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OK Brainiacs… Riddle Me This: Crowdsourcing Diabetes Management

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Let me explain why the pattern above troubles me.  I have been having late afternoon lows off-and-on for months.  Normally I would think I need less insulin except for a few pertinent facts:

  • Last Bolus: 11:30 am
  • Basal rate goes to zero (yes zero) at noon
  • I use Apidra, so the last dregs of my insulin should be gone from my system by 3pm, at least that’s how it works the rest of the day

As you can see above, my numbers continue to drop well past 3pm. If I was to skip eating some glucose tabs, it would continue to drop until 5:30 or so. With hypo-unawarensss, that could make drive time dangerous if I forget to test around 4pm or so.  I consume 4 glucose tabs which bumps my numbers up to the high-100s, but they start dropping again once the glucose peaks.

Both my educator and I are puzzled as to what could cause these late afternoon numbers to continue to drop, realistically there should be zero active insulin in my system by 3pm and most definitely by 4pm

Help a guy out, what the hell is going on?

© 2013 Scott Strange, Strangely Diabetic and http://StrangelyDiabetic.com

  • I was gonna say a basal issue, but since you are at zero, I got nothing. Maybe your pump is confused and giving you a little anyway? Maybe try disconnecting instead of just no basal and see if that makes a difference?

    • Thanks Michelle, but my basal rate goes to zero at noon… when I say there should be no active insulin in my system I really mean none, zero, nada…

    • Thanks Michelle, I did try disconnecting one afternoon and got the same results…

      • That is so bizarre. Could it be activity related? Stress? Or maybe the duration is for whatever reason longer in the afternoon? Or maybe it’s just diabetes and isn’t supposed to make sense.

  • Maybe reduce your bolus amount? I know Apidra is technically supposed to be out of your system in 3 hours, but mine was more like 5.

    • That’s the only thing that seems to make sense, the weird thing is it only “lasts” that long in the afternoon. You know, Alzheimer’s patients sometimes have what’s called “sunset syndrome” where they are much clearer-headed and cognitive late in the day. Maybe this is my pancreas’ diabetes equivalent…

  • I would be curious how much protein you’re having with lunch? Also, charge your battery 😉

    • That lunch was actually pretty high in protein… batteries? hell, I’m so old, I’m steam-powered

  • Sara

    What time of day do you work out? Late effects of exercise (even from the night before) would be my only guess at this point.

    • Unfortunately, I don’t think walking downstairs for another Diet Coke counts as exercise… exercise isn’t an issue

  • Being a life-long member of the “HEY! You’re body’s not supposed to do that!” club, I’m going to go with Sarah K. Maybe go to a zero basal an hour or so earlier & see what happens. I mean anything is possible. Says the woman with reverse dawn phenomenon (I tend to go low while sleeping).

    Also, does anyone else suddenly have that Muppets song stuck in their head now?

    • I didn’t… thanks, Cheri, thanks…

      I keep backing off on the time, hopefully I’ll find the sweet spot soon…