Bad hypos even when following all dafne rules!

Hi,

I have suffered from some bad hypos in recent months so started to follow my DAFNE rules more strictly (complete weighing of foods etc) - i completed the course a few years ago. Last night, 4 hours after my dinner and appropriate dinner insulin my BG was 5 going to bed so i approx 3 CP to keep it up overnight, which i have found has worked well before but this morning i had an extremely bad hypo. I couldn't test my sugar as my limbs were super jerky so it took all my focus to get the lucozade down me!

is there any explanation why this might have happened? I usually wake up if I am low but this morning and am able to resolve the situation normally, but this morning this didn't happen either.

thanks
Claire

Hi, I'm not sure why you would need to take 3 CP's to 'keep your BG up' overnight. This would suggest your background insulin is too high.
You should be able to have 'stable'-ish BG's if you don't eat anything with just background insulin. If you are having to eat without injecting that doesn't sound right. Having accurate estimates of CP's should only affect your Quick acting insulin. You don't say when these hypo's
occurred and under what circumstances. Are you doing more exercise, have other things changed in your day to day life. You need to look
at the big picture, which is what your Blood Glucose Diary will hopefully tell you. Look for patterns, especially round the hypos and try to
spot causes. You can also post your BG's on here if you want too, to get advice from others, although I appreciate many people (including me) find it difficult to share their BG's.

P.S You should get yuorself registered as a graduate on the site, having done a DAFNE course.

If you had 3cps and didn't take any insulin and still had a hypo during the night, I would say that your background insulin needs to be altered. Can i ask if you are injecting or using a pump

thank you, i do find the site useful to record my sugars and I've tried to register as a graduate but my hospital code won't work!
is that a generic code for each hospital or should i have a specific one for me as a patient?

the problem with the background is that if i drop it any lower than it is (i take 12 of lantus each night) I start to run v high the next day, almost as if the lantus runs out. What would you recommend as a pre-bed sugar, if my last insulin was more than 4 hours ago? I use the pen, and the disposable lantus pen has a minimum dose of 2 units (ie either 12 or 14 but not 13)

On Friday I had a pint with my dinner, but only one so I'm not sure if that would have caused it? i'm very conscious if i've been drinking to have a carb snack before bed, even if it does induce a higher morning sugar (as I've had the post alcohol hypos and they are not fun)

My general problem is that my hba1c is too low - its thankfuly gone up in recent months (from 5.4 to 6.3) but i feel that some of that may be due to hypo kickbacks but when i reduce insulins, even by a unit im suddenly up over 10 all the time so im on a permanent sugars see-saw.

i use the Lantus Solostar pen it has 1 unit doses on it, also i found i was haveing problems with my Lantus lasting for 24 hours so with the help from my HCP's i split the dose and now inject the Lantus twice a day this has worked very well for me.

Claire with regard to registering as a graduate, I'm not sure what you mean by 'hospital code'. If you email us using the link at the bottom of every page, with your name, what hospital you did your DAFNE Course at and roughly when (exact dates are not necessary) we can get you verified via DAFNE Central and your account changed to graduate. You will then be able to access the online handbook.
You can also send us your 'hospital code' however I suspect it is more likely to be a DAFNE Centre number, a number of centres seem to confuse this with the DAFNEOnline code which is generated by them on the site itself. There are codes per centre NOT per patient.

Hi Claire,

I don't know if you are already splitting your Lantus dose but if not it might be worth a shot. Your post is all too familiar sounding. I used to have a very similar experience taking it all in one dose. Have since switched to twice daily injections and things are a whole lot better. Night time and early morning hypos are now a rarity and well worth an extra dose. Though am def convinced that for me there is no lasting in Lantus in a once daily shot and no where near the 24hour coverage

As to pens, I'm using an Autopen 24 that comes in single unit doses but it isn't a disposable pen if that is where your preference lies.

Hope things work out for you