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Re: [IPk] Hypo control

Hi  Diana

What you say is exactly what I said to the DSN - it is just as if there is a 
pool of insulin which works in the night.  Up to Christmas everything was 
OK.  After that I was worried with sight problems and this seemed to affect 
control and it got very difficult.  I was very depressed and felt I couldn't 
cope properly.  My requirements seemed to go up and up.  I then tried 
changing the site from tummy to legs thinking absorption was the problem and 
the site change made more variables but seemed to settle down until 3 weeks 
ago when the problems were at about 2.00 am.  This 5.00 am trick was a new 
one for me.

I am beginning to think it is not the basals at all but the bolus after all. 
As I have gastro paresis I do not put the insulin in too quickly or I might 
go hypo in the meal.  If I don't inject sufficient I do not come down a 
couple of hours after the injection.  How low do you go 2 hours after a 
meal?  I think you are correct about cutting the bolus for my evening meal 
and this will mean putting up with a higher bg for a while so there is 
something for the insulin to work on.  It sounds simple.  Got to do 
something.  I was sitting here long the computer last night and felt 
perfectly OK.  I didn't want to face bed.  I made a move at 2.00 am and did 
a test.  It was 1.9!  I felt OK!  Still, once corrected I got through the 
rest of the night and had perfect control this morning again.

I'm afraid I do very much less exercise than you due to pain and 
breathlessness.  Trouble is, according to the chart showing ages of pumpers, 
I must be one of the oldest.

Thanks for listening.

----- Original Message ----- 
From: "Diana Maynard" <email @ redacted>
To: <email @ redacted>
Sent: Friday, June 23, 2006 5:37 AM
Subject: Re: [IPk] Hypo control

> Hi June
> I wonder if the insulin is somehow pooling in your body and being absorbed 
> very slowly when you're inactive at night?
> I tend to see this effect (with the opposite result, i.e. I go high) when 
> I use my legs or bum as an infusion site.
> In your case it could be that you need to lower the insulin starting 
> earlier to deal with this, and/or take less bolus with your evening meal. 
> Perhaps you should also check your BG around 2am to see if you're already 
> low then.
> Can you think of anything different from 3 weeks ago when you first 
> started noticing this?
> Good luck - it sounds awful. I used to get something like this (persistent 
> nightime hypos despite reducing my insulin loads and not bolusing at all 
> for evening meal) after softball tournaments and finally figured I had to 
> *really* slash my basals to almost nothing (as you're doing) to deal with 
> it. I only realised the true effect when staying up partying till 5am 
> after softball one time and having really bad hypos despite loads of Coke.
> But I assume you're not suddenly doing unusual amounts of exercise (I can 
> do up to 10 hours a day of vigorous exercise during a tournament) in the 
> last 3 weeks!
> Di
> June Searle wrote:
>> Hi
>> My present problems did not improve last night. Unusually for me, but to 
>> ward
>> off a problem, I had a biscuit before bed and I have now cut my basals 
>> from
>> 1.00 am - 5.00 am from 0.0.  At 5.00 am basal set at 0.5.  Last night at 
>> 5.20
> > I was 2.4 and took 15g Lucozade. Each quarter hour it was still down and 
> > took
>> further 15g Lucozade.  It didn't rise until 6.30 am and 60g Lucozade 
>> later.
>> I just can't work out where the insulin is coming from.  Please, does 
>> anyone
>> have any idea what is wrong or what I am doing wrong?  The hypos have 
>> been
>> going on for nearly 3 weeks now but usually earlier than last night.
>> June
>> .
> .
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