Sudden, Scary and Stubborn Low!

One thing to also think about is the type of food you're eating vs the insulin. The nachos were probably pretty high in fat and protein, which extend when the food spikes in your system. So even if you took the correct amount of insulin, it likely hit you before the nachos did.

With meals that are high in fat or protein, sometimes I'll take the shot immediately before eating or even a bit after starting the meal. Otherwise I'll go low, correct with smarties, and then end up high from the food + sugar later. This doesn't sound like it was your issue in this instance - but as you're new to insulin, thought it was worth mentioning.

Yes the cheese probably slowed things down roodgirl. Maybe it was a combo of things, I need an even lower I:C ratio at night, still had some insulin on board from lunch bolus, a honeymooning pancreas improving after a couple weeks of help from the insulin, or I hit a little blood vessel? Not the Merriest of Christmas’s for me but I guess the good news is I tolerated the low fairly well (lots crazy palpatations but never felt faint) seeing those 20s sure was an unpleasant surprise though.

Maybe you’re fighting a bug? Such things can send us higher than usual or lower than usual.

I don’t know, I feel ok. The holidays have been stressful and tiring but wouldn’t that make me need more insulin? I think I’ll just not have diabetes anymore, it’s too hard…

Hopefully your insurance covers the "diabetes holiday package," because going non-D is pricey. But so worth it at least once a year to recharge the batteries. Now I'm picturing a sci-fi world where that was actually feasible...

I'de like to join you and not have it anymore for sure. Another thing I forgot to mention was once you start to come up, with a low like this, you can try eating something too, I usually do and it can help to stabilize you more so that maybe you won't keep going low. Nothing with too much fat usually.

I think that's a good idea, just take it easy until you get over this experience. and ask your doctor how to manage this better. I would get two glucagon pens, one for at home kept in the same place- tell everyone where it is and one in your purse. It sounds like maybe that was just too much at that time, you were running lower, had more of your own insulin, the fat combined, maybe a combo of all those things and then another bolus even within 5 hours was too much. have something installed in the rings to make them tighter? Or just get a temporary set to wear until hopefully you gain back more weight.

I read through the thread and there's some great tips. I'd add that many of the "shots" or "gels" that are popular for running have Maltodextrose as the "active" ingredient but I've found that that particular sugar works pretty slowly in me. I mostly use them for running as like food, which I only do if I'm running a pretty long way, like > 13 miles, or maybe one of the coffee ones (w/ 60 mg of caffeine...) at the start of a 1/2 marathon, to have some food on board for the race. My CGM has confirmed a peak from those at like 2 hours after I take them so I don't know that they are the best thing for lows, particularly savage ones in the 20s? It just happens sometimes though and eating a bunch of food will usually catch it. Good job!

Oh jeez I didn’t know that, I’ll look and see what was in the one I used, I think its meant for correcting lows but I’m not sure now. Thanks acidrock, I did eat some potato chips too since those normally shoot me up high and some nuts to try to give me some protein. I have to admit, even after I got my BG back up I was a little paranoid it would start going down again. I guess this just takes time to get used to.

Gosh, so sorry to hear this, Lilli, but very glad you're okay!

The suggestion to dilute your insulin is a very good one. You are so sensitive that you need much more resolution than you're getting with U100. You need to accurately administer tenths of units.

Downside is you won't be able to use pens -- you'll have to switch to disposable syringes. Although there are some pens with replaceable cartridges, so you might be able to fill cartridges yourself and still use a pen and pen needles. Anyone with experience at this?

Here is a link for the glucose drinks- they aren't the sports drinks or anything like that, they are designed for diabetes- specifically to raise bg quickly. The main ingredients are water and dextrose, no caffeine etc. Walmart has their own brand called Relion. They all taste pretty awful but they work really well for me. Better than the gels maybe because the stomach has to release liquids quickly they will get into you fast, even if you're having digestive issues unless you're not able to keep food down. I haven't tried Angivan's tip, I'm going to try that one too, it sounds like a good idea.

