High BG late evening, what is the best thing to do?

[Flakey Bake]

Hi everyone,
I am looking for a bit of advice. I am just coming to the end of the honeymoon period and with the help of my diabetes dietician I have started carb counting. I do ok for the most of the day but thing tend to go wrong later on in the day. Sometime it is my own fault (snacking), other times miscalculation, or maybe I need a different carb:insulin ratio in the evening. Whatever the reason I sometimes end up with a high BG just before bedtime when I take my basal dose. What is the best thing to do when things **** up like this? Do people take a wee top up of fast acting just before bed? Is this safe? I feel like I am caught between a rock and a hard place, I am loathed to go to bed with a BG in the high teens, likewise I am uneasy taking novorapid just before bed. What do other folks do in this situation (besides not get into in in the first place)? Advice would be appreciated.

 

[Omar101]

A better idea than a correction every night may be to split your basal say at bf and then at dinner or something to that effect. I did this when I noticed my levels begin to elevate increasingly at night.

 

[Flakey Bake]

A better idea than a correction every night may be to split your basal say at bf and then at dinner or something to that effect. I did this when I noticed my levels begin to elevate increasingly at night.

Thanks Omar101. That something I might try. I spoke with my dietician last week about this and she suggested getting the basal dose correct first then trying splitting. I think is may help. Thanks.

 

[Omar101]

If your basal actually needs to be split then it would be hard(quite likely impossible) to get your current dose correct. As you would need a large enough one to keep your later levels flat that would probably cause your earlier levels to plummet, whereas keeping your earlier levels flat like you currently do causes your later levels to rise if that makes sense.

The only way to truely know is to test every hour(or as often as you can) for a couple of days with as few variables as possible(snacks).

 

[Charles Robin]

I would advise getting up a few times one night when you have a relaxing day the next day. Test every couple of hours, and see what your levels are doing. If they are too high all night, some short acting insulin may be necessary. I find that I need to give myself a small dose of insulin about 2am to stop high blood sugars. Obviously be very cautious with this approach, making sure to test after administering insulin, and having a source of glucose at the ready if need be.

 

[Spiker]

If it's not you needing more basal in the evening then try changing the evening insulin:carb ratio. But confirm the basal first.

Sent from the Diabetes Forum App

 

[daisymoomoo]

Hi everyone,
I am looking for a bit of advice. I am just coming to the end of the honeymoon period and with the help of my diabetes dietician I have started carb counting. I do ok for the most of the day but thing tend to go wrong later on in the day. Sometime it is my own fault (snacking), other times miscalculation, or maybe I need a different carb:insulin ratio in the evening. Whatever the reason I sometimes end up with a high BG just before bedtime when I take my basal dose. What is the best thing to do when things **** up like this? Do people take a wee top up of fast acting just before bed? Is this safe? I feel like I am caught between a rock and a hard place, I am loathed to go to bed with a BG in the high teens, likewise I am uneasy taking novorapid just before bed. What do other folks do in this situation (besides not get into in in the first place)? Advice would be appreciated.

If you are going to bed with sugars in the high teens, what are they the next morning?
Is this every night or when you eat certain things?
How soon after your meal is the 'bedtime' test?
Have you attempted to calculate your snacks (after the fact) & inject the appropriate amount along with your eveng meal insulin?

 

[Flakey Bake]

If you are going to bed with sugars in the high teens, what are they the next morning?
Is this every night or when you eat certain things?
How soon after your meal is the 'bedtime' test?
Have you attempted to calculate your snacks (after the fact) & inject the appropriate amount along with your eveng meal insulin?

Hi daisymoomoo,
It is not every night, usually just when unbudgeted snacking takes place or unusual events (eating out). I guess the honeymoon period has come to a sudden end and I now have to inject for everything, where I got away with a lot over this last year. I am having to re-educate myself and adjust to full-on type 1. Previously if I went to bed with a high BG (>12) my basal would mop it up and I would wake with a BG 6 to 8. I have been advised that a bedtime BG with basal should result ideally with a BG similar to the bedtime reading, if the basal dose is correct. Therefore this suggests my basal was too high. So on advice I have lowered my basal dose and therefore need to aim for a sensible bedtime BG. I have just starting carb counting and I am trying to budget for snacks and keep to sensible snacks to stop myself getting so high before bed but I have been caught out on a few occasions.....hence the question: can you/should you take a correction dose just before bed? I guess I could check afterward like Charles Robin suggests.

 

[daisymoomoo]

If your bedtime reading is the same as the morning reading then it means your basal is correct & your bolus has stopped working for the night.
I would take a correction dose if my BG is high, but i've been doing this for years now and know if my bolus has stopped working - I find mine can go on for about 5-6 hours, so bear that in mind if you decide to make a small correction.

I also don't snack after my evening meal. This was the hardest thing I ever had to give up - but it really paid off!

 

[mrman]

Good advice daisymoomoo (lol)
By having your last main meal and only a small snack if needed to prop up levels slightly, you get to know I if evening meal bolus was correct and also if any changes needed to basal sooner than later

Sent from the Diabetes Forum App

 

[daisymoomoo]

Good advice daisymoomoo (lol)
By having your last main meal and only a small snack if needed to prop up levels slightly, you get to know I if evening meal bolus was correct and also if any changes needed to basal sooner than later

Sent from the Diabetes Forum App

You could do a test before proposed snack? If its below 7, then take a 1-2cp snack, in not trust your BG level and the dose you took earlier.

I LOVE food, skipping evening snacking has been like losing a pet, all over again - but I am so happy I did.

 

[Flakey Bake]

Thanks Daisymoomoo and Brett.
That's really helpful advice. I hear what you are saying about the evening snacking. I am going to try and cut right down on evening snacks. I guess I have been trying to avoid the inevitable sensible eating and instead looking for a magic bullet to allow my bad habits to continue. So cold turkey tonight and no more snacking! tonight, and tomorrow.
Cheers

 

[daisymoomoo]

Thanks Daisymoomoo and Brett.
That's really helpful advice. I hear what you are saying about the evening snacking. I am going to try and cut right down on evening snacks. I guess I have been trying to avoid the inevitable sensible eating and instead looking for a magic bullet to allow my bad habits to continue. So cold turkey tonight and no more snacking! tonight, and tomorrow.
Cheers

Good luck. Coming into summer does make it that bit easier - winter is the worst time for the evening comfort eating!