# Help!!!! Recurring Hypos



## mckencf (Feb 28, 2014)

Hi,
I have been diabetic for 23 years and have always ran on the lower side (Hba1c = 5.9)
However, have just switched to the pump, which I love, but am in the adjustment phase of trying to get my doses right, which is currently causing more hypos than I am used to and my glucotabs don't seem to be working anymore. 
Last Tuesday night, I was 3.3 - took 4 glucotabs and waited 15 mins and retested. Was still 3.3 - took another 4 glucotabs, waited 15 minutes and retested. Still at 3.3, couldn't stomach anymore glucotabs and had a banana. Blood came up to 5.9, then continued to climb up to 10.9, I assume due to how long it took for the glucotabs to finally be absorbed. 
This morning at 5am, I was 2.9, decided not to take any glucotabs and just had a banana - at 7am BG was 5.6.
Could it be that glucotabs are just no longer working for me? Could a banana be my new 'go to hypo treatment?'


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## bev (Feb 28, 2014)

mckencf said:


> Hi,
> I have been diabetic for 23 years and have always ran on the lower side (Hba1c = 5.9)
> However, have just switched to the pump, which I love, but am in the adjustment phase of trying to get my doses right, which is currently causing more hypos than I am used to and my glucotabs don't seem to be working anymore.
> Last Tuesday night, I was 3.3 - took 4 glucotabs and waited 15 mins and retested. Was still 3.3 - took another 4 glucotabs, waited 15 minutes and retested. Still at 3.3, couldn't stomach anymore glucotabs and had a banana. Blood came up to 5.9, then continued to climb up to 10.9, I assume due to how long it took for the glucotabs to finally be absorbed.
> ...



Hi Mckencf,

I dont feel its your hypo treatment thats the problem it sounds more like either basal or bolus is out and needs tweaking. How long have you had the pump? How much have you reduced your overall insulin by? In general people find a reduction of 25% is needed and sometimes more. My son only uses either coke or lucozade as a hypo treatment as it works quickly for him Bev


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## mckencf (Feb 28, 2014)

Thanks Bev. 
I have only been on the pump 2 weeks and the first week was a bit of a trial as the Mio Infusion Kit was not suitable for me - the canula kept bending and not dispensing any insulin at all. Switched to the quick-set and all is working as it should. 
Initially I was on a standard basel dose of 0.650 per hour and my ICR was 1u: 15g carbs. I have been tweaking and have reduced by basel to 0.625 between 4am and 8pm and 0.60 between 8pm and 4am. I have also adjusted my ICR to 1:16g. My BGs are better today, but it is in the early hours that the hypos start, so tonight/tomorrow morning will see if the latest tweak evens me out better. I assume I should stick to the new rates for at least a few days, before I make any further adjustments to establish an accurate trend?
Before the pump, I was on 28u Humalog and 14u of Lantis a day, so my bolus usage is really low compared to that.


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## Pumper_Sue (Feb 28, 2014)

Sounds like way to much basal insulin. Perhaps do a 20% reduction via a temp basal and see if things improve if they do then start basal testing. after a couple of days.

Just seen your reply to Bev no1 rule is never change more than 1 thing at a time leave your carb ratio well alone or you will confuse things no end.


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## bev (Mar 1, 2014)

mckencf said:


> Thanks Bev.
> I have only been on the pump 2 weeks and the first week was a bit of a trial as the Mio Infusion Kit was not suitable for me - the canula kept bending and not dispensing any insulin at all. Switched to the quick-set and all is working as it should.
> Initially I was on a standard basel dose of 0.650 per hour and my ICR was 1u: 15g carbs. I have been tweaking and have reduced by basel to 0.625 between 4am and 8pm and 0.60 between 8pm and 4am. I have also adjusted my ICR to 1:16g. My BGs are better today, but it is in the early hours that the hypos start, so tonight/tomorrow morning will see if the latest tweak evens me out better. I assume I should stick to the new rates for at least a few days, before I make any further adjustments to establish an accurate trend?
> Before the pump, I was on 28u Humalog and 14u of Lantis a day, so my bolus usage is really low compared to that.



Hi Mckencf, 

Your doing really well considering its only been two weeks - well done!I would concentrate on your basals first - it can take a day or so to see if changes you have made are correct. I would do some testing through the troublesome hours and increase accordingly. Do remember that if you want a change at 6am for example you may want to start that basal change at 4am or 4.30am for it to have time to have an effect. And if your making a change I would steer clear of any troublesome foods like chinese or pizza as it might give a false result - maybe stick to foods that dont normally cause a spike. Once you have got your basals as good as you can then start on your ratio's - but only do 1 change at a time or it will get confusing like Sue said. Pumps are great and give great control -but it doesnt happen straight away - it can take weeks and sometimes a few months to see good results as you are re-learning things about your diabetes and it can get frustrating at times but you will get there! Keep us updated with any changes you makeBev

p.s.What is your total daily insulin now including basal?


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## mckencf (Mar 3, 2014)

Thanks to both of you for your advice.
I dropped my basel dose to a flat 0.60u per hour on Friday evening and have had good BGs in the early hours of Saturday and Sunday. Last night before going to bed at 10pm, my BG was 5.0. At 1.30am - 9.0; 4.30am - 8.1 and 7.00am it was 5.6. Previously, I would have taken a correction dose after the 1.30 result, which would have brought my 4.30 result down into the 5's, but then my BG before breakfast, would have been in the 3's. 
Total daily insulin dose is between 28 and 32u per day.


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## bev (Mar 3, 2014)

mckencf said:


> Thanks to both of you for your advice.
> I dropped my basel dose to a flat 0.60u per hour on Friday evening and have had good BGs in the early hours of Saturday and Sunday. Last night before going to bed at 10pm, my BG was 5.0. At 1.30am - 9.0; 4.30am - 8.1 and 7.00am it was 5.6. Previously, I would have taken a correction dose after the 1.30 result, which would have brought my 4.30 result down into the 5's, but then my BG before breakfast, would have been in the 3's.
> Total daily insulin dose is between 28 and 32u per day.



Hi Mckencf,

To be honest I would be doing some basal testing.Its difficult to know whether a bolus/foods are interfering with numbers so the easiest way is to go back to basics. I know that isnt always easy so maybe do in blocks rather than a full day. If you do a search you will find details on basal testing to helpBev


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## Pumper_Sue (Mar 3, 2014)

Basal testing guide is at the top of the forum as a sticky


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