LIFE STYLE SAME, YET SUDDEN DROP IN B/G?

[Karleen1]

Food, Exercise, Meds, Life Style the same, yet one or two months b/g is the same, then suddenly the b/g drops drastically with a need to cut insulin dose in half, but when the dose is cut a great need to urinate and drink a lot and weight loss indicating the need for more insulin, yet b/g stays very low for some days or so.  What's happening to this type 1 brittle diabetic for over 20 years?! Months later b/g goes up and stays up, need for more insulin to level things out.  Then the cycle repeats itself all over again.  Yes, indeed, what's happening?

[Karleen1]

Great line of reasoning!  She believes it is possible insulin overdosing (to fix the highs...) that trigger stress hormones that ends up raising the blood glucose.  However, when cutting back the dose (slowly)  at times the b/g goes up high then quite LOW  again throughout the day, but with the need to urinate quite often (then a slight loss of weight, I guess from all the urinating of calories).  If it's low all day (they know this from testing the b/g throughout the day) then why would one have to urinate a lot though?  She feels it is a vicious cycle that keeps repeating itself.  She has often thought about this rule:  to fix the high b/g readings one must always FIX THE LOWS first so that it doesn't keep bouncing.  However, she had been told over the years to just keep increasing the insulin once it goes up, but what about the days when it was low (40 - 65 much of the day with same lifestyle... - ) if one increases the dose back up now that the b/g has bounced up high, you guessed it, the LOWS come back.  Yes, a vicious cycle.  How to break it is the question of a life time!?

[S. Kaul, MD]

Hi there!

Well, there are a number of factors that could trigger changes in blood glucose levels including stress, infections, inflammations, hormonal changes, food intake, exercise, lifestyle etc. Lower than normal blood glucose could trigger increased levels of glucose as well. If the levels tend to vary widely, this would require close monitoring and slight re-alteration in the lifestyle and insulin. It is also advised to avoid insulin overdose that would trigger the stress hormones, paradoxically raising the glucose levels. If these measures do not seem to help, I would suggest consulting an endocrinologist to look for potential issues that could complicate the situation and for appropriate management.
Hope this is helpful.

Take care!