First low

Hey guys. I am a 20 year old sophomore in college and was diagnosed about a month ago. Its been a crazy overwhelming journey to get to this point, but today i experienced my first true low. IT was scary to go through and i can’t help but be afraid of getting a low in the night and not waking up.

Any advice? Ill take anything like good food to be eating, what is a great snack? Is it totally ok to be worried about this?

Thank you,
Courtney Ek

Always check you blood sugar before going to bed. If it is under 120, I will usually eat a snack with complex carbs and protein so it is digested more slowly. If you really want to get a good idea of what your blood sugar runs, you can test in the middle of the night for a few nights in a row to see if your blood sugar tends to get lower or higher at a certain time. I haven’t done this in several years, so someone else might have a better idea of what times to test, etc. I always wake up when I’m low, but some people don’t, so testing in the night might be a good idea to see what your blood sugar tends to do.

I haven’t been low at bedtime yet, I have only been diagnosed for two weeks. My Endo told me a granola bar was a good choice, no more than 20 grams of carbs, and only if Im under 100!

Hello type1ofakind!
Sorry you were diagnosed with this weird as heck disease! First and foremost read and understand what carbs are. If you eat a peanut butter (6 carbs) wheat sandwich (30) for instance the body absorbs the bread slower because the pb is protein and fat. Because the stomach is working to dissolve the fat and pb the bread doesn’t HIT your sugar as quickly. There’s a buffer of sorts in the way.
If you eat the bread alone the stomach instantly starts to break it down making the sugar rise quickly.
Make sense? Anything you eat affects the stomachs absorbtion of nutrients/sugar. If you eat protein and a small carb granola before bed the sugar will be absorbed slowly and a little more lasting due to the protein. yogurt has always worked for me……
If you wake up low you will feel anxious, STARVING, and maybe disoriented. I kept juice and a can of pop in the fridge for night lows.
Also, i wanted to know what my body was doing per meal so for a week I ate the exact same things @ breakfast oatmeal pb, lunch yogurt apple granola, then dinner beans and sausage. Very interesting.
It will take you sometime to figure out how your body will respond to the various foods but a mediterian diet works well.
Take your time and breathe……you got this!

My 17 year old son was also diagnosed T1D a month ago. Night time lows have been a worry for him as well.

We have figured out that a Capri Sun or Kool Aid Jammer pouch will give him a 30 point jump in his BG reading. So if he is between 80 and 100 before bed he will drink one of those.

I agree, however, that a complex carb, like 1/2 a peanut butter sandwich or cheese and crackers is better because of the slower breakdown. I suggest you buy a box of Ritz Bits and Capri Sun, and keep them by your bed for a quick boost when you need it. He feels better having those in his room in case his sugar drops, and I’m sure when he leaves for college in the fall, he will have those in his dorm as well. :slight_smile:

In addition, it sounds like you may still need to adjust your night time insulin dose. We have adjusted his 5 times already (started out on a nightly dose of Lantus at 30 - now at 19). Continue to talk to your Endo about that. If your low is happening during the day, what time is it happening? You may need to adjust your insulin ratio for meals. We have adjusted meal ratios as well. (for him, he was still having a big drop between lunch and dinner. So the doctor had us adjust just the lunch ratio. Problem solved.)

It’s a delicate balancing act at first, but you will get there!

I’m sorry you’ve been diagnosed and I’m sorry your first low was at such a scary time of day. I was 7 years old when I had my first low, and it just happened to be during a doctor’s visit. The quack decided to use it as a teaching moment for my parents and waited until the end of the visit to point it out. I used to think I slept through the appointment, but looking back now I think I may have blacked out. I’ll have to ask my parents about it sometime…

I’ve had diabetes for 21 years and night-time/early morning lows are still my biggest fear. I would much rather have a high blood sugar than a low blood sugar. Recently I’ve had several early morning lows - woke up completely disoriented, very unsettling - and I’ve been working with my doctor to adjust my insulin doses. I remember a few weeks into my freshman year of college I realized that for the first time ever no one would notice or care if I didn’t wake up on time. It totally freaked me out. My way of working through it was by being completely open with my new friends about my diabetes. I checked my blood sugar and took my insulin in the dining hall, answered any and all questions, and established a routine fast in the hopes that someone would notice if I deviated from it. I was also glad to find out that the phone in my room had a panic button on it. Press it and you get a call from security. Don’t answer the call, and they send someone to your room. I’d find out if your college has a similar service. But anyway, my point was going to be that it’s totally ok to be worried. You’re definitely not alone in that.

