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[IP] THE UNKNOWN HYPO (was: Time for an overhaul?)


Ahhh, the tale of the "UNKNOWN HYPO".  When I was using straight Humalog, I
experienced really tough post meal hypos which were very reluctant to react to
glucose, until about 2 hours later, when everything seemed to kick in
(finally) and my bg would soar.  I went back to pure Velosulin for a few
months to get "straightened out", and then began mixing H and V in a 3:1
ratio.  This has, for the most part, been super for me.  That is, until this
past week.  I still don't know what happened, but for two evenings in a row, I
went hypo after dinner.  One meal was low-fat with only 36 carbs, the other
was high fat (cheeseburger and hashbrowns, YUM!) and 70 carbs.  I bolused my
standard one unit per 20 carbs. (I really hope that I don't need to change
this ratio because it is so easy to calculate in my head!!  Divide by 2 and
move the decimal)  Then last night, I ate 48 carbs for dinner (steak, baked
potato, broccoli, and fruit salad) and bolused 2.4 units.  I was 86 before
dinner, 88 one hour later, and 99 two hours later.  Go figure!  It may be a
delayed reaction from the extraordinary amount of physical activity I've had
in the past month.  Even weirder... my basal needs didn't increase before my
last menstrual cycle.  Just stayed flat, and the "event" snuck up on me. :-(

I am in the process of profiling my basal rates. Actually, I should be more
specific and say RATE (singular).  I have been getting by for the past year
and a half with only one basal rate, 24 hours a day.  I know this seems odd,
but it HAS been working.  I'll report back to the group if I find any
surprises, but so far, my .4 is holding true.

I agree with you, Sue, it is comforting to know that I'm not the only person
who has these mysteries.  In the meal you described, though, do you think that
the protein slowed things down enough that the Humalog went to work before
your carbs?  That is why I went to mixing V and H.  The V impedes the H just
enough so that it doesn't hit too soon, but I still get the quick action of
the H.  I'm terrible about remembering to bolus far enough in advance of a
meal with only straight V or R.  But the fact that you only gave 1/2 of the
normal dose here, and you still went low, sounds like this is more a case of
(eerie organ music playing now) THE UNKNOWN HYPO (echoing sounds).

Mary Jean

<< For instance, the other night before dinner I had a BG of 86.  My meal
 consisted of a lamb chop, salad w/ranch dressing, dinner roll
 w/margarine and diet drink.  Only 40 carbs there.  I normally use a
 ratio of 1:10 Humalog but because I was starting out a little low, I
 only used 2 units (half of normal).  1-1/2 hours after dinner, I checked
 my BG and it was 74 (I lost 12 points)!  Where did the carbs go?  Why
 didn't the protein and fat in the meat make any difference?  I struggled
 until after midnight that night to get my BG to stay up between 100 and
 120 -- I live alone so I don't like to go to bed with anything near a
 low/hypo.  I was also pretty sedentary this particular night.
Insulin-Pumpers website http://www.bizsystems.com/Diabetes/
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