I am having a terrible time with my blood sugars lately - since about Sunday. They have been extremely low - with no changes in insulin or diet. This morning my FBS was lower than it has been in a long time. When I ate a bagel for breakfast and gave myself Novorapid to cover it, I dropped. When I had my lunch - I dropped. Supper - dropped again! I don’t know what to do - I am supposed to take my normal dose of 14u of Levemir tonight - I know I should lower the dosage, but to what? And how do I figure out what to give for Novorapid until I can see my endo? Any help would be appreciated - I don’t want to drop low in the middle of the night…eek.
I’m coming from a different perspective, because I never worked with my doctor to set my insulin dose. I always did it on my own. I don’t want to speculate on what caused these low blood sugars as there could be a number of reasons, but I’d say you should definitely lower your dose.
You should do two things actually… first, you should lower your dose and eat a snack before you go to bed so you don’t go low while you’re sleeping. I can’t tell you how much to lower it, because I don’t know how bad it has been for you. You just have to wing it and measure the results–which is the second thing.
Second, you should do some tests on yourself to make sure your insulin dose is correct. You have the right insulin dose if your blood sugar doesn’t change after you’re finished digesting, so test 4 then 5 hours (ideally 5 then 6 hours) after eating and see if your levels remained stable.
Other than that, you need to figure what caused your low blood sugars, especially if it doesn’t go back to normal. You should also consider going on a very low carb diet so that the highs and lows don’t control you so much. I eat around 13 carbs per meal (9 for breakfast).
Good luck Jenn
Dear Jenn:
I guess I COME FROM A DIFFERENT PERSPECTIVE too. My first reaction is to call my DR. He or she is the one that’s most familiar with you and your history. Sam is right, though. You should eat a snack before going to bed. And then call your DR the next day with your numbers. It does sound like you need to lower your dose, but I certainly would shy away from asking non-medical personnel about how much. Now you know that you should probably lower your dose, you should go to the person who is charged with your care. I absolutely would NOT make a major change in my care based on uninsured, nonmedical advice. Sorry, don’t mean to offend anyone, Sam. Even if you ARE a DR, it would be most improper and scarey to offer a position on another DR’s patient. You have to be careful of what you do when you go to a site like this. Use it only for information, support, companionship BUT do NOT use it to change your regimen without your caregiver’s input.
Check it out, Jenn, and keep in contact with your caregivers.
Don’t mean to sound bitchy, but I am concerned.
Lois La Rose, Milwaukee, WI
Jenn - this is a scary process, isn’t it? Can you call your endo’s office to give the endo on call the basic scenario, and ask them their advice about how much to lower your dose? You may also want to just set your alarm for every 1 1/2 to 2 hours through this evening to keep an eye on your glucose so you don’t totally crash to a seriously low level. A drag, I know, but better than waking up to an ambulance crew starting an IV and putting you on a stretcher, believe me! Let us know how things work out - we’ll be thinking of you.
I agree with Tracy. Check about every 2 hours through the night. It’s tough, but it can be done and it is the safest way to keep from dropping too low. Especially if that is a real fear for you. Do you live alone or is there someone there with you that can keep a check on you or know if you don’t wake up to the alarm? If not, make sure someone will call you in the morning to check in. Definitely call your endo tomorrow and try to get your dosage straightened out. Good luck. Let us know how you are tomorrow.
jenn:
I suggest half dose tonight and check two hours later. If it is up cover it with the rest of the dose. If it is neutral hold off. However this is just for tonight. Call the doc tomorrow. I predict if you go half dose and no coverage you will be high by morning.
Rick Phillips
Jenn,
I had a skim through the comments and I had one more thing to add - do your sugars fluctuate through the month with your period? For me, about 3 days after I start, my sugars drop ALOT with no change in diet or exercise. And the week before I get some unusual highs.
Hormones play a big part in blood sugar regulation, I have come to find! This may be something you could speak to your endo about.
Just a thought.
Cant comment on how much insulin to take - different people have different insulin sensitivity!
My advice is ring the hospital and ask for help as to what you should do. In the meantime make sure someone is with you 24hrs aday who knows you are diabetic and can react when needed. I have had this with my sons and help was needed. Make sure they have a set of kit with hypo stop and drinks, glucose tablets and Gly injection. They may need them.
Just to echo Tracy, I go low several times the day before and the day that I start my period. That’s often how I know that it is coming. Even when I reduce my insulin dose for those days, I go low. I am very insulin sensitive specifically then for some reason. After the first day of the period, my insulin needs remain the same. So watch for patterns to decide if these lows could be connected to something in particular!
Have you talked to your doctor yet? This is a reason to call in and not wait until the next appointment.
Thank you all so much for your overwhelming support! I cut my does down to 8 units of Levemir and checked myself every two hours during the night - so far my blood sugar is holding steady at 8.0 with a couple glasses of juice during the night. I have a call in to my endocrinologist and the diabetic education centre so fingers crossed they can see me today! 
Thanks so much to the people that suggested how often to check it and how to adjust my dosage for the night!
Lois - I realize that a support forum doesn’t replace medical advice but being a new diagnosis (just six months ago) and it being late in the night with no access to medical personelle, I was a bit stumped! I don’t have a family doctor (the joys of living in a town where ten thousand don’t) and am only being followed by the sole endocrinologist in the area, who is hard to get an appointment with. I was just looking for a bit of advice on how to survive the night until I could talk with my endo. Don’t worry, you didn’t sound bitchy and I appreciate the concern!
Sam - I had no idea how to test myself like that to see if I had the proper insulin dosages! I am still struggling to find the right balance of how to correct a high sugar. I was told by my clinic to check my blood sugar two hours after eating and “adjust as needed”. But I’m not sure where I go wrong if my blood sugar is high after eating - did I miscalculate my insulin to carb ratio or my correction factor? Would you be able to elaborate on how to do some more accurate testing on myself? I would love to go on a low carb diet, but before I was diagnosed, I lost about 40lbs so I’m to eat about 40-60 carbs a meal to get my weight back up into a healthier rage (am only 108lbs).
Tracy and Kristen - you called it! Guess what I woke up with this morning? lol! I didn’t realize that my hormones could play such a huge part in my blood sugars during that time of the month and that I would be so sensitive to insulin right now! You guys were bang on - from steadily dropping three days before and going very low the day before and even the strange highs the week before - I had a glass of pop and gave myself insulin to cover it - but a little bit later, my glucometer showed a critical high of over 33! So unusual for me!
Get in touch with your doc by phone this might be a reaction to the insulin or you may just need to have it lowered but if you are unsure you need to call the doc or the diabetic educator. but do it really soon. Karen