I don’t know what the heck is up with these massive drops. Yesterday I
had a drop of 12.3 (221) points in an hour which is huge. At least that
was somewhat explainable because I was exercising, but even exercise
shouldn’t make me do that.
Well, tonight I beat even that. I had
Starbucks on the way to meet friends and bolused for that. An hour
later I was starting to eat dinner and was low, so drastically reduced
my dinner bolus due to the insulin on board. I also lowered my I:C
ratio and my basal rates. I had a burger at White Spot and did not use
a combination bolus. Then I went to a play and did not test for several
hours. Hence, I was not all that surprised when I was 24.2 (436) when I
tested on the train as I was heading home.
A mere 50 minutes
after that test and appropriate correction bolus, however, I am down to
11.6 (209). I checked the 24.2 multiple times so know I was that high.
I checked my current blood sugar multiple times so know I am much lower
now. But how do I drop 12.6 (227) points in under an hour???
And
now it’s 12:30 and I am exhausted and would like nothing more than to
fall into bed, but I have 6.4 units of insulin on board that haven’t
even peaked yet. That is enough insulin to lower my blood sugar to zero
and then some, and that’s if I drop as much as I should drop, and I’m
clearly dropping much faster. In fact, ten minutes after being 11.6
(209) I am down to 10.1 (182). I think it’s time to go eat, and with
that much insulin on board and dropping this fast I’m going to have to
eat a lot …
Diabetes would be so much more simple if it
actually made some semblance of sense. Sometimes I feel like it’s
almost a science when things are actually somewhat predictable … and
sometimes I feel like I’m just playing Russian roulette with a hormone
that happens to be necessary for life.
WELCOME TO THE ROLLERCOASTER. The rollercoaster is where I end up when I stop thinking ahead, and instead only react to bg readings after they’ve gone out of control. BG shoots up, take a lot of insulin, BG goes down. Too high to too low. Rollercoaster!
Eating and not taking insulin to cover it and ending up with a sky-high bg. Is that in any way “random”? Some might lead you to believe so but it was a completely predictable result.
Not criticizing you … because I’ve had bad lows and responded to them (because they were so scary) by skipping my next insulin shot. Worked out pretty much like it did for you.
BG dropping from 209 to 182 and you want to eat? I recognize being scared by a drop in bg, sure… but 182 is not low. Most of my rollercoasters come from me over-responding to hypos. Again, notice the theme of my rollercoaster? OVERREACTING.
If you cut back your insulin and your bg is high as a result, then you take the insulin you missed and your bg goes lower, that’s how it’s supposed to work. It can feel like a rollercoaster. The ROLLERCOASTER is a result of REACTING TO BG’S. The only way to avoid the rollercoaster is to proactively plan. If you’re eating, you gotta take insulin. Watch the results, use them next time you eat that meal to fine tune your control.
Remove some of the variables!
For a little experiment, next time you’re low before a meal, consider treating that low with pure glucose, re-check in 15 minutes. Don’t fool with basal or bolus rate to try to treat a low. Worried about caloric intake? Pure glucose is low in calories. It’s the using of snacks to treat lows that adds to later rollercoasters and to too many calories.
Do you know how many points each gram of glucose will increase your bg? If not, it’s a good thing to figure out.
OK, now that you’ve treated the low and just the low, are you back on target? If so (and there’s no stacked insulin on board or physical activity anticipated), then proceed with regular basal and mealtime bolus.
It’s not true for all of us, but if your basal rates are pretty solid, lows should (but mileage varies) be treatable with pure glucose in a quick amount of time. That gets you back in range, so that you can proceed “normally.” Best wishes!
OK, according to my meter, I hit “normally” maybe 50% of the time. But, the effort matters. I’ve never been a fan of rollercoasters 
Hi Kelly,
I actually do treat lows with Skittles. But then after doing that, because I’d just eaten an hour ago I let my pump reduce the recommended bolus because of the insulin on board. I had walked a bit (but not a lot!) around the city before getting to White Spot, I think that’s what may have caused that. Unfortunately I was meeting friends and didn’t realize the restaurant would be a bit of a trek from the station. I treated the low with about 12 Skittles, and one Skittle is about a gram of carbs. A gram of crabs raises my blood sugar about 0.3 mmol/L as far as I can figure. I probably shouldn’t have then reduced my bolus, but was going to a play afterward and didn’t want to deal with treating possible lows.
I should clarify I reduced my I:C ratio and basal because I’d been having huge drops after meals (either low or near low at two hours) or after corrections like above … That wasn’t just done because I was low at that one meal!
Hey Tim,
It was actually the fast drop that was random, NOT the high initial reading as that was obviously from not bolusing properly at the meal. And obviously my blood sugar should come down when I correct it … but I would anticipate it coming down to range in 2-3 hours, not be well over halfway there in 50 minutes!! At 50 minutes the insulin hasn’t even had time to peak! I did end up eating and was 9.0 (162) before bed and 10.9 (196) waking up this morning. A little high for sure, but considering I ate about 50g of carbs with no bolus, and how high I went earlier doing nearly that exact thing, I have a hard time believing I wouldn’t have gone low if I hadn’t eaten something before going to bed.
Oh well, hopefully today will be better. Yesterday was actually great up until the evening. If you take that out I stayed between 5.3 (95) and 9.3 (167) all day!
I agree with Tim. Almost ALL of my Roller coaster days have come from an OVERREACTION to blood glucose levels. I had a scary low of 36 yesterday morning, and my friends called the Emergency Squad because I could not talk nor get out of the bed. I had overreacted to a bedtime high of 234, and blilussed before bed. I wasn;t wearintgthe CGMS, so I did not know I was crashing through the night. I should have remembered that I had extra exercise on Friday afternoon( a brisk walk with comrades around a high school track-5 times before the rain stopped us), and that I shluld have lowered my basal rate to the exercise level… I did not before, during nor after the exercise. I ate a meal with unkown carb content at a restaurant a bit later that night and guestimated a bolus, thus a higher blood sugar than I wanted at bedtime. I used my general correction factor bolus, but I should have remnembered that extra exerciise makes me more insulin sensitive, so I did not need as much for a correction. I OVERREACTED, and that led to the severe morning low. The medical technichians made me eat that entire gel tube AND ran a glucose IV. Of course on Saturday, I soared into almost 300 and basically did not eat and didn’t bolus much all day, just went about my life and waited for my sugars to level out… They did . I am back on the CGMS. Most Rollercoasters are due to OVERREACTIONS… I WILL REPEAT. I won’t be riding them again. Who said if you “FAILTO PLAN , YOU PLAN TO FAIL”?
I will plan better for the next exercise excursion and react more appropriately to the highs
God Bless,
Brunetta
Hormone changes (that time of the month!) will cause drastic changes in my insulin requirements. I find that tracking, tracking, tracking everything for a month every now and then helps me understand trends and how to make adjustments for them.
Are those lows after meals after eating high-fat meals? Have you experimented with extended or wave boluses? I’m still trying to figure out if those help (I wish it was easy to run multiple science experiments on ourselves on a daily basis–but “stuff” keeps getting in the way