Recovery time from morning lows

Hello, My daughter is 15 years old and is experiencing low blood sugars in the mornings several times per week. Oddly, she feels low when she is 70 - 100. When treated, it takes her about 2 to 3 hours for her to begin feeling well enough to out of bed for school. I am concerned with her having a feeling hypo when she is actually not and the recovery time seems really long. Even when her blood sugar returns to normal and most times goes high, the recovery time is the same. If anyone is experiencing similar issues, I would appreciate hearing any feedback advise. Thank you.

What is her average bg or A1C? Numbers in the 70-100 number range can feel low if average bg's are running high.

Additionally, any nervousness or anxiety can itself feel like a hypo even if it isn't actually a hypo. It has actually further infuriated my friends and relatives in stressful situations when I have to take a brake from arguing, to go check my bg because dang it, that sure feels like a hypo.

My son (not diabetic) is having severe getting-up-for-high-school-way-before-the-break-of-dawn issues too, and the stress of that drives me nuts too! Never mind me worrying about the stress he's feeling.

Thank you for your feedback. My daughters A1C is 7.8 and she does feel much better running higher say 220. That has been her lowest A1C since she was 9. Your experience with the nervousness and anxiety would also explain this since she tends to be anxious about school situations and getting up early is difficult as well. Thank you again for your reply.

A BG of 70 is still normal, so she might just be really sensitive. I start feeling those sensations at about 78, which I'm grateful for because I'd rather have that then not feel it until I'm down to 40 like some people do.

It should only take 15 minutes to start feeling better after a true low once you treat it with about 15g of simple carbs, maybe 30 minutes max. My guess is there is something else going on that is making her feel lethargic. By any chance are there any issues going on at school that is making her dread getting up and going? I know I went through that at that age...

If she is low during the day or evening (not sleeping) and her BS goes low, it does take 15 to 30 minutes for her to feel better. It's only the morning lows that take much longer. You could be right that the thought of getting up and going to school may be elevating her low feeling if she is nervous. However, she will eventually go to school tardy and being tardy causes her stress. I appreciate your feedback. Thank you.

I have also had some hypos that were "doozies" and took me a while to get back into sync with the real world.

But for me, the best way to get back into sync with the real world is just to go to school(then)/work(now) and power through with all the everyday activities. Getting actively involved in real stuff helps me forget the hypo after-effects. Staying home for me, has always been the worst choice, ensuring that I stay out of sync.

Completely agree with Tim.

Years ago, when I started with my first real endocrinologist, she asked me to go on MDI and get my fasting BGs down to 100. I immediately bristled and pointed out how low and shaky I would get @ 120 mg/dl.

Over time I was able to bring down my numbers and can feel comfortable in the 70-100 range.

Is she going low in the middle of the night as well? Some lows can really knock me down more than others, but multiple lows can also leave me feeling loopy and disconnected.

Is she doing MDI or a pump?

Thank you Mike. Sydney is taking injections for every meal/snack and corrections. She tried the pump and did not like it. Please don't take this wrong, but it's comforting to know that you felt low and shaky at 120. This helps me understand more of what my daughter is feeling. Sydney tells me often that I just don't understand how it feels too be low and can't get out of bed. And my struggle is that her numbers don't always read as low, 70 or less. I appreciate your sharing your experience.

You are experiencing much of the same as my daughter. She doesn't feel good often because of her lows and she feels low when she is actually high. Thank you so much for sharing your experiences. You have been a great help to me.

Tim, I totally agree with you. I really appreciate your help.

Why can't she get out of bed???? How long has she been diagnosed?

Physically it takes fifteen minutes, sometimes, sometimes thirty for sugars to behave enough so we can easily continue whatever we were doing originally. But the thirty minute window is fairly extreme cases. Most times, having been diabetic more than a day or two, I can continue doing whatever WHILE low... or at least within ten, fifteen minutes tops.

How much sleep is your daughter normally getting? Not when she's in her room, but when she is actually asleep there? The three hours sounds like a HUGE buffer, far more for emotional reasons, than for any physical ones.

The sheer fear will wind anybody up, you or her. But three hours sounds like an extreme case, and you'll have to dig a lot deeper to figure out why she needs that long?

How are you treating her low(s) exactly? The other easy possibility is you/she is not treating with enough sugar, and the low itself could last that long. What are her numbers showing during that "three hour" period?

