wife gets low at night, hard to level out

[selphjd]

Hello.  I have been married to a type 1 diabetic for 5 years now.  My wife is extremely smart, so I've always listened and helped her according to her needs.  She's 26 now and I am 33.  Up to now, she's taken huminalin N (1 a day) and R (twice a day).  Her childhood endo and then one we had been taking her to kept that norm.  Then we moved back to her home area of Dallas and had to find another one.  This doctor said that her regiment was a hold over from her being a kid and should have been changed before now.  She's changing it to be one long term shot and then a different shot anytime she eats carbs (and she will have to calculate how much to take).  From my understanding, it won't be R and N any longer.  That will be happening within a month, because they have to retrain my wife first on how to do it.  Anyway that's backstory.  My wife sometimes gets into spells of getting low at night (it wakes her up).  She'll drink a glass of juice or something, wait 20 minutes.  The problem is, it doesn't always work that fast.  So she'll drink a bit more, and eventually after 2 hours stop being low.  And then the next morning, she'll be high.  I'm hoping this new insulin helps.  But we've never really gotten a direct answer from her past endo's about why that happens to her.  Sometimes she'll go along without this happening at all.  Any ideas on this?  Is it normal for a juice or a coke to take 2 hours to help her BS?

[selphjd]

Luckily my wife takes care of hers very good and she can normally feel when it's off.  The scariest thing I've seen was actually just a couple of weeks ago.  She was needing to get up and take a shower.  But she sat there a minute, told me "after you shower (I had already showered) you either need to ***** your finger or check your blood sugar." and then she just layed down against me.  Which didn't make any sense to start with I was like, "honey I don't do that you do. are you low?"  I made her drink something and kept quizzing her to try to force her to think.  It was scary.  Usually at worst I've seen is her mix up words and get frustrated until she was normal again.  But this time she didn't even know.  It's a very helpless feeling because I couldn't do much except keep her going until the sugar to hit her.  I'll be glad for her to get a better regiment.  Thanks for the information guys.

[Markie]

Lows in the early hours of the morning are quite common when NPH (of which Humalin N is a brand)is injected before bed. It happens because NPH peaks 6-10 hours after being injected. It doesn't always happen because there is up to 30% variation in absorption and the level of action with NPH.

Your wife is probably being put on Lantus or Levemir basal insulin, both of which are peakless. And the intraday variability is much lower. So things will improve. The hardest part is figuring out what the correct dose is. But once she gets that sorted, her control should get easier and better.

Cheers,

Mark

[JDRF-Team-ES]

First of all, I want to compliment you on being such a supportive and knowledgable husband.  It sounds like your new endocrinologist is on top of current best practices for treament of diabetics.  The switch you wife is making is what many Type I's are on and it seems to be the best way to manage diabetes with injections. The new longer acting insulins are much better since they do not have a peak and hopefully won't have the same impact on your wife's middle of the night blood sugars.She may find that she can control those highs and lows a lot better with this new insulin routine, as long as she continues checking her blood sugars and paying attention to her own unique patterns. One of the problems with diabetes is that it looks different on every person and there is no absolute answer to why it takes so long for your wife' blood sugars to come back up when she is low.

It is not normal for jice to take 2 hours to raise your blood sugar.  It does take at least 15 minutes for juice or coke to work and when you are feeling low, and it is sometimes hard to wait that long to feel better.  The tendency is to keep drinking  and then end up with a high blood sugar.  In her case, her insulin may have peaked and she just had too much insulin in her system.

Anyway, best of luck on this new routine.  I think you will find it much easier to manage.
Es