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What Causes Drop In Blood Sugar?

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Posted on Mon, 16 Jun 2014
Question: I am a type 1 diabetic since the past 8 years (Last HbA1c 5.9%). Since the last 1 week I have been experiencing hypoglycemia at an odd time. On two occasions in the last one week, I wake up in the morning(at around 7 AM )and my fasting blood sugar was around 100-120. By the time I reached office at around 9, my bood sugar dropped to 50 mg/dl. I did not eat anything or take any insulin during this time. I had my dinner the last night at around 8 PM and my blood sugar levels 2 hours after dinner at 10 PM were 130 mg/dl. I generally eat a small portion of banana or 3-4 XXXXXXX gold biscuits before going to bed to avoid nocturnal hypoglycemia.
My insulin schedule is as follows.
10 units(actrapid) before breakfast
12 units at lunch
4 units before an evening snack
8 units before dinner
18 units of Basalog (before going to bed at around 10 PM)

I also take pregeb 75mg after dinner.

Kindly tell me what could be the possible reason for a drop in my blood sugar after waking up even though my last bolus shot was almost 11 hours ago? Do I need to reduce my Basal dose?
doctor
Answered by Dr. Dr. Phanindra Dulipala (3 hours later)
Brief Answer:
Never skip breakfast or meals.

Detailed Answer:
Hi, I had gone through your query and understood your concerns.

Sir, you said that early morning blood sugar is 100- 120 which is quiet normal for a fasting blood sugar level.

You said that you skipped the breakfast in the morning. Even when we don't take insulin body utilizes some sugar for the energy by the activities done by us. So gradually sugar level decreases. This is why we say we should never skip meals while diabetic, and also when treated with insulin.

As you skipped the break fast and the action of previous bolus of insulin slightly is still in action, the sugar levels continue to decrease. Never again skip the food.

If everything is normal like no change in taking food and lifestyle and even then hypoglycemia occurs, then you need to discuss that with the treating physician regarding dosage.

Hope this guides you. For any other queries you can write to us. we will be happy to help you. Thank you.
Dr Phanindra Dulipala
Diabetologist.



Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Phanindra Dulipala (16 minutes later)
Hello,

I did not skip the breakfast. My routine is that I have my breakfast once I reach office generally at 9-9:30. I have been following the same routine since the last two years. I have never experienced a drop in blood sugar in the morning earlier with the same routine. Also to the best of my knowledge (correct me if I am wrong) the action of bolus insulin does not last more than 8 hours. I am just wondering if I need to reduce my basal dose? To be honest I do not really understand the function of basal insulin, so my question might sound stupid. I would request you if you can explain me what exactly is the function of basal insulin and why do we take it?

doctor
Answered by Dr. Dr. Phanindra Dulipala (14 minutes later)
Brief Answer:
Insulin can be long / short/ intermediate acting

Detailed Answer:
Sir,
Please may i know the basalog injection either long acting(extended release) or intermediate or short acting. Then we will see what exactly hapened.

Thank you.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Dr. Phanindra Dulipala (30 minutes later)
Its a long acting 24hr action. Its description is "BASALOG™ a long acting (24 hours) peak less human insulin analogue, Glargine"
doctor
Answered by Dr. Dr. Phanindra Dulipala (11 minutes later)
Brief Answer:
Insulin is central to regulate glucose metabolism

Detailed Answer:
Sir, This answers your one of the above queries regarding duration of action.

Basalog was a human insulin Glargine to control the chance of dropping of glucose levels at night. Unlike other insulin's which take some time to act and reach peak level and then subside, Basalog ensures that it acts at a constant level for 24 hours.

I hope you understand what insulin does. I would like to give brief information about it. Insulin is a hormone that is central to regulating energy and glucose metabolism in the body. Insulin causes cells in the liver, muscle, and fat tissue to take up glucose from the blood, storing it as glycogen in the liver and muscle. It also stops the use of fat as an energy source. When insulin is absent, glucose is not taken up by body cells and the body begins to use fat as an energy source, for example, by transfer of lipids from adipose tissue to the liver for mobilization as an energy source.

In your case, you need to take breakfast not later to 6-7 am in the morning. Because the action of basalog insulin still there. If the drops persist despite this change, then you need to reduce the dose after discussing with the treating doctor.

Hope this guides you. If you have any further questions I will be happy to help. If you do not have any clarifications, you can close the discussion and rate the answer. Wish you good health. Thank you.
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.

Above answer was peer-reviewed by : Dr. Prasad
doctor
Answered by
Dr.
Dr. Dr. Phanindra Dulipala

Diabetologist

Practicing since :2008

Answered : 722 Questions

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What Causes Drop In Blood Sugar?

Brief Answer: Never skip breakfast or meals. Detailed Answer: Hi, I had gone through your query and understood your concerns. Sir, you said that early morning blood sugar is 100- 120 which is quiet normal for a fasting blood sugar level. You said that you skipped the breakfast in the morning. Even when we don't take insulin body utilizes some sugar for the energy by the activities done by us. So gradually sugar level decreases. This is why we say we should never skip meals while diabetic, and also when treated with insulin. As you skipped the break fast and the action of previous bolus of insulin slightly is still in action, the sugar levels continue to decrease. Never again skip the food. If everything is normal like no change in taking food and lifestyle and even then hypoglycemia occurs, then you need to discuss that with the treating physician regarding dosage. Hope this guides you. For any other queries you can write to us. we will be happy to help you. Thank you. Dr Phanindra Dulipala Diabetologist.