Meaning, give her half the can to treat it, or the whole thing for that matter, not a few measured sips of the soda. How you/she are treating the lows might be a cause as well.

But any low which lasts that long says there is something very, very wrong somewhere in the equasion. Lets dig a little see what we can come up with...

Hello Terri:

Something you said caught my attention. How many shots are we talking about in the course of a day? What does she take at night, before bed? Im wondering if a cause for the issue(s) might not be what's called "double stacking". The serious overlap of insulin(s) such that shes getting hammered in the middle of the night or morning right before school. What kinds/types of insulins are on board in that morning time frame?

As for the numbers not equalling a low per se, just be careful if its border line kinda sorta low, she might well be. Capillary blood sugar readings are not outstandingly accurate shall we say?!?! The 2010 FDA Gatherberg MD meeting was pretty clear on that point.

Have you tried getting her out of bed anyway, and forcing the normal routine on her, at that point. Feeling a LITTLE better hon, HUG, lets get you to school kiddo. Get your butt up, lets go...


Up... come on. Normal daily stuff, lectuers, homework, SCHOOL.

Play it like a bad experience, but do not let her hide behind them. Fear gets bigger when you feed it... do not let her feed hers, move her along maybe.

The standard that governs meter accuracy is notoriously loose. Working from memory, it’s something like +/- 20% above 75 mg/dl and +/- 20 mg/dl below 75 mg/dl. As if thay isn’t a loose enough standard, it only has to do that 95% of the time!

If your daughter’s meter reports a 70 reading then it could be as low as 50. Have you checked your daughter’s meter accuracy when she gets a lab draw for A1c? Request that her doctor order a blood glucose test in addition the the A1c. I usually do two consecutive fingersticks right before the blood draw. I then compare the average of these two readings with the lab report. If you do this the next two or three times at the lab you’ll have an idea how your meter performs. I always use the same meter for comparision, even though I have a back-up meter, too.

The other thing that has not been mentioned is the concept of glucose variability. When I range from 200+ down to 50 and back again in a relatively short time, it is very tiring. It’s not just the lows and highs that tire us out. I’m trying to provide some additonal context for you to sort out what’s going on with your daughter.

I agree with others that there may be more going on emotionally that needs to be addressed. Teenage years are hard enough without the additional burden of T1D. Good luck with sorting things out!

I'm one of the probably rare people who only felt low when I actually got my first low (which was like 66 mg/dL, thanksgiving 2013 .Coming close to my first hypo anniversary lol) . I felt a little crappy when I started going below 100 mg/dL at first (though not low , still a different feeling), but now I'm pretty content until I get into the low 70 mg/dL range. I often wake up around there and I feel fine if it's first thing in the morning, but I feel like the room is spinning and I get sweaty if I'm in the low 70's at any other time. I tend to eat small snacks while recovering from a hypo like a hand full of mixed nuts or an atkin's bar (the daybreak kind=perfect) , nothing to spike me up but to give me some protein . I'm not sure if this'll help your daughter, but it might. I get hypo with physical activity mostly no matter how much I reduce my insulin or how much I eat (though eating snacks regularly helps) and I recover fairly quickly because I CAREFULLY snack through least I think that's the reason?

Terry, The meter accuracy may be "dead on" what the problem could be. My daughter often tells me it's not correct and we recheck immediately after a get a similiar reading. Great suggestion to check against the lab work. The 200+ to a low is also experienced every morning when Sydney's lantus kicks in so the drastic drop could be affecting her along with her lacking the 12 hours of sleep she prefers. On school nights she gets 7 to 8 hours normally. Thanks so much for your feedback.

Great input. Thanks for you help. I will try the mixed nuts and the atkins bar for protein. Today she drinks orange juice and peanut butter on white toast. That is a the snack she prefers for her daily lows.

Btw, you can also get CONTROL solution for any meter I've ever heard of/used. It checks the calibrations of the meter, apparently. Just call the manufacturer whomever it might be, and ask them to send you some ASAP. Its an itty-bitty bottle. And you wont have to wait for the next lab draw to check it against. Aware of it???

The control solution can confirm that the meter and strips perform within design range. Doing a lab comparison can tell you if your system reads high or low compared to a solid standard. Doing this for two or three lab draws can reveal that your meter and strips always read x points high or low, more info than a control solution. And if the lab comparison confirms accuracy and precision, the control solution test is moot.