Mysterious lows

A few weeks ago I noticed that V had gone for 3 weeks without a reading above 180. It was a new record. I told him and the next morning he was at 250.

I also noticed that he had not been above 300 in over 3 months.
Yup, 2 days later, 370. So, is this my fault?

The serious part of this discussion: Twice in the last 10 days he has gotten serious lows within an hour of eating dinner… Normal dinner, normal pre-meal reading, 45 minutes later dropped to high 30’s.

This is followed by a snack, of course, to correct the low; with a normal reading an hour later. By morning he’s above 300.

If this happened every day, or even most days, I would think a digestion issue, but the only thing in common is that it happens on Sunday - which is a day like every other for us.

Is this just another hill on this roller coaster called diabetes?

We have a doc appointment next week - (with the twit that told him the only important reading of the day is in the morning - it should be 100 and that Lantus was only for the night) We will ask her but I thought I’d ask you all first - because I know I’ll get better answers here ;-))


And Happy Spring,


Hello Kate, it is not very mysterious in my view. V had his pancreas partly removed and this is in general causing digestion problems. So I would assume that his digestion is slower than before the surgery. On sunday it is likely that the meal is bigger or higher in fat. This will furthermore increase the tendency to have a slow digestion. If the current insulin is too quick for his digestion rate he will experience an early low. Some hours later the digestion has processed the carbs and then the blood glucose will rise. In these situations it is a good recommendation to use slower regular insulin. It is just a try and V will see the difference within one week. It could fail but I see these advantages: regular insulin does fit to the slower digestion rate, it is active for more hours so it will more likely catch the carbs that are coming later.

Well… He had his complete pancreas removed…
And Sunday, unlike most people, is usually the lightest meal of the week for us. We have big dinners on Friday and Saturday night, and Sunday is usually just a pasta or risotto, much the same as it’s been for the last year and this has happened only for the last 2 weeks.

You are right. In general the current situation looks much better now. I did not had the time to look at your data lately but I think you two should get our applause here:

Proportional trend (looks good if this continues):

182 Days in comparison (looks greener now, but morning and late evening has room for improvements):

Mean glucose for the last 30 days (this also shows the higher morning and the rise in the late evenings)

To my surprise I do not see the massive low tendency after meals anymore. So I think you have found a way to compensate the faster insulin by injecting after eating etc. What I sometimes see is a very late meal. This is something I totally abandoned for myself. Meals can be unpretictable sometimes and I always want to have no insulin on board at bedtime. This way I can just correct when I am high before sleeping and do not have to worry about stacking insulin. If I am low I just compensate for that by eating carbs and the basal will hold me steady to the morning. It seems that sometimes the additional insulin for the late dinner helps to reach good numbers in the morning. Do you think the basal insulin alone will allow V to reach good numbers when waking up in the morning? What happens if he does not eat three hours before sleeping? Will a good number at sleeping time be followed by a good number in the morning?

My insulin need goes down as spring and warmer weather comes.
I’m suggesting you take a look at the total daily Lantus (as opposed to short acting), compare it with awhile back. What was he on last summer? Less? Maybe he needs a bit less long acting as warmer weather comes along.
This is a very non professional response, but a just maybe.

I’m hoping it’s just a combination of the warmer weather and the outdoor work that comes with it. We did reduce the lantus. As to the non-professional response - most professtionals only deal with this be textbook - it’s the practical response we’re looking for ;-))

We eat dinner late, and have for the last 20 years. It’s one of those things that we want to work with rather than change… and sometimes it’s challenging His numbers have been fairly good lately, it’s just these last two incidents I’ve been trying to figure out.
I’m sure that fact that he doesn’t have a pancreas makes getting to the bottom of some issues a little more difficult as well.
Also, he refuses to get up at night to test so there’s no way to really do a basal test… Another thing I have to work with ;-)) We did a daytime basal test when he had to fast for another medical exam, and that was good.

Do you remember the dates of these hypo events so we can look them up?