6 month LaDA here. All going well and using MDI. I take my Basel (trujeo) in the am. This morning, woke up at 133/ I took my usual 20 units trujeo–and about 45 minutes later prepped some breakfast . Didn’t ‘feel’ the same and retested at 80. So big drop from the 133 fasting bg. About five minutes later I started to drop sweat --and knew I was in trouble. Retested at 49-- new low for me. Managed some juice and cookies and kind bar – waited and bg rose to 117. Boules for my oatmeal and began to feel better. I cannot figure out why I would drop 80 points within a hour and go from 80 to 49 in the span of 5 minutes. I did not bolus , I did not exercise – additional info is unusual to go low – only 3 hypos in past 90 days and a1c of 5.9. Only think I did different is start Crestor the night before and a Prilosec in the am – but could not find anything online relating to bs drop and those drugs. Thanks for any insight …
Is it possible that you injected your Toujeo basal insulin into the muscle in your arm? It’s important that basal insulin be delivered into subcutaneous tissue (fat) and not into muscle tissue. Injection of basal insulin into muscle speeds up the metabolic absorption of the insulin and can cause hypoglycemia.
That’s a lot of toujeo imo. Toujejo is like lantus, but triple strength. (I don’t know any type1s on it)
anyway, if you were 133 when you woke up and took your 20 units, if you were trending down, you could have gone this low in 45 minutes. another idea, did you wash your hands before testing? You may have been lower than 133.
what meter are you using? you might want to check it using the control solution.
May have something here. I inject in leg – and have. Been doing that since the beginning. But there was a drop of blood after injection —so perhaps that means I hit a small blood vessel and the trujeo was absorbed faster ? I do see some blood drop about every other month after injextibgn in leg but don’t recall this reaction.
I use a Dario and it’s pretty solid on the readings. I think the reading was accurate based on my bedtime readin (155)
As per hands I don’t think I washed.
Sorry, I misread “am” as “arm.” Is it possible that you could have injected in your leg muscle?
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May have something here. I inject in leg – and have. Been doing that since the beginning. But there was a drop of blood after injection —so perhaps that means I hit a small blood vessel and the trujeo was absorbed faster ? I do see some blood drop about every other month after injextibgn in leg but don’t recall this reaction.
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Don’t know if I hit muscle but yes-- skinny legs here so hitting muscle entirely possible. It does explain the big drop as I did not boulos yet–
I did see the small drop of blood so weather that’s muscule or blood vessel not sure. I really appreciate your help here. Oh and yes – I want to make sure that doesn’t happen again!
Here’s a National Institute of Health study abstract that may help.
Toujeo is a form of insulin glargine.
Also if it was due to too rapid absorption, it may mean you’ll have less around later (since it got used up early/didn’t crystalize right), so be aware you may run a bit high in the evening or overnight.
I believe trujeo is very similar to lantis but is a little flatter and last about 2 hours longer –
As for the dose I also think that’s the typical dose-- maybe could be a little lower as my daily novalog is about 14-17 units and I was told should be about even amount of each –
Thanks for your help
I understand that more concentrated forms of insulin (U200, U300, U500) are all the same when you compare “unit for unit” of insulin. The U300 Toujeo is three times more concentrated than U100 Lantus, so the exact same dose is an equal amount of active insulin while the volume of the U300 Toujeo will only occupy 1/3 the space of Lantus. One unit of Toujeo = 1 unit of Lantus, but only one third the volume.
It gets confusing but I think the people who formulated these standards wanted to minimize the possibility of overdosing. We had a member here one time who was drawing up with a U100 syringe, a U200 dose of Tresiba from a pen cartridge. Her doctor prescribed the U200 pens and wasn’t aware of his patient’s habit of using a syringe to deliver insulin. Luckily, other members here picked up on her intentions and were able to prevent that member from over-dosing.
Bottom line, it’s my understanding, no matter the insulin concentration, a unit is a unit. I also understand, if you use syringes, only use a U100 syringe with U100 insulins, never for U200, U300, or U500 insulins.
Thanks Terry. I think this is it. Not sure why it ha not happened before. To be safe I will start to injecting in my love handles. I use my stomach for the novalog. Appreciate your activity on this blog in helping me and others
Thanks-- I was just thinking that ! I think so – I have been running a bit higher today but I think I’ll lay off the Basel u Il Tommorow am. Thanks much –
thanks for the correction terry.
You’re welcome, @pfriedfeld. The study I cited mentioned changing the injection technique of the study subject and eliminating this from happening again. I know a recent study that said we should all use 4mm depth needles to help prevent this from happening. I also realize that some people pinch up the skin to prevent intra-muscular injections. Mention this to your doctor next time you see him/her.
Thanks. I appreciate the knowledge that is being shared here. I always wondered why it said 300 units ml but on the bottom it says small print 450 units /1.5 ml. Yes I use pen not syringe. I dropped my dose back to 18 once to see what would happen but my bg went a bit higher. Thanks again – feeling better ! Have great day
Thanks. I use the 4mm nano needles. I guess I need to put on some weight !
Injecting in the leg can make the insulin act more rapidly and if you hit a small blood vessel your long acting insulin works much faster. There’s something like 23 or more things that can raise or lower your blood sugar so diabetics have to go into CSI-mode to figure it out.
Best of luck and glad you safely took care of it. I keep a roll of glucose tabs in the night stand, two in my purse, one in my laptop case, and two in each vehicle.
Thanks Jane. Appreciate your thoughts and well wishes