as well or lantus. it sounds like your basal dose is way too high. are you not taking your basal (lantus) and going to bed OK and waking up OK. there can often be two phases of type 1 diabetes, maybe you still have some fasting ability. a cpeptide would show how much insulin you're still producing, has to be a fasting test. PLEASE, please see an endocrinologist. I can't believe someone's just put you on insulin with no education or correct diagnosis (it sounds type 1..but IDK). do you know how to count carbs, etc...what's you I:CR and ISF? Did anyone set any goals for you, BG's to target for fasting, between meals, before and after meals? If so, what are those numbers?
Hello for me low lows are in the 70-90's, because I can tell when I start feeling funny. I've read other people have extreme lows in the 50 to 20 range. I can't imagine that. I have read quite a few books, articles, blogs and taken 1 class for 6 weeks. Like I said I thought I had it pretty well under control and understood what I was going through and what I needed to do, but I guess not. It was a coincidence that my primary care dr was on rounds that night, so no I never saw an endo. I did take a class and saw a dietician and everything was going ok until this weekend. When I say no insulin, I mean no insulin bolus or basal. That is what's scaring me. I was up 2 nights in a row drinking orange juice and having snacks, and it's Memorial weekend (no emergency room for this silly episode)so I just thought I'm going to try skipping one dose then both now all. I feel like I'm going to check and it's going to be 500.
I just checked our phone book, we have 1 endocrinologist for a city of 46,000 and county of 128,000.
keep checking and testing. i think your basal dose is too high. have you called your primary, have him/her do the antibody, cpeptide testing and refer you to an endo. i can't believe, while in the hopsital, they'd allow a primary care doctor to oversee a DKA patient in ICU, never heard of that. That's like having your primary care take care of you while you've just had open heart surgery or cancer...makes no sense. not sure what country you're in. what are you after meal numbers without your bolus - humalog? are you low carbing. have you called your doctor yet?
lol...I live in New Mexico, but like I said it's only 46,000 people but not that small. I went to see my doctor today, he said let's wait and see. Wow I didn't know primary care doctors weren't that educated in Diabetes. I ate about an hour and a half ago and my bg was 147 just now.
I think your body is adjusting to "normal" bgs. 70-90 is normal, not low. After being high for a long time it takes awhile for your body to adjust. I also think your Lantus dose is pretty high though
hmmm I'm totally confused. My dr said to try and keep my bg at 140. I really am frustrated, how have I been doing this for 3 years? Seriously?!
Seriously?! I would be thrilled with numbers of 70-90! My goal number is 85 all the time :)
What exactly did you learn when you "read quite a few books, articles, blogs and taken 1 class for 6 weeks."? 140 is the 2 hour goal for lots of folks after a meal, but otherwise not usually the recommended goal number.
147 is not so bad after a meal 1 and 1/2 hour ago. Still no insulin?? I am totally confused, too!
I'd see about getting an appointment, taking some food/blood glucose/insulin/ logs to him/her. It could be that your thyroid meds (if there are any) need adjusting, along with your insulin.
140 is usually what we target for 2 hours after a meal. yes, 90 is a perfectly normal blood sugar but can feel low if you're not used to it. What's you A1C, certainly your doctor is checking every 3 months, correct? What was your A1C when diagnosed? What do you go to bed at, wake up at. You're not providing a lot of info so it's hard to help. You just saw your doctor and you told him you're going low and went off insulin and he said, 'wait and see' wait and see for 'what'? if you're a type 1 diabetic, we can't go off insulin..there is also a honeymoon period where we have to adjust down but we don't go completely off insulin and the honeymoon period doesn't typically start three years into diagnosis.
Ok here’s my info: When I wake up my bg is 147 and I try to have that as my goal for bedtime also. I use the Humalog before meals to try to keep it at a relatively normal range. My last A1C1 in March was 7.1. I’m not sure what it was when I was diagnosed. It’s been 6.8-7.1 my 2011 diagnosis. I take 150 mg of synthroid daily. When I was diagnosed in 2011 my Dr explained the sudden onset to me this way. You have vitiligo and thyroid disease which are auto-immune diseases. He said when you have one AID you are more likely to get another one. I have taken the 35 total Lantus and the Humalog since. Usually if I skip Humalog with a meal it will go into the high 200’s or 300. Hasn’t been higher than that though or lower than 79.
