How 'low' do you let yourself go at night?

[-Artemis-]

Hi all... If you've seen any of my posts recently you'll know I'm still super new to insulin (2 weeks) plus a bit scared about night time hypos - not that I've had them, I just live alone and the thought of them frighten me.

Anyway, on Tuesday I saw my endocrinologist and he switched me from Lantus to Levemir. He was, however, a little vague about my dose and said just to switch like for like. I've only been taking 8u of Lantus, and I've been taking it in the morning because of my night-time hypo fear - but know that the peak is different between the two - so thought I'd try splitting the Levemir dose.

I took 5u at 9.30am yesterday and 3u at 9.30pm. The daytime dose was fine - tested often and my readings were similar to the Lantus.

The nighttime one; I went to bed at 11.30pm and was 9.8... A little bit high, but I figured better high than low as its my first night. At 1.30am I was 6.8... Still fine. At 4am I was 4.9. As I don't know where the peak is yet, I didn't know what to do... I know 4.9 is completely fine - but didn't know if it would keep dropping... So had a small bowl of strawberries... And woke at 7.3.

I should mention I had a glass of wine with dinner last night - only one - but I do know this can effect numbers. On the Lantus I could definitely have more wine and didn't go lower than about 5.5 at night... Though I was taking the Lantus in the am...

I'm now not sure if; a) I should have left the strawberries and/or b) if I should take less tonight and/or c) I shouldn't split the dose at all and should take it all in the morning, as I was the Lantus... As ever, very grateful for any thoughts/opinions.



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[ElyDave]

you're doing the right thing with the testing. The thing is to make sur eyou are testing in a fasted state to ensure that you can adjust the basal to your liver's secretion throughout the day.

Also remember that there is a natural low overnight followed by an increase as we wake, the Dawn phenomenon, stronger in soem than others.

Personally I'm happy as long as I go to sleep >5.0 for a margin. If I've had more to drinnk than normal, I may have a bedtime snack as well.

 

[jack412]

While you are working out your basic basal, I wouldn't drink.
Fwiw, I think splitting is a good idea

 

[stinky25]

i take 12 units of levemir before bed, was originally told to take 16 but it was dropping me in the low 4's first thing in the morning, 12 seems to be about right for me, everyones gonna be different though, plus i think i am still on 'honeymoon' so guessing this will change at some point. quite new to it all like yourself, is all about testing, and being self aware i think, i still have a drink now and then, but, im aware that its going to raise and drop my bloods, so food before hand is a must!!

i was also told that levemir only last around 18 hours...i normally take my shot around 10 pm, so this technically lasts me to around 4pm, by which time im due to eat again pretty soon so my shot of nova carries me through till 10pm again, nice routine and seems to work for me at the moment, but, again , im sure that will all change!!

good luck

 

[-Artemis-]

Thanks so much for your replies! Gosh, I'm all over the place since starting Levemir - still trying to figure it all out... Not had a drop since I posted this and now my numbers are horribly high.... oh the joys! Really good to know splitting is the way to go though @jack412 & @stinky25

Am testing, testing, testing....

 

[-Artemis-]

PS - love your blog @ElyDave - especially liked the "in a non pancreatically-challenged individual" - I'm going to call myself pancreatically-challenged rather than t1 from now on... ;-)

 

[ealingr]

When I was injecting, I had similar concerns about overnight hypos and preferred to take my Lantus once a day (in the morning) and use different bolus ratios (Novorapid) for different times of day rather than split the Lantus dose. I used one ratio of insulin units to carbs from waking until late afternoon, then a different ratio (more insulin for the same number of carbs) from early evening until bed. The advantage for me was that I knew the evening bolus would be out of my system relatively quickly, so if I did have issues with BGs dropping overnight then I could solve more rapidly and not worry about a prolonged effect. This might be another tactic for you to try?

If there's one thing this forum shows, though, it is that the same approach doesn't work for everyone. Whatever you do, it is really impressive that you're giving different things a go - I'm sure you will find your groove.

 

[-Artemis-]

Thanks @ealingr! Good advice... And thanks for the encouragement




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[jack412]

There is a free online course and workbooks that will give you a good overview till you can do your course
http://www.diabetes.co.uk/forum/threads/newly-diagnosed.60873/#post-583801

 

[iHs]

i take 12 units of levemir before bed, was originally told to take 16 but it was dropping me in the low 4's first thing in the morning, 12 seems to be about right for me, everyones gonna be different though, plus i think i am still on 'honeymoon' so guessing this will change at some point. quite new to it all like yourself, is all about testing, and being self aware i think, i still have a drink now and then, but, im aware that its going to raise and drop my bloods, so food before hand is a must!!

i was also told that levemir only last around 18 hours...i normally take my shot around 10 pm, so this technically lasts me to around 4pm, by which time im due to eat again pretty soon so my shot of nova carries me through till 10pm again, nice routine and seems to work for me at the moment, but, again , im sure that will all change!!

good luck

mber: 113439"]i take 12 units of levemir before bed, was originally told to take 16 but it was dropping me in the low 4's first thing in the morning, 12 seems to be about right for me, everyones gonna be different though, plus i think i am still on 'honeymoon' so guessing this will change at some point. quite new to it all like yourself, is all about testing, and being self aware i think, i still have a drink now and then, but, im aware that its going to raise and drop my bloods, so food before hand is a must!!

i was also told that levemir only last around 18 hours...i normally take my shot around 10 pm, so this technically lasts me to around 4pm, by which time im due to eat again pretty soon so my shot of nova carries me through till 10pm again, nice routine and seems to work for me at the moment, but, again , im sure that will all change!!

good luck [/QUOTE]
Youve more or less got the right idea there.....

 

[iHs]

Nightime hypos do exist unfortunately so for people who live on their own and want to keep bg levels tightly controlled either basal test frequently or get a cgm, or aim to keep bg levels controlled at a sensible 6mmol during sleep time.