A Conundrum

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A Conundrum


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Old 05-08-2019, 22:20   #1
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My BG keeps slipping down around 3-4 overnight which seems good, right? Except this is in spite of having had carbs at dinnertime and no bolus insulin. I get hypo symptoms at 3, and it bothers me that I could go very low overnight and not even know it was happening.

Also, where a few months ago it would take ages to come down from a carb high, it now seems to drop like a rock. Its not a rebound, it doesn't go that far, but its coming down to "normal" much faster than it used to.

Until now, I have been having my Lantus in 2 divided doses, but I am thinking that under these circumstances (and its very new to me) I had maybe better just have it all in the morning. I'm still on 2gm of Metformin XR at night so should I perhaps reduce that, too?

All suggestions welcome. My GP is a lovely fellow and very encouraging, but isn't very good at diabetes.

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Old 05-08-2019, 23:44   #2
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Maybe you could start out by first reducing your night dose if your good thru the day.

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Think I've had this since 2003. Told I was Type 2 lean on 2/13/12.
a1c 8.8 (8/2011) 5.4 (10/2018)
TC 206 LDL 102 HDL 85 TG 96 (10/2018)
Supplemental vitamins and electrolytes
63 YY Love the LCHF diet. The cheese goes well with my whine

updated 10/26/18
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Old 05-09-2019, 02:00   #3
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Reduce... insulin or metformin?

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Old 05-09-2019, 08:31   #4
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Over the years, I've learned that your doctor can only be so good. Diabetes affects all of us differently & your doctor spends a few minutes with you, while you've spent many years living in your body.
My blood sugar also sometimes drops suddenly & I always feel it whenever I'm anywhere near 100. I have to always be near sugar or I'll be in trouble. It is totally unpredictable. It's as if I'm not diabetic on some days, & the insulin causes lows - totally at random.
My doctor advised me not to treat blood sugar unless it's under 80. That may be OK for most of her patients, but not for me. I'm not able to walk safely or even stand whenever I'm at 100. And my hands shake so uncontrollably, I wouldn't be able to do anything except lie down. She won't be there when taking her advice causes me to fall down the stairs or pass out while driving. I'm not blaming her; she's giving me advice based on what she's been taught. I don't see her for help; I listen to her politely, but I only see her because she won't refill my prescription for insulin if I don't.

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Old 05-09-2019, 13:08   #5
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I have no suggestions for Sue's (kyteflyer's) situation, but...
Quote:
Originally Posted by xring View Post
Over the years, I've learned that your doctor can only be so good. Diabetes affects all of us differently & your doctor spends a few minutes with you, while you've spent many years living in your body.
These are excellent words for so many of the situations we face as diabetics! Listening to our own bodies is always in order compared to generic advice or "protocol".

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Old 05-09-2019, 15:00   #6
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Reduce... insulin or metformin?
Since excess insulin does cause more things other than low BG, if it were me, I'd work on the insulin reduction. My goal would be to work to get my exogenous insulin needs reduced and, if possible, eliminated. If I were able to eliminate the insulin needs, then I would look at cutting back on the metformin, if my BG was still going low. Metformin, on its own, is not supposed to be a direct cause of hypoglycemia.

That's my opinion, after much googling about what too much insulin in circulation does. That and a dollar will get you a cup of black coffee at McDonalds.

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Think I've had this since 2003. Told I was Type 2 lean on 2/13/12.
a1c 8.8 (8/2011) 5.4 (10/2018)
TC 206 LDL 102 HDL 85 TG 96 (10/2018)
Supplemental vitamins and electrolytes
63 YY Love the LCHF diet. The cheese goes well with my whine

updated 10/26/18

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Old 05-09-2019, 22:15   #7
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Nice. I had not got back here before night fell in Australia, so I decided to forgo the night time dose of insulin anyway. The thing is, even without any RAI I found that my BG dropped after an initial small rise after dinner, and was heading south again. I decided to have a banana sandwich (I know... CARBS!!!) and it hardly raised a bump. I dunno... its truly weird. BG overnight was 5-5.4. I'll have my normal morning Lantus and see how things go. Could be dodgy today, its scones, jam and cream for morning tea at a friend's house... I'll test to see how that affects me... But I am ever so glad to have the Libre which makes it much easier to keep a close eye on whats happening.

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Old 05-13-2019, 13:39   #8
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Quote:
Originally Posted by kyteflyer View Post
My BG keeps slipping down around 3-4 overnight which seems good, right? Except this is in spite of having had carbs at dinnertime and no bolus insulin. I get hypo symptoms at 3, and it bothers me that I could go very low overnight and not even know it was happening.



Also, where a few months ago it would take ages to come down from a carb high, it now seems to drop like a rock. Its not a rebound, it doesn't go that far, but its coming down to "normal" much faster than it used to.



Until now, I have been having my Lantus in 2 divided doses, but I am thinking that under these circumstances (and its very new to me) I had maybe better just have it all in the morning. I'm still on 2gm of Metformin XR at night so should I perhaps reduce that, too?



All suggestions welcome. My GP is a lovely fellow and very encouraging, but isn't very good at diabetes.
You need to speak to a diabetes specialist nurse who will be able to help you with this. GPs do not specialise in diabetes and will not usually be able to advise patients about dose adjustment of insulin. Consultants and DSN's are the people who can help you.

Sent from my SM-G928C using Tapatalk

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Old 05-13-2019, 18:53   #9
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Quote:
Originally Posted by Shimmmer View Post
You need to speak to a diabetes specialist nurse who will be able to help you with this. GPs do not specialise in diabetes and will not usually be able to advise patients about dose adjustment of insulin. Consultants and DSN's are the people who can help you.

Sent from my SM-G928C using Tapatalk
I had a diabetes educator, she wanted me to eat more carbs. Don't think I will talk to her again. IN any case, it all seems to be resolved. Thanks for your input

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