Constant hypos during the night!

[3001]

Does anyone else have this problem?
I work shifts, so daily my hours are varied which effects meal times and insulin!
I rarely do nights so that's not an issue but I'll take my regular dose of levemir anything In between 20-25 units depending on my reading before bed which is usually around the 9/10 mark, I always make sure I have a snack before going to sleep and my sugars are normally good in the morning around 6 or 7. Over the past few months once or twice a week I just don't wake up, luckily I still live with my parents and it's usually them waking me up giving me everything possible to wake me out of this 'coma' like absence. I've completely lowered my levemir dose and some nights in too scared to even take it so end up missing it. This is now effecting work and causing me to miss shifts. The diabetic team haven't been much help as of yet and it's becoming a worry! Any help or advice is so much appreciated.

 

[CarbsRok]

Can you split your basal dose? If it were me I would do some night testing to find out exactly where you go low. Obviously you are on to much insulin to cause you problems like that. Do the lows correspond with a certain shift IE evening shift and the hypo appears in the night.

 

[Garr]

Hi @3001 , You really need to do a basal test, if you're having a snack before bed and still dropping by 4 mmol/l during the night it certainly suggests that your basal dose is too high, it should only drop by no more than 2 (without the snack). How's your BS when they manage to wake you up?

 

[iHs]

Hi @3001

Just to make you feel a bit better, I too also controlled my bg levels at night in the same way as yourself. I just adjusted the nightime Levemir up or down to suit what bg level I was at before going to bed and eat a snack in the hope that I wouldnt go low. This was a bit 'hit and miss' as 8 times out of 10, I was ok but the other 2 times, I was either going low in the night or waking up in the morning with a bg being a lot higher than my ideal level of 5-7mmol. The only difference for me to you was that I didnt do shiftwork.

What changed? Unfortunately, I was just under GP care at the time and saw a diabetes trained nurse at my surgery who also had a husband who was type 1. I got guided to keep my overnight basal dose the same but was not told how I could ensure that the same basal dose could always be used. The answer to that came from reading one of @Nobleheads messages on the forum a few years ago where someone was urged to get their evening meal bolus correct so that when going to bed, the bg level would more or less be the same. With that, I then started to dabble with carb ratios and figured out how much bolus I would need to eat whatever carb content was in the evening meal and go to bed with the sameish bg level every night. This started to work much better and the nightime hypos got much less but not vanish. I now have a pump which I have been able to fine tune all the overnight basal rates so that a really low bg doesnt happen anymore. I also use cgm when I can afford the sensors and that helps no end as alarms can be set up to wake someone up before a low bg starts to cause real problems.

Like others have said, you are having way too much basal so either skip evening meal and monitor bg levels every hour and then inject the evening basal without eating food and carry on bg testing every hour until about 3am in the morning to see just what is happening.

 

[Zabs]

I am also having hypos through the night, the doctor has lowered my insulin for both the night and morning, but still had a reading of 2.4 this morning.

 

[BeccyB]

Your Levemir dose should never depend on what your current BG is or how much you've eaten - if you are a little high at bedtime you should correct with your quick acting insulin not basal. If you increase your basal to correct you will continue to have extra insulin through the night and following day.