Hi there! I’m new to this forum, but need some help with hypoglycemic episodes.
My husband is T1D and has been for over 20 years. We’ve been married 12 years and he has always been on a Medtronic pump. His A1c increased recently, so his endo started him on the T:Slim with Control IQ (in April of this year). The Dexcom and notifications have been awesome, but we have been dealing with a significant amount of lows. In the 12 years we’re been married, only one other time did he have a diabetic seizure, and he had another recently that I had to call 911 for. He has daily lows- often below 50 and we’re having a really hard time trying to figure out how to manage these. He cannot eat constantly and we’ve found that that is almost the only way to prevent them.
Here’s a little background on him: he works shift work, so works a few nights in a row and then switches to days. His job is physically tough, so he is in constant exercise mode and turns the pump to that when he gets to work. Even with this, and eating right before he gets to work- he will still drop to below 50 within a couple hours. I’m at my wits end, because the lows worry me like crazy. If he is working nights and the Dexcom goes off- all I can do is sit there and watch for it to go up.
When he recently had the diabetic seizure, the CGM notified me that he was low (said 55), I got up and gave him some juice, but he was more unresponsive then he would normally be with a BG of 55. He drank 12ozs of juice and I waited. He was not improving, so I gave him more. He had almost 48ozs of apple juice in about 30 minutes and then started seizing. CGM would only register LOW at that time. When the paramedics came, they gave him a full bag of D5 and had me make him a PB&J and milk. He was with it and responsive by then, so they didn’t transport him. He did not enter ANY carbs for anything that he ate. BG increased to just over 100 and in less then 2 hours, was 74 again.
I have realized that juice (which is our normal “rescue med”) will quickly bring up his BG but not sustain it with this pump. He has had to start also having a snack to make sure that it will stay up whereas in the past with the Medtronic pump, that would last him through the night. I’m at the point that I feel like maybe this pump is not right for him, simply because you cannot adjust the basal rate to be higher. Another thought I had is if switching insulins would make a difference (he has been on Humalog for as long as I’ve known him).
Any advice on dealing with this would be appreciated.
Are there certain snacks that help keep it up during physical activity (protein shakes, certain types of carbs)?
Has anyone had luck with decreasing how many carbs they account for to see if their BG would stay higher?
Has anyone had less hypoglycemic episodes on other insulins?