I would also try to get a dexcom if you can, it will help you with your treatment a lot. I say that even though mine is not always accurate still, it has helped me a great deal.

When you're correcting a low, only use rapid-acting carbs! Any fats or protein you consume will delay the action of the carbs. Once you're back up, the nuts make sense to stabilize the BGs, but while you're down, they're counterproductive. Also, try to correct with very discrete portions of carbs, rather than just munching a ton of stuff. You'll learn over time what portions of carbs bring you back up without overshooting. And the low-BG munchies can be intense, so it takes willpower not to binge!

Lilli - One thing I've noticed in my case is when I have a severe low or a significant high, I tend to follow that track 24 hours later. It won't be as pronounced or extreme. It's just that my metabolism seems to have a 24-hour memory. I call it a BG-echo. If you're like me, watch your glucose levels at the 24-hour mark.

That’s interesting Terry, I’ll watch for that pattern, thx!

I’ll bring that up with my doctor, I remember someone discussing that once here on TuD and thought I hope I don’t have to do that, more math, but that’s the way it goes, my body doesn’t do anything the easy way it seems.

Oh ok, I’ve never had such a severe low, my reactive hypos only went to the upper 40s, 50s, or 60s and eating any carbs corrected them easily and quickly.

Doing combat with the "low-BG munchies" enables me to understand the classic lure of Homer's sirens. I only wish I had the metabolic equivalent of wax ear-plugs!

These things happen; be prepared but don't worry about it.

Normally when we inject the insulin takes about 4 hours to be fully adsorbed, but if we manage to inject intravenously its all adsorbed at once; no 4 hours. What happens in practice, very, very infrequently, is that we inject close enough to a vein or a feeder capillary under our skin for adsorption to be fast. Then we need to eat a **** load of food fast. Treat it as a gift ;-)

I've done more than 10,000 shots in my life so far and it's happened to me a couple of times. It's annoying, really, really annoying, but it's also very rare; it may never happen to you again. The bruise is a fairly obvious symptom, you must have known that when you wrote your post.

Things like this tend to drive 3rd parties, like doctors, into obsessive behavior, but, IMO, we should not order our lives around events that will happen a couple of times in every 10,000. There are bigger, more important, long term risks and going low won't kill us unless it does.

John Bowler


I use U50 novolog in my pump to get the fine dosing amounts I need. Hated having to eat up to the available pen dose availability. Even with a Novopen JR, which can do 1/2 unit doses you have to start with 1 unit and can then do 1 1/2 unit from there. Syringes can let you approximate 1/2 unit but smaller than that is not really consistently possible.
NovoNordisk makes a diluting medium for their Novolog. You need to get your endo involved as they will only ship to endo office. They need to contact the NovoNordisk rep for the paperwork. If you Google search insulin diluting medium for novolog you will see the "educational only" research paper I found. Can't link to if from my kindle.
I needed to lead my adult endo practice to this, but once they were aware and I showed them my intended dilution methods- 1 vial of novolog, 1 vial of diluting medium, 2 x 5 cc sterile syringes with 21 gauge needles, pull 5cc from each vial, then swap syringes and return to vials making 2 vials of U50 novolog. I'm a lab geek so am used to this kin of thing. But will be easy for you to do. I make sure to date my vials with preparation date, as well as marking when I begin to use them. Takes me a month to go through the first vial, can get about 3 and a half weeks out of the second before i notice it is not as active. So for me with storage in fridge get about 7 weeks of useful life to my U50.
I also needed to show the team I had a good grasp of dosing with diluted insulin. With U50 dosed via syringe when you measure to the 1 unit line you are giving 0.5 units. If you approximate to the half unit line you are giving approximately 0.25 units.
It will help with meal time dosing, but just as importantly Will let you make corrections sooner with out having to wait till you are high enough to need a full unit.