Getting hypos on very low insulin

Hello everyone,

I was on 12 units background, 7 units fast acting until a month ago when I decided to switch to a very low carb diet

Today, I only take 4 units of background and no fast acting. I only ever inject in the morning

My levels are excellent. However, I am still prone to hypo’s, especially towards the night or end of the day

I don’t understand how this is physically possible -with such little insulin administered. And at such a long time after administration

What is going on?

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My guess is that your insulin needs dropped due to your change in diet. Your proactive withdrawal of insulin increased insulin sensitivity and your actual needs for the time being are less than the four units basal you injected in the morning.

Many of us, and apparently you as well, are more sensitive to insulin later in the day. Insulin sensitivity is not constant through the day; this is why some people switch to an insulin pump. You could consider splitting your basal insulin into two injections, one in the morning and one later in the day or at bedtime.

We’re all so used to the idea of more insulin = dropping glucose and less insulin = rising glucose. I’ve also witnessed this paradox of less insulin leading to dropping glucose, even hypoglycemia.

During this time of changing nutrition, check your glucose levels frequently and perhaps start a written log to help with analysis later. You may want to drop your long acting dose further, perhaps to 3 units. It’s amazing that you need so few units.

Are you T1D or T2D? Newly diagnosed or at it for a while?

I am of the opinion that less insulin, providing in-range glucose, is always better than more insulin. Please keep us posted!

Welcome to TuD!

That’s great!

When did you start using insulin?
Have you lost weight ?
Were you diagnosed Type 1 or LADA ?
Or type 2?

What levels do you consider excellent?.
Have you increased activity/exercise in same timeframe?.

I’m type 1 and on insulin for over a year now. For the years leading up to my diagnosis, I would have episodes of non-insulin hypoglycaemia too

And yes I have lost weight by switching to a low carb diet. I’m also weight training. I guess I need to lower my insulin to 3 units like Terry suggests, which is pretty crazy

I just hope all of this is technically safe? Like I said, my bloods are fine (except for hypo at night time) and believe it or not -my ketones are fine too

You probably are honeymooning, which can be prolonged (years) especially in adult onset T1 (LADA). It basically means you still have islet cells working, possibly still quite a lot of them, they just needed the assist of low carb and/or a little insulin to get by. If you have been correctly diagnosed, you will eventually need more insulin as more of them die, so enjoy this while it lasts! Keep checking your blood sugars, and not a bad idea to keep tabs on ketones, bur if both are fine, you’re ok to back off insulin if hypo.


Insulin works in your body the way it actually works, not the way you might expect it to work. You can, of course, argue with your body about what it should be doing, but I don’t think you will win that argument. :blush:

My recollection is that physical activity does not completely translate into lower BG immediately. There is some immediate effect but also a delayed effect. Often the delay can be as much as a day later. (Or at least it seemed to work that way for me. :confused:)

So if you expect that a workout you did in the morning is long past and forgotten, that can come back to haunt you with a hypo during the evening or even overnight. I believe the technical term for this is a WTF hypo.


Another possibility is TYPE-1B, However, I have been diabetic for over 40 years. type-1b is a sub-type of type 1, and I was told needed to be treated as any type-1.

Given the poster is still in their early years of Dragon fighting, ‘honeymoon’ is more likely the reason.

I also have Addison’s (autoimmune), which can and has raised H311 with my diabetes. My Addison’s has caused lows as well. My BGs took a Mad-Mouse ride, & I was a “brittle” diabetic until I got my Addison’s in good control.


I tested positive for two antibodies i believe they were GAD and zinc transporter8

I do suffer other autoimmunes. Uveitis, psoriasis, sarcoidosis

Diabetes was just the icing on the cake

I had a very similar experience. Once i was diagnosed I started somewhere around 12-14 units of basal daily and had to keep backing off due to hypos. As time went on I eventually had to back off completely . I am Type 1/LADA and I honeymooned for a solid 6 years . I think the initial 6 months of insulin use after diagnosis provided Beta cell rest. My c-peptide was 0.52 at diagnosis with GAD antibodies .

Needles to say I am insulin dependent now, but still some detectable c-peptide. With your doctors blessing of course, you may be able to discontinue insulin or function at a very small dose for quite a while given your diet remains consistent , but with positive GAD your numbers will inevitably creep back up so you will need to be on the lookout for that as well as metabolic distress as that can escalate quickly. My doc always gave me a stat bloodwork rx for a metabolic panel in case I felt sick. Best of luck to you .

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Yea. I have T1 and recent Addison’s too, as well as no thyroid due to Graves. My M.D. cousin described managing this trifecta as being like juggling running chainsaws. Got that right!