High at Bedtime

[dtennant9]

For the last few nights I have been really high at bedtime. Last night I was about 16.4 at 2am. I have been taking correction doses at bedtime yet last night decided to see what would happen if I left it and at 7am it is 9.3, which is quite a drop.
If it's always a particular time I day that you are high is it likely to be the previous meals Bolus that's the issue?

I was going to add a couple of extra Lantus units to my morning dose but not sure if this will knock me off somewhere else. My blood doesn't usually drop overnight, it's more the later high I'm worried about.

I should probably do some basal testing but I'm going on the pump soon so may just wait until then.

Any advice would be appreciated.

 

[Loobles]

I'm not an insulin user, so forgive me if this is way off the mark....

Could it be that you've been going to low overnight and your liver has chucked out a load of glucose? I'm sure I've heard of that before. Any insuline users care to comment?

 

[hale710]

Even with starting the pump soon I would do an overnight basal test to see what's happening. It will help if you know you're BG pattern well pre pump as it speeds set up!

 

[dtennant9]

Even with starting the pump soon I would do an overnight basal test to see what's happening. It will help if you know you're BG pattern well pre pump as it speeds set up!

Yeah I'm thinking I may have to.

It doesn't generally drop like it did last night though. Usually if it is high at bedtime it will be in the morning as well, same with being lower. I think a few of my night time highs have been down to my evening meal but I'm wondering if my ratios are out slightly in the evening. I'm currently on 1:10 but maybe have to try uping it a bit.

 

[noblehead]

For the last few nights I have been really high at bedtime. Last night I was about 16.4 at 2am. I have been taking correction doses at bedtime yet last night decided to see what would happen if I left it and at 7am it is 9.3, which is quite a drop.
If it's always a particular time I day that you are high is it likely to be the previous meals Bolus that's the issue?

Your bg dropped 7mmol without a correction dose so I wouldn't be upping the basal dose, if you'd gone to bed on a reading of 6-8mmol you would have undoubtedly gone hypo.

If you split-dose your lantus then the morning dose may need tweaked, however if your just on one injection I would think about reducing the dose as your fasting bg should not fall much more than 1.7mmol when your asleep.

I think you've got your evening meal ratio wrong and need to review it, if you ring your DSN and tell them about your bg readings they will advise you further,

 

[dtennant9]

Your bg dropped 7mmol without a correction dose so I wouldn't be upping the basal dose, if you'd gone to bed on a reading of 6-8mmol you would have undoubtedly gone hypo.

If you split-dose your lantus then the morning dose may need tweaked, however if your just on one injection I would think about reducing the dose as your fasting bg should not fall much more than 1.7mmol when your asleep.

I think you've got your evening meal ratio wrong and need to review it, if you ring your DSN and tell them about your bg readings they will advise you further,

Yeah I split my Lantus.

I added an extra unit in this morning. I will tweak my evening ratio, although Wednesday evening is quite an active evening for me so will prob leave it until tomorrow. I usually have to drastically reduce my insulin on Wednesday evenings.

Also doesn't normally go down much overnight, just seemed to last night.

 

[noblehead]

Yeah I split my Lantus.

I added an extra unit in this morning. I will tweak my evening ratio, although Wednesday evening is quite an active evening for me so will prob leave it until tomorrow. I usually have to drastically reduce my insulin on Wednesday evenings.

Also doesn't normally go down much overnight, just seemed to last night.

I would do one at a time, adjust your basal first then adjust your insulin ratio if necessary. The morning basal may need increased to get your early evening bg down, by missing your evening meal or postponing it till later in the evening will say if it does or not, just have a low-fat lunch as normal and test your bg 4 hours after eating, if it starts to climb then you will need to increase your morning basal.

If your night-time bg doesn't fluctuate much in the early hours then leave well alone, but last nights bg did drop a fair bit so you should just keep an eye on it over the next few nights and test, especially if you get your pre-bed readings down into normal range, it might just be that you still need to reduce your evening basal.

 

[dtennant9]

Only had a drop of 0.8 overnight last night and was sitting at 8.8 when I went to bed which was a lot better.

Wednesday night is my really active night though.

I will maybe make sure I do a post prandial test with my evening meal for the next few nights to see what's going on.

 

[dtennant9]

Seems ok now.

5.6 at bedtime last night. Bit on the low side for me so had half a rich tea biscuit and I was 6.1 this morning. Probably would have been ok without the biscuit.