Unexplained Lows

This has been going on almost everyday for over a week now. my new struggle is trying to figure out why I keep going low mid-morning. I tried lowering my basal rate during this time, but it just made me go high…a tiny drop in basal sent me too high. sigh. I go low no matter what, if I eat carbs and bolus, I go low. If I don’t eat carbs and don’t bolus, I still go low. I even tried adjusting to a slightly lower I:C but it just made me go too high. It’s like I either go too low or too high during this time of day. If I’m active or not active, I still go low. My point here is it doesn’t matter what I do or don’t do, eat or don’t eat. I keep a close eye on my BG and it’s always like a sudden plummet, super fast, around the same time every day. I ate carbs today (with no bolus) to try to counter the low before it happened and ended up with the worst low yet! After I ate I still went low so I ate some pure sugar (ran out of glucose tabs) and felt like I was coming back up, but then I plummeted again quite rapidly and had to eat more. Then I felt so sleepy I might as well say I passed out (but I was there enough to go get my pillow off my bed and bring it to the couch). Then I woke up nearly four hours later with a BG really high (284). Geez!

Could this have to do with Metformin? Or my gastroparesis?

Suggestions, please.

Hi Tamara,

Is this helpful to you?

Reduced Epinephrine Secretion and Hypoglycemia Unawareness in Diabetic Autonomic Neuropathy

ROBERT D. HOELDTKE, M.D., Ph.D.; GUENTHER BODEN, M.D.; CHARLES R. SHUMAN, M.D.; and OLIVER E. OWEN, M.D.
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Ann Intern Med. 1982;96(4):459-462. doi:10.7326/0003-4819-96-4-459
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▸Requests for reprints should be addressed to Robert D. Hoeldtke, M.D., Ph.D.; Temple University Hospital, 3401 N. Broad Street; Philadelphia, PA 19140.

Philadelphia, Pennsylvania

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The cause of the susceptibility of certain diabetic patients to severe hypoglycemia is not known. Because the awareness of hypoglycemia is heightened by catecholamine-mediated physiologic responses, deficient catecholamine secretion may cause frequent and severe hypoglycemia. Plasma epinephrine and norepinephrine were measured after insulin-induced hypoglycemia in 18 diabetic patients, nine with autonomic neuropathy, and in nine normal volunteers. Our results show that two thirds of patients with diabetic autonomic neuropathy have moderate to severe deficits in epinephrine secretion and that these patients have diminished or delayed subjective responses to low blood sugar and are at risk for developing severe hypoglycemia and its neurologic consequences.

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I haven’t been diagnosed with autonomic neuropathy. But who knows, I have almost every other complication, LOL. I don’t usually start to feel a low until I am in the 60’s, sometimes even lower.

Hello Tamra11,

Gastroparesis is an autonomic neuropathy. Speak to your physician.

Best,

Jo

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Geez, I knew that, I guess I’ve been lying to myself for quite awhile, I guess because it’s so scary. I suppose this could be what’s contributing to my mid-morning lows. I just don’t know how to fix the problem. I’m going to have to see my GI about it. And I really need to get a referral to see a neurologist. I’ve never seen one even though I’ve had peripheral neuropathy for years.

A good friend was recently diagnosed with diabetic amyotrophy after several years of misdiagnosis. Although the conditions aren’t precisely the same, I’m curious as to whether he experiences anything like this. Have to ask.