Rare Low Blood Sugar


(Hannah Stanford ) #1

My blood sugars normally stay between 90 and 220. I checked around 9:30 p.m. to see a good reading of 97 so I ate my normal peanut butter crackers (12 carbs) with almond milk (1 carb for cup). Here I am getting ready for bed, feeling fine, and checked at 10:30 p.m. to see a low reading of 49. My body did not alert me, I felt no symptoms, and my CGM read 129 going slightly up. It made me concerned because if I had went to bed without checking it, would I have felt the symptoms later?? I grabbed my apple juice box and drank half thinking maybe that would help, but now I’m feeling the jitteriness and confusion. I went ahead and drank all of the juice box (24 carbs) because that is a really low reading. I rarely have lows!!! Isn’t it supposed to go up after you’ve eaten a snack, especially if no insulin was present on board? I have been a diabetic for 6 years and I still have so many unanswered questions. My CGM is sometimes not so trustworthy!


(Dennis J. Dacey, PwD) #2

Oh YES Hannah @hanstan, I can relate to what you experienced - been in very similar places myself.
First: How are you today? Did your levels straighten out enough for you to get some sleep?

When I get differences like that between fingerstick BG and monitor BGL, I treat modestly right away and then really scrub my hands with soap and water, rinse well and do another fingerstick. (Remember that meters are not exact.) If the meter reading or monitor reading reflect what I am not feeling, I get out my duplicate meter and recheck.
If nothing matches, I play conservative and eat - I’d rather be “high” than low. Over the years, 61+ on insulin, I’ve had really crazy experiences like this a few times, including once when I was in Joslin during the development of the awesome HbA1c protocol.- - the doctors were baffled and couldn’t figure out what my body was doing.
If everything has now leveled out, chalk it up to just the vierd things that happen to us - if readings still differ from meter to monitor and your body isn’t giving signals change your CGM and then reassess - 24 hours after changing.


(joe) #3

@hanstan hi Hannah, really good stuff from @Dennis, all I can add is these few things

if you were slightly low, somewhere in the day, your liver could have dumped its store of sugar. this is supposed to happen and can help when needed… but what happens next is that if you eat something your liver can begin to store sugar and it acts as if you are stacking insulin (liver reducing blood sugar while insulin is doing the same thing). instant crash.

the other is delayed stomach emptying… while less typical, if for some reason your stomach delayed emptying, the complex carbs you ate (peanut butter as opposed to a fast carb) may not absorb the same as usual. in this case it’s like eating pizza… the insulin is just working faster than the carbs are absorbing. again… crash.

that’s my 2 cents… from Jersey.


(Sal) #4

Hi Hannah,

I don’t want to get too technical, but can you share what happened throughout the afternoon?

Did you change your infusion site that day? Exercise? did you bolus for those crackers you ate at 9:30?


(Hannah Stanford ) #5

@Dennis My blood sugar dropped this morning after supper. I woke up with a 240, took correction, ate a blueberry waffle (14 carbs), and took insulin for that. About 2 hours later, it was 83 with .25 left on board so I started eating on sugar free chocolate jello (10 carbs). Of course, being at work it’s harder to eat a snack when you have students coming in. I work at an office job at a school so it gets busy sometimes! However, the not enough sleep thing hit me throughout the day so I am hoping for a good night sleep tonight. I went to bed around 1:15 a.m. last night with blood sugar being 255, but fell asleep before taking insulin. It’s definitely quite odd when they are two separate readings!


(Hannah Stanford ) #6

@Zale I rarely bolus for snacks unless I’m hungry and my blood sugar is over 150 where I need to. I don’t exercise and my office job consists me sitting on my butt all day basically. I just changed my pod tonight. I think my blood sugar bounced so much today it made me feel terrible. Last night I was just too concerned to get any sleep because I wanted to be alert on my blood sugar readings. I have come to the conclusion though that whenever blood sugar is high, whether between 200 and 300, I am better off only taking half or a third of my correction. I seem to drop if I take my full correction.