Why might my insulin requirement have changed in the last 30 hours please ?

Question

I have been type 2 for the last ten years and taking insulin plus metfo for two years. I take Novorapid with meals and Levemir at night. I have been struggling with hypos since yesterday and don't know why.

I have not had a sudden weight change, have not changed my exercise regime and am not aware of a sudden change in my health. I am not eating less and have not changed what I eat or when I eat so why am I suddenly getting hypos (three in the last 24 hours)?

Last night I ate a normal evening meal (meat, veg, two potatoes, no dessert), halved my normal insulin dose and still went hypo about 9.30pm. This is the same thing as happened the night before when I needed 1 litre orange juice, biscuits, toast and 30g dextrose to stop the hypo and it took 2 hours to get it under control. Fortunately last nice a glass of orange juice and a slice of toast did the trick.

I have asked my consultant about the bad hypo, she said these things happen and didn't know why. But I need to understand it!

Sorry typo! I take metformin not metfo

I do take my blood sugar regularly. Before meals, and before bed

I am not taking any new medications or any over-the-counter preps. I am stressed and my blood pressure was up a little when checked yesterday but that usually puts my blood sugar up, not down.

I am using the same insulin pen and I haven't changed my insulin but I did change the vial the day before yesterday I have used two other vials from the same packet ...perhaps there's a problem with the vial. Is that possible?

Just to say thank you to everyone for their help. All of my readings have continued to be low for the last two days. After eliminating problems with my insulin batch and testing machine I spoke to the diabetes centre. Turns out sudden alterations in insulin requirement and be due to impaired renal function. I have had a full set of bloods done and i am waiting for the results.

Meanwhile, as directed by the hospital, I have halved all of my fast-acting insulin doses and stopped the long-acting dose...

Answer 1

Are you taking your blood sugar on a regular basis?
Maybe you should ask your doc about a sliding scale.

Also, when your sugar drops the OJ will bring it up quickly, but you need some protein to sustain the level. Your body uses up that high sugar/carb stuff in about 40min.

Answer 2

Hi, Im diabetic too 4 11 years, recently had spate of hypos and diabetes difficult to control, went to see diabetic specialist nurse, great help. When you have one hypo and are taking a considerable amount of sugar to rectify the situation, does this affect your next reading and thus if its higher you are taking extra insulin, which is what i was doing, the nurse told me that the reading i get after hypo and having eaten sugar is a "false high" and you do not adjust the next amount of insulin you just take your regular dose no matter how high the reading, previously i was taking extra insulin to counteract the hypo sugar and ended up hypoing again, also if intermittently i was high say 15 mid afternoon 4 no apparant reason i would take maybe 6 units to bring it down, she explained that you only need 1unit of insulin per 3mmols glucose i.e. if your sugar is sitting at 18 and you want to be at 6, u need to be brought down 12 (18 -6) you therefore divide 12 by 3 ( as in the 3 to 1 ratio) getting 4 so you take 4 units if that makes sense. Hope you are feeling ok and all you can maybe do is just keep doing your blood sugar and will prob return to normal soon, sometimes anxiety, stress, illness affect your sugar levels, pain in the *** the whold thing but you got control if and not vice versa.xxx

Answer 3

Something has changed....that much is clear. What can change? You (what, when, how) and the drug/drugs-(what, when and how).
You: Your diet, your exercise, weight and other environment factors appear constant (are they?-please review), biologically you also think you have not changed......you have not suddenly become more insulin sensitive (many factors can change insulin sensitivity-weight loss, reaching an ideal weight, exercise and so on.) Have you added any new over the counter medicines/supplements/herbals?
Have you change anything about what, when and how you do anything over the past 30 days?
What about your drugs, have you changed a manufacturer, the device you use for your insulin, the location you inject.
Similarly, how your drug is made, who and how may have changed and you may not be aware. Dig further. Are others using the same formulation and batch from the manufacturers having the same problems? Such that you are giving your self too much insulin. Look at the devices you are using and the markings on them too.
Lastly, has your disease changed?
Sorry, I have more questions that answers. Hope it helps you think through the problem and lead to answers.

Answer 4

You do realize that type 2 is an ever changing progressive disease? and that what works today may not work tomorrow?

I really have no clue as to what causes these changes, but I too, have had the hypos while doing the same routine as usual.

I have split my Lantus injection to 2/3 in morning and 1/3 at night. I have eliminated most all cereals, grains, potatoes, carrots, peas, corn, dried beans, etc from my food plan in an effort not to have to take the Humalog with meals. For me, this is working fairly well. I take Metformin XR morning and night.

But comes the odd day, and I crash with the same routine as yesterday and the day before that. I like regular Coke rather than OJ.

My doctor explains it as the nature of the disease!

Answer 5

Many common natural remedies are claimed to have blood sugar lowering properties that make them useful for people with or at high risk of diabetes. Learn here https://tr.im/ANr6l

A number of clinical studies have been carried out in recent years that show potential links between herbal therapies and improved blood glucose control, which has led to an increase in people with diabetes using these more 'natural' ingredients to help manage their condition.

Answer 6

I take it you didn't have any sort of tummy upset? Vomiting and/or diarrhoea, and I'm on the floor hypo before I know it.
Have you lost any weight recently? Controlled weight loss can mean you are overdosing on insulin.

Answer 7

check the label sometimes the chemist gets it wrong because the insulin container look similar. if ok it could be your pancreas is partly working check blood level before evening injection if below 6 reduce insulin by half

Answer 8

I heard that there is some thing came up recently that you can take 24 hours insulin injection.
Not: Penfil / Metral / Atcropad etc.

Answer 9

Many factors influence insulin sensitivity. Admittedly it is usually the opposite effect...hyperglycemia due to decreases in insulin sensitivity due to stress or infection.

Something is going on with your metabolism....could be diet changes...some foods can speed your metabolism...or eating routine changes.