Hi community members,
My partner tends to go low pretty often. They don’t go dangerously low, but enough that there are changes to their behavior; they get confused and become difficult to communicate with. I was wondering how other partners cope with this? Is there a way for them to better control the lows so that it doesn’t happen so often?
Thank you!!
Hi @PumpkinFairy9 ! My first thought when I have frequent lows - or highs - is that I need to adjust my basal rate and/or carb ratio on my pump - if your partner takes injections then they would check the dosage of their long-acting insulin, and sliding scale for meals. It’s not unusual to need to do this periodically: it doesn’t necessarily mean we’re doing anything wrong but simply that our body’s needs change now and then - and I imagine that’s true for those without diabetes as well - their bodies just adjust on their own while we have to put in some analytical brainwork.
Experienced diabetics typically make adjustments on our own, but if your partner is new they should work with their doctor to find the right settings or doses. I find small changes - even just 1/10 of a unit on my pump can make all the difference - so it’s best to start small.
If you haven’t done so yet check out the book Think Like A Pancreas by Gary Scheiner - he has Type1 and is a diabetes educator so he has a unique perspective. I found it both educational and fun to read.
The cause of too frequent lows, or too frequently trending towards going low, is too much insulin. Seems obvious but it can’t be reiterated too much. The solution is just as straightforward: stop giving so much insulin.
Of course, just how much less to give, and when, is a big challenge. Besides seconding what wadawabbit already said, try keepng a close track of how insulin and carbs affect their blood sugar. Start with small changes, and go from there. But frequent lows are just not a good strategy for managing T1D (in my opinion). After first diagnosed I was so afraid of highs I was going low way too much, way too frequently. It’s taken me close to a couple of years to finally get better at not going low, and to realize that, and this is just my personal experience, as bad as hyperglycemia is, lows are five times worse, they feel 5x worse, they have worse affects on my body after the low itself is over, they make doing anything difficult to impossible, they add carbs to my diet I don’t want, and they are more difficult to manage (for me) than simply taking a bit more insulin when I happen to get too high. My last A1c was 5.2. So I’m not saying, “don’t avoid hights”, but rather, personally, erring on the side of not going low/not trending towards going low is way better management, makes me feel better, and is less dangerous.
So, again, stop giving so much insulin, albeit gradually (say 1/2 a unit less for a carb ratio, or 1/2 to 1 unit less of basal/day. Like wadawabbit said, even 1/10 of a unit of short-acting insulin can have an effect). Work with any medical professionals you trust/feel comfortable with. But T1D needs to be managed primarily by the patient/close caregiver, if possible, since there’s so much daily fluxuation. Always of course keep sugar on hand, as well as a glucagon kit. I hope that helps! Good luck! It’s a challenge, we’re all in that boat together…
Hi @PumpkinFairy9 Generally too many lows involves more insulin than is needed at the time. Physical activity and or stress can affect blood sugar as well. The main trick to treating low blood sugar is to find the cause by determining a pattern. Finding a pattern will help you and or the medical professional figure out the problem. Do they happen before or after meals, at particular times of day, particular days? Not all days are created equal some days I am running around more than others. Other than days look at how they relate to meals or activities, are they 2 hours before or after? Some other time increment? Looking at when they happen will affect the treatment. Ultimately they will need less insulin, but whether it is going to be in general or only on specific days, times or for specific activities will vary depending on the cause. It might be a good idea for you or your partner to keep a journal. Are they using a continuous glucose monitor? With a CGM usually you will get a quicker notification when it is dropping. Good Luck!.
Boy, I hear you! This was a frequent occurrence until my hubby started using a CGM with his pump. No more surprises in the middle of the night (aka, seizures), and no more mood swings after overdoing it outside. He was using a Medtronic 670g paired with a Guardian 3 until this morning(!). Now it’s a Tandem t-slim paired with a Dexcom. So far, after just a few short hours, watching the software keep him in range is nothing short of amazing! I’m hopeful that tighter control will be possible, without all the negative things that go with it. Best of luck to you. Hang in there!