I trust the collective wisdom here more than my doctor to shed some light. Two days in a row I had staggering afternoon lows, unlike anything I've experienced. EMS left a few hours ago. Thankfully, my husband was home to call EMS because I was unable to speak or move. He tested me. BG 37, which has never left me near comatose before. Ok, here's the strange part. I had taken Apidra 7 hours before the low. None should have been available to cause a plummet. Also use Levemir. If I accidentally took two Apidra shots (sure I didn't), I would have been dead before I hit the floor. I'm careful about rotating injection sites & take small doses, so I don't think it was a scar tissue absorption delay. No exercise to account for a low either.
EMS injected IV dextrose because glucagon would have taken too long. A minute or so later, I was able to talk. BG went to 315 after the dextrose & then dropped to 223 10 minutes later & then to 175 after I ate crackers with peanut butter & is holding at 175. Needless to say, I'm terrified to take a correction to bring it down.
I am really sorry to hear this. These sorts of lows are really scary and when you can't explain it based on your insulin it really just throws you for a loop. I wish I had a simple answer for you, but I don't. Something is going on and it is not clear what. I would certainly be conservative and prudent about your insulin. I know that you may want to use insulin to normalize your blood sugar, but given the strange circumstances, it is probably reasonable to just wait things out a bit.
Wow, glad you are ok. I would say maybe your Levemir dose injected too close to an artery but this would require uncommonly bad luck to occur two days in a row. Did the drops occur around the time that your Levemir dose typically peaks?
Maybe move evening Levemir up however many hours after lunch the staggering lows are occurring? If it's not the Apidra, it must be that? If you can move the "peak" of the allegedly "flat" insulin, you'd at least have identified your "culprit"?
Of course, the other solution might be to eat more carbs? Re the glucagon, I'd keeled over a couple of times recently (both related to family gatherings...eeek...) and they used dextrose both times. I think it may be just that the EMTs are using that instead of Glucagon? It didn't make me feel as "wrung out" as the glucagon so, if they ask and I don't try to bite their face off, I'd request the dextrose!
Thanks, bsc. I'm waiting it out. Never been scared to take insulin before. Am going to try for a doctors appt tomorrow, but I honestly don't expect an answer. He's an internist. Wish I'd had a C peptide before to compare to what it is now. Would be interesting.
Maybe getting close to an artery was it. Would be bad luck, but guess that's possible. I've never noticed much of a Levemir peak, compared to what I had on Lantus. I take split Levemir doses & my morning dose was about 7 hours from the low. Thanks, Don.
I'm so sorry this happened to you, Gerri and equally glad you are ok. My first severe low when I first started on insulin (which was entirely my own fault because I didn't have a clue) really scared me for awhile and I put off starting bolus insulin for a month because of it. More recently I wrote on here about a series of highs and lows I had that didn't make any sense. I too had a low that just kept going down and down hours and hours past any bolus. I decided that low was from some kind of uneven absorption but I guess that's a lot more likely with a pump than shots, but even though you rotate, it's not impossible that you got some kind of knot that dissolved and hit you much later.
Did you have any unusual highs as well as the low? Whatever caused it it sounds like you plunged down really quickly. My recent number of 28 was the result of several steps down and I really didn't feel that bad. Where I've had 38 and been completely disoriented I assume because it was sudden.
Obviously I don't have any real answers for you and I know that desire to have a definitive answer because then you can prevent it from happening again. It's really hard to accept that it might just have been your turn on the gremlin's wheel. And the good news is he/she/it will probably leave you alone for awhile now!
I totally understand your wanting to stay high for a bit instead of correct. The feelings will lessen with time. And, no, your doctor probably won't have any idea what to tell you.
Oh Gerrie ...big concern and I don't have an answer to your question , but please be aware I am thinking of you ...I always wonder, if and when the insulin delivered starts working but also when it stops working ...the " golden rules " do not always apply ,it seems ...the most frustrating thing about the insulins we use today and then in my mind !
I'm so sorry that this is going on. I'm going to pass on some "standard" advice which seems like it might be appropriate. Since the lows don't appear to be related to the Apidra, you might cut back on your basal to give yourself some room. You might also correct to 150 or 140. That way you'd see how your body was reacting to the correction while still leaving yourself a decent margin of safety.
I really hope the demons decide to leave you alone and things get back to normal.
I'll try moving the Levemir--thanks, AR. I'll also eat more afternoon carbs. Most days, I don't eat lunch & never had a problem before, but something is changing.
Man, I was so grateful they didn't use glucagon. Heard enough stories of how sick that makes people & assumed that's what they typically inject. At the time, I couldn't utter a word.
So sorry that you keeled over at family gatherings. I felt so helpless & can't imagine if there were other people around.
i dont know what caused it for you. im what has been called a brittle diabetic, where my blood sugars rise and fall without cause and warning, but i suggest if your afraid to correct, maybe do only half a correction dose or a quarterat a time. that way it is ore controlled than a sudden drop in your sugars
Turn on the gremlin's wheel! That's true & a great expression. Hope she/he is done with me & off to mischief elsewhere, but no diabetes trouble making for anyone. It must have been a sudden drop, which makes it all the more perplexing, because I've never been immobilized like that before & I've been lower. One of the EMS guys said he said had recently been called to a man who's BG was 8!
Am only going to the doc because my husband's freaking out. What's he going to say except test more & take lower doses?
Oh Gerri, I am so glad you are ok!! Wow, this is strange....I am so very sorry. I wish I had an answer for you. I know I was dropping a few months ago after lunch and couldn't figure it out, realized I was dialing up my Humalog pen to the amount needed to cover BS and food, setting it down and eating then I was going and dialing it up again....DUH....so I was taking double the amount. I was in friggin la-la land with too much stress (eyes, life, etc) Now I double check. I hope this stops for you. Glad your Hubby was home. How are you feeling and doing now? xo
Hey Gerri!! Gee whiz! I'm sorry that you had to go through that. You must have felt so scared and helpless not being able to move or speak. Bless your heart! I haven't had that happen yet(touch wood). Many good and possible reasons given here. The ones I thought of are already included. I'm just so grateful that you are okay Hon. :)
There must be something in the air since I had a 25 min. seizure(Hubby was counting) about 3 weeks ago. He tried to wake me up and give me some juice but it was too late. He called 911. The Head Paramedic arrived first and gave me a shot of glucagon in my shoulder since I was 1.2(21.5). The other medics arrived soon after and gave me another shot of G since my test showed 2.1(37.8). Then they gave me the Dextrox I.V. for good measure, I guess. Talk about overkill. A few hours later I tested at 8.9 which surprised us both. I also noticed after gathering all my brain cells in one place, that my pinkie, ring finger and side of my right hand was numb and weak. Crap! Gonna have to fix that. I also wasn't in any hurry to get my sugar down but kept an eye on it and took half doses as Maurie suggested when needed. Thank God for my Hubby and the Paramedics. I'm glad that you and AR had no lingering affects. Me thinks we all need a vacation. :)
Gerri I’m so sorry this happened. I’m also glad you are still here to tell us about it. What I was thinking has already been said. So glad your husband was home.
You're right, Zoe. Second time he's saved my life & he's earned all freaking out rights. I'll send your thoughts! First time was DKA when I insisted I had the flu.
Believe you're right about basal. Definitely going to take a smaller dose in the morning & test like crazy to better learn when it hits. I've been taking the same morning Levemir for years, but the times they are a-changing. Grateful for the advise.