Last week I started feeling like I was coming down with something. I was having a hard time keeping my bg down because I was sick, so I was checking often. I was still eating normally though. After about 4 days of this my bg started staying in a normal range (for me). Then it started getting lower finally after a couple of days of this, I skipped a dose on purpose then another dose. So today when I could get in to see my Dr I told him all of this. He said maybe the cells that are usually attacking either my insulin or pancreas might be fighting an infection, I still have a low grade fever. He told me to keep my glucagon close and just check my bg often and let’s see if it keeps being normal or goes back up. I asked him what I should do if it started rising again and he said do what you normally do.
I’m not sure if I’m not asking him the right questions or if this is just normal because he wasn’t really sure what he could do. It’s pretty scary because for 3 years, it’s been don’t forget your medicine and I actually just stopped taking it.
ditto what sarah said about gps. my gp always remembers to tell me i know more than she does.
Thanks that does make sense.
As others said, 70-90 is normal for 99.999% of human beings, and only not if you have some very unusual medical condition. If you are otherwise healthy, then 80-100 / 90-110 is the range you should be targeting.
Hypoglycemic symptoms in the 70-90 range are usually the result of "false hypo" resulting from chronic high blood sugar for an extended period of time. If you are chronically running over 200, or even in the 150-200 range, dropping BG down to normal will cause the brain to act as if it's being starved of glucose, when its not and is perfectly safe. Your brain has gotten used to being bathed in syrup -- it takes some time to re-acclimate.
I know this from direct personal experience, having gone through it myself.
Based on your postings, you have some learning to do. It's not like a full college course or anything, but there are a few bits of advice I'd give you that I'll 100% of your fellow D's here will agree with:
- There is no one, literally, that can and will manage your diabetes effectively than you. No relation, no friend, no doctor.
- As such, you need to get educated. Learn about basal/bolus (the levemir is basal, the humalog bolus). Accurate carb counting and bolus dosing. Determining your basal requirements via basal testing. What I:C ratio is, and how to figure out what yours is. What a Correction Factor is, and how to figure yours out. And more.
- Get up to speed on all of this right away, preferably before you see your doctor again, or a new patient visit with an endo. Demonstrate competence and confidence, and the doctor will work with you. In fact, many if not most love patients like that, so you become a case they naturally invest more time and thought into.
- Learn about pumps, their advantages/disadvantages, and consider if this technology is for you. Many many of us think insulin pumps are God's gift to diabetics.
- Learn about CGMs -- same advice as pumps. Gift #2 from God.
My guess is that, with the treatment approach your doctor has you on, and your hypo symptoms in the 70-90 range, you're running pretty high BG most of the time -- certainly above 150. This still places you at considerable risk for all the bad diabetic complications.
You want to get your fasting BG down below 120 routinely, under 100 ideally. 2-33 hours post-eating should be under 140. 3-4 or more hours after a meal you should be back down to fasting level.
Achieving this kind of control requires testing at least 7 times a day (wakeup; 2h post breakfast; before and after lunch, before and after dinner; before bed) at the beginning while your learning your "numbers" (i.e. dosing ratios, etc.).
All this said, T1, T1/LADA, T2, MODY, doesn't matter... You're glucose metabolism is impaired, and you need to take conscious control to keep it in line.
Hi there -
No matter how bad you feel at 70-90 those aren't bad lows. Normal individuals have fasting blood sugars in the 80s and often visit the 70s. If you're not taking insulin - especially basal - you must test every few hours. Not taking insulin and not testing is a recipe for disaster. If you find yourself a little low, eat a glucose tab or have a couple ounces of milk or juice.
I realize I'm answering this particular post rather late and good news may be on the second page of the thread. I hope so.
Maurie