New Member, Type 2 for 6 Years

Type 1 and LADA New to Type 1 Diabetes
1

I have been diagnosed with Type 2 for over 6 years. I honestly was in denial and wasn't taking care of myself. I was on what seems like every oral medication out there, and nothing really was working. I honestly wasn't watching my carb intake as well as I should have been, so I am sure that is why the meds weren't working.

I am currently maxed out on Metformin, two Diamicron, and started on Trajenta (sp?) about a month ago. For the past three weeks I have been restricting my carbs to no more than 40/day. My numbers still very high (9-10 after meals).

My diabetes coach recently wanted me to try Lantus at night to try to get my numbers in the morning down (they were over 11.5 every morning, even on Low Carb diet).

Within a couple of days my numbers are coming down! This morning I had a 6.2 fasting, which may be my lowest fasting number ever. Throughout the day, I have been having between 6-8's.

Last night I had a low (went from 6-4.4 in about a 1/2 hour). My coach had told me to treat for a low when it starts getting to the low 4's). I treated and it started coming back up.

Here is my question. The low happened right before bed. I treated and then tested after 15. It came up a bit (5).

So when this happens right before bed or even during the day, after you treat, should I eat something after treating? I was worried that after I treated and checked that maybe I would go low again in my sleep.

Any advice would be greatly appreciated!

2

If I have a low before bed, I will usually have an additional snack to be sure I don't go low in my sleep. I do have a continuous glucose monitor (CGM) that wakes me if low, but I don't want to take chances.

3

You should always treat a low, but having a low from Lantus suggests another issue. Since Lantus doesn't really start working for 3-4 hours, it seems unlikely that a normal Lantus injection would cause a hypo. But I say normal. Lantus is an interesting insulin, it is an acid mixture that when injected into your bodyfat layer instantly crystallizes and then those crystals slowly dissolve releasing insulin over 24 hours. Unfortunately, if you accidentally inject Lantus into muscle or a vein, it will fail to crystallize and act like a rapid insulin. This can be a source of sudden lows. This may have been what happened to you.

You should always take care to pinch up and inject Lantus into the bodyfat layer right below the skin (subcutaneous). This is a specific part of the prescribing instructions. You may also want to take you Lantus around dinner time rather than right before bed, that way if you do have a hypo you will be awake to treat it.