Blood glucose levels before bed

[Brownie1993]

Hello,

I've been type 1 since last June and I've only just started to think about this... I take 16 units of lantus solostar every 24 hours just before I go to bed. Because I have to take into account my BG levels dropping over night, I eat a snack before bed so that my levels are around 8/9. I'm assuming this is the case for most other type 1s?

But surely this isn't good being on BG levels of 8/9 every night.. But I don't know how else to manage this, because if i go to bed on BG levels of 4-7 then I'm likely going to have a hypo during the night/when I wake up.

So is there a better way to manage this, so that I'm not going to bed on BG levels higher than 7, but at the same time not having a hypo when I wake up?

 

[Type1Bri]

If you have no QA on board and you are experiencing hypo if you go to bed on a reading of 7 then you need to review the amount of basal or the timing of your basal. The idea is that dose should hold you steady overnight.

 

[Brownie1993]

How will the timing of my basal make a difference? I could reduce it, but then surely id have to reduce it by quite a lot, which surely wouldn't give me enough basal throughout the day to be having my standard 15g-in-between-meal-snacks?

 

[pinewood]

If 16 units of Lantus drops your BG overnight by more than approx 1.5mmol then you are probably taking too much (assuming you've not had any fast acting insulin in the 4 hours before going to sleep).

Therefore, if you're needing a snack to stop going hypo during the night I think you should try some basal tests to work out how much Lantus keeps your levels steady.

 

[pinewood]

How will the timing of my basal make a difference? I could reduce it, but then surely id have to reduce it by quite a lot, which surely wouldn't give me enough basal throughout the day to be having my standard 15g-in-between-meal-snacks?

It's likely that, on the correct basal dose (i.e. the dose that keeps your BG steady without any food or exercise) you will not be able to enjoy 15g carb snacks without some fast acting insulin. It's rubish, I know....

 

[Brownie1993]

Ah that is rubbish, but worth it if I'm to achieve steady BG levels at all times! Time to rethink my diet a bit then I guess..
I do get quite hungry in between meals. What low carb snacks would you recommend that wouldn't boost my BG levels sky high then? An orange, something like that?

 

[Type1Bri]

Oranges have between 15 and 20g carbs in. Nuts are carbs free and most meats too

 

[pinewood]

I'm in my honeymoon period but usually can't get away with bananas or oranges anymore unless I've exercised beforehand or have low levels to correct. Nuts are my usual between meal snack. Cheese, protein shakes, vegetables etc. are also good choices. Some nuts are more carby than others but personally I haven't noticed much difference in moderation.

 

[pinewood]

Oh, dark chocolate (like 85% plus) is also a good choice. I used to hate it but you get used to the flavours after a while and now I now really enjoy it. Lindt do a really nice one and it has negligible effect on my levels. Also, Google "fat bombs" for some other ideas of treats that you can hopefully enjoy without any fast acting.

 

[Brownie1993]

Thanks for your input guys! Going to lower and experiment with my basal over the next few days and stock up on low carb snacks!

 

[Type1Bri]

Just start by lowering 2 units. Bear in mind it will take at least 2 days for the changes to filter in when using lantus

 

[noblehead]

If your basal insulin is set at the right dose your fasting bg levels shouldn't fluctