FUDiabetes

Help For DM Regarding Stubborn Crashing Lows

if i build a pool in my livingroom then i will no longer need to take insulin :wink:

well, we all know who that is, and unfortunately for me, he’s on vacation :blush:

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What do you use to treat lows?

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I assume you’re refueling enough after swimming and it’s not the liver kicking in to reclaim sugar later?

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Perhaps you’re already familiar with this strategy, but I find that either treating lows with liquid carbs (juice, soda, etc) or washing down solid carbs with water/another drink usually helps them get to work more quickly

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i dont know how many carbs/protein you use to refuel , but i use 2 Boost protein/carbs shakes with 32gms of both, respectively. i do this right when i walk back into the house from the pool. lately, i have needed to take less and less insulin to account for them. i used to take 50% of my ICR, and now i have been taking even less. so for 32 gms i have been taking 1.2 units of insulin. then i nosh on cheese and nuts before dinner. for dinner i generally eat 4 slices of rye bread with 2 cans of tuna and a salad. i started out with a IC of 1:12 and now i am at 1:20 !!! OMG.

i still go low, sometimes right during eating my dinner. and this becomes a roller coaster throughout the night, the overnight, and the next morning. i treat the lows, get close to target range, go low again, and again and again. and at 12-1am i spike (184-ish) and do an IM correction, which puts me right back into range. but then i wake up low again.

i have to say that this is not something that happens every day. it does not. but when it happens and i have tried everything i can think of to treat the lows, i feel beside myself. i put so much energy into remaining flat lined, stable and in target. when something like this happens to me i become beyond frustrated. being low frightens me. when i am swimming, i feel free. i dont feel diabetic. but when i go low, i am acutely aware of my symptoms and i despise it.

btw, i treat my lows with Apple Cider, OJ, Chocolate, and glucose tabs.

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how many carbs is actually “enough” carbs? i did discuss this with eric, and he seemed to think that 32gms was sufficient. perhaps i should be taking in a little more???

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Oh man I have no idea. I wish I did though!

How much have you dropped your basal compared to how much you usually drop it for exercise? How long have these lows been plaguing you?

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usually i drop my basal by only 5% after consecutive swim days. i swam 3 days in a row this week; and i have to admit that the dificulty levels were high. i swam very hard. but i had to lower my basal levels by about 20%. but what made things overwhelmingly challenging was that my insulin needs were not consistant throughout the day/night; during overnight i needed 80%, daytime 90% and evening about 75%. it was a true balancing act. there was no one solution every time i made one change, another problem presented itself. and on and on and on.

i was terribly low all throughout last night and this morning, then this afternoon i began to creep up again, and most recently i spiked to 191 and had to give myself an IM shot in my calve muscle. of course i raised my basal back to 100% and my BG has come back into range, but i feel like life is happening around me and i wasnt given the “play book.” :grimacing:

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I suspect this is just increased insulin sensitivity; if I’m relatively inactive for a few days I end up needing a higher basal, but if I keep exercising at a sufficient rate to significantly increase my heart rate every day I’m fine.

The counter-point to this is the rub; if I leave my basal at the “inactive” level and then go out and do stuff, swimming more than 100m a day would certainly count, then my basal is too high and I will crash’n’burn.

It’s extremely difficult to handle for me because I have a 24 hour lag; my body only kicks in shoveling the carbs the next day. Over time I’ve been dropping my basal back to the lowest I can, but all the same I sometimes cancel my basal (I’m pumping) for an hour or so, typically in the morning.

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Also:

Forget the OTP title, from my experience @T1Allison’s last observation "Activity" is not the same thing as "Exercise": Allison's Running Trial matches mine; the effects have a lifetime of about 24 hours, so the good stuff happens BDQ, but, [again, my experience] if I drop out one day I feel the effect the next day.

My experience is with muscle soreness; it’s hard to walk up hill after 48 hours, but 24 hours, no problem. I believe the same applies to insulin sensitivity, it makes 100% sense to me that it does and 0% that the two are unrelated.

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do you run EVERY day??? i cant swim that frequently. when you are a runner, you have the entire world to exercise. when you swim, as i do, you are limited to the time schedual of the pool that you swim in. i must go between 1-3:30 on the weekdays.

(today will be my first Sunday in over a year, but i HAVE to swim, b/c i missed 2 days in a row and finally my D body has returned to my 100% basal without dropping) (and i desperately NEED to get what i get out of my workouts: peace and calm and a sense of “normalcy.” )

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haha that’s Samson’s breakfast CR!! And he’s about 1/3 the size of you probably, LOL. Just shows what all that swimming can do.

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late last evening my BGs stabalized. i seem to have gotten my basals,etc., back in line. i swore i would not swim on a Sunday, but my husband practically pushed me out of the house to swim. he knew it would clear my mind, even if it meant another night of roller coaster BGs. (he’s tremendously supportive, for which i am infinitely grateful)

anyway, the swim was great. my numbers were perfect. i accomplished everything i wanted to, and i am feeling wonderful. but the night is young!!! anything goes. i bolused, post swim, very gently, in hope of warding off the coming evening’s potential crashes. i dont usually crash after just one day of swimming (its usually the consecutive days that kill me). but we’ll see.

i am just praying that i made some wise decisions, and that my evening is wonderfully uneventful.

please keep me in your prayers. i am grateful to all of you who have carried me through these past few days of difficult times. thank you :heart:

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This used to happen to me a lot! I think the recommended solution is to do an extended bolus so that you are only getting a small percentage upfront, and the remaining over several hours. I know you do not use Loop, but I noticed by “mimicking” the extended bolus on Loop by specifying the carb absorption of 4 hours or more, and specifying the time of actual eating (not the time of the pre-bolus), I can usually prevent these lows during dinner and not spike!! :slight_smile:

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thanks for this info. i do LOVE doing dual (square) boluses. i find them very very helpful, but only with certain foods that are higher in fat (b/c they do digest very slowly compared to a high carb meal)

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PS: last night was wonderfully uneventful. i turned down my basal by .025 u/h and it got me right through the night without any crashes or spikes.

today, so far, i had to lower my basal a little more b/c i am going into the City and will be very active. i will see if i need to raise back my basal when i am leaving the City to come back home.

i am really looking forward to my swim tomorrow, and i am hoping that this new “formula” will be as successful as it was last night. :swimming_man:

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Yay for uneventful! Glad you managed to not have a low that kept going. Hope the City was fun and you got to eat something tasty. This has been an interesting thread. Thanks for sharing!

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I’ve experienced this same problem and I found for me the biggest help is to ride it out and trust the SIMPLE SUGARS I eat will eventually bring my sugars up. Being low is an uncomfortable feeling but you have to give your body time to digest.

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i generally give myself about 1/2 hour to notice any change in my BG after treatingw ith simple carbs (Gtabs, Apple Cider, Chocolate). sometimes it takes an entire hour. i do try to be patient, but, like you said, it is really uncomfortable being too low and not getting the immediate “fix” from the correction.

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I had a very WILD period a year ago. I came down with full blown Addison’s! my diabetes went berserk, and labeled “brittle” (ER trip) My insulin needs dropped almost exactly by 1/2. 1 unit correction dropped me about 28 BG points, then after Tony (Addison) set up shop 1 unit dropped me almost 60 BGs! I had a spike when this started in earnest, took 4 units of bolus, and instead of dropping about 115-120 points, I dropped by, more like CRASHED by 220!!! Good think I had, & have a habit of not correct big spikes in one single correction dose.

I went to a NovoPen Echo that does insulin in 1/2 units.

I can dial in 1u, 3u, 6u or even 4.5, 6.5 units etc. Worked GREAT, and still use it now that my Addison’s is getting treated properly. My factors are near but not exactly the same as before Addison’s.

Now I am Air dependent, insulin dependent and now steroid dependent. Having more than 1 autoimmune make you susceptible to more autoimmune diseases. I even have a new friend that also made a home on my ody. I have a face-like area behind my thumb & index finger, with milky white eyes, nose & mouth with hyperpigmentation face. I was calling it my jack-O-lantern, but learned the darker skin was from primary Addison’s, and the milky with features were Vitiligo, were from adrenal autoimmune activity. My new endo noted, it was probably festering for a few years, before my syncope and horsepital stay last year.

Gomer

PS: I changed the name of my new friend (oxymoronic term) to Tom-O-Lantern, since this new AI disease is named for Thomas Addison. Who said ya don’t get an AI diseases after you hit your 70s?