Nighttime low

My blood sugars have been excellent over the past half a week or so. I'm still using lots of insulin, but my readings have been great. I've been using Diabetes Pilot to manually log everything, including all my food (including calories and other nutritional information), glucose, insulin, exercise, weight, and blood pressure (it's up and down so I'm supposed to monitor it), and any related notes like site changes. Logging has not been that hard since I can do it from my computer or the DP iPhone app, and since foods can be groups into meals and I tend to eat the same meals over and over again which makes entering that information as simple as one click. I'm hoping I will continue it since I really like this program in addition to the data I can download from my pump.

I woke up at 1:00 AM last night with a low of 3.2 (58 mg/dl). Even though that's a mild low, I've been running kind of high lately and had ZERO lows for like a month, so I really felt it. I ate literally 90 grams of carbohydrates as treatment! I intended to bolus for it but fell asleep before I could. I was sure I'd wake up this morning in the low 20s (350-450) since that's what's happened in the past when I've eaten so much to treat a nighttime low without a bolus. But when I woke up I didn't feel high at all, and I was only 7.3 (131 mg/dl). Eating that much without a bolus and not going high is just crazy! These are the lows that I find kind of scary, because what would have happened if I hadn't woken up and eaten the equivalent of a large meal for treatment?

I did exercise last night, but I'd set my basal rate to -10% for eight hours as usual. I've done that every time I've exercised the past week or so and never had any kind of crazy low like that, so I have no idea where it came from!

Hi Jen ~

I always enjoy your posts and writings.

I have had the very same thing happen to me. I am not nearly as disciplined as you in the recording of my food intake, blood sugar readings, nutrition information, etc., and seldom have lows after beginning use of the pump,. but when they do happen, most of the time I have a difficult time knowing why. When it does happen, I usually take in carbs, and see what happens. Again, sometimes my blood sugar goes way up, and sometimes it levels off to where it should be. Living alone, it is scary.

I guess it is because we are both up to the challenge. Sometimes, it is good to be diabetic. When this scenario happens, I am not sure that this is the time.

Be well.

Brian Wittman

Yikes, I'm familiar w/ the "eat 90G of carb and run up syndrome" (New term: ENGOCARUS?). Did you miss some food somehow? It sounds like you are keeping track of stuff. MrsAcidRock has been using an iPhone app called "Lose It" that seems to work pretty well, you can manually look up foods to enter them or scan the bar code and how much and it logs everything, carbs, fat, vitamins, etc. At the same time, I've had a few times where I get carried away by the "holiday spirit" and figure "oh, I'm gonna pig out for sure..." but somehow eat the "normal" amount instead of the the "holiday gonzo" amount and end up low. It may also be that I'd cut back on booze/ beer/ etc. a bit so those carbs that were in the carb chunks in my head weren't there again leading to some hypos through the season. Thanks for continuing to post your blogs, it's a great account of trying to get things going.

That can be crazy and scary.. I make sure glucose tabs are everywhere easy access. and now we found something called Quick Sticks which don'e need chewing and taste great.

I have to tell you. I can have what is called Late Onset Hypoglycemia (LOH) (also called PostExercise Late-onset (PEL) hypoglycemia). Some people believe that you deplete your glycogen during exercise and then at some time within the next 48 hours your body starts a cascade to refill the stores. I have had to fight some lows after exercise with similar amounts of carbs and it was Not the insulin. What I did find was that having a meal after working out totally stopped the hypos. You may have something similar happen and it may be good to eat after evening exercise.

ps. LOH is a particular issue for kids who can have really bad hypos at night after an active day.

Interesting about the late-onset hypoglycemia, I have heard of that with exercise. I actually do usually have a small bedtime snack on nights I exercise because I get hungry. Maybe I need to reduce my bolus when I do that, but then if I'm off I end up sending all night high.

I had some really bad lows as a kid where I didn't wake up in the morning (and yes, at least one was after activity the night before) which is why I sometimes find overnight lows scary and overtreat them (even though I know I am eating too much). I haven't had one like that in over ten years but I think it's kind of a traumatic experience. To this day my mom still gets freaked out if she doesn't see me log onto MSN or post to Facebook each morning.

I think I might need to lower my basal rates a bit (I just put them up a week or so ago after my endocrinology appointment). Last night I went to bed at 8.0 (144 mg/dl) with no correction and did a -10% basal rate since I'd been drinking (only two drinks), and I woke up this morning at 5.5 (99 mg/dl). Great way to start 2012, but if I still drop a lot tomorrow night I think I will put my basal rates down a bit.