I agree with the advice about checking during the night. I had a series of early morning lows when I was in college and first started taking lantus. (Lantus first became available when I was in high school.) I usually slept from midnight until 8 am, so for a week I woke up every morning at 4 to check my blood sugar. I was able to figure out that my blood sugar drops most between 4 am and 8 am and from there was able to work out an insulin/snack combo that would keep me stable over night. I still drive up my blood sugar before I go to bed because I know it will drop in the early morning. You’ll need to work out your own numbers. I know someone else said to only have a snack if your blood sugar’s under 100, but in college I needed my blood sugar to be above 180 when I went to bed or it’d be low when I woke up. The rest of the day my target was 150. Everyone’s body reacts to insulin differently and it will take you a little while to figure out how yours works. I also like the advice about eating the same thing for a week. I do that when I need to adjust insulin doses, too. And check your blood sugar often.

I also recommend keeping snacks within easy reach of your bed (and on your person when you’re away from your room). I kept a jar of jelly beans, a granola bar, a tube of instaglucose, and a glucagon kit by my bed in college. I also made sure to have plenty of snacks in my room at all times. I actually still do that, even though my kitchen’s right around the corner from my bedroom. Like Type1@42 said, high protein snacks are great before bed because they take a while to digest. As a kid I used to eat graham crackers with peanut butter. Granola bars and peanut-butter-sandwich crackers are good, too. But also keep lots of sugary foods nearby (jelly beans, marshmallows, fruit juice, glucose tablets, etc.) so that you can raise your blood sugar quickly when you need to. I usually go with both to treat a low blood sugar. Sugary food first, followed by something with some protein in it.

I hope that helps. Good luck!

I have been a T1D for 20 years now and lows have always been the scariest part. I can usually feel it once I am low and am always able to deal with it myself, however, that does not make it any better. As a T1D you will probably deal with a lot of lows in your lifetime and some can be dangerous. Here are a few things that I have learned that really help:

  1. Avoid processed foods. For me processed foods require more insulin, and more insulin in my system means more lows after the food is digested. Eat more protein/vegetable/fat sort of foods and less carbohydrate foods so that less insulin is required.

  2. If I have insulin on board I cannot exercise without going low. I have to wait 3-4 hours after I take insulin to exercise. Even then, I need a small snack before I start.

  3. Use an insulin pump (if you are not already). It really helps that you can adjust your basal rates for different times of day, instead of hoping that Lantus will provide the right amount of coverage for 24 hours.

  4. ALWAYS KEEP SUGAR CLOSE BY. I find that for me glucose tablets are a must. They bring my blood sugar up fairly quickly and don’t shoot it up too far. It usually only takes 2 or 3 tablets. I keep a bottle of them in my purse, and one on my nightstand at all times.

  5. If possible, get a Continuous Glucose Monitor. I LOVE my Dexcom. Medtronic Enlight was not accurate for me, but the Dexcom is spot on and always tells me if I am heading low. For example, I can check my blood sugar with my glucometer and it could say 110, which is great. But then I check my Dexcom and I will know if my blood sugar is dropping and how fast that 110 could turn into 50. If it is around 110 and staying level I won’t eat anything. If it says that I am dropping I know I have to have something.

Hope this helps. Looks like there is a lot of good advice on here already. T1D is a pretty personal disease and unfortunately you will have to figure most of this out on your own. I wish you the best of luck!

Too bad about the diagnosis, but the good news is if you manage your blood sugar levels and do what you are supposed to, there won’t be any complications.

My daughter has T1D and was also afraid of going low and not waking up. Her nurse told her to try not to worry as that won’t happen. She said it was similar to when you have to use the washroom at night - you wake up. If you are still concerned, you should talk to your diabetes team. My daughter’s team has been a fantastic resource!

As for snacks:
Before being on the pump her bedtime snack had to consist of either toast with peanut butter or crackers with peanut butter or she would go low during the night. The protein in the pb helped to carry the carbs through. If she ate fruit for a morning snack, she had to have some complex carbs like a cookie or cracker or she would go low. Welches Fruit snacks are good to treat her lows.

As I mentioned earlier - a diabetes team (endocrinologist, nurse, dietician) can be a great resource to help you figure out your numbers and how to deal with them. Best of luck!

In my book: “Diabetes! A Lifetime of Being Too Sweet” I talk about how, at the age of fourteen, when I was newly diagnosed (46 years ago), the doctors at the hospital deliberately gave me an overdose of insulin so I would “know what it felt like” when I got out. They forgot to tell me about it and I started feeling really bad and collapsed in the hallway. I’ve been pretty much paranoid about lows ever since, especially at night. I still do a check at night as well. What I do is take a reading before I go to bed, sleep, and then take another reading a few hours later. Subtract the two and divide that number by the number of hours between the readings and you can pretty much project what your “fall” will be. If your fall is over 20, eat a snack. Note: Since you are in college, if you decide to go and party, make sure you test before you go to bed or if you over do it and pass out. I know of several students who died after doing that, one just a couple of months ago. Be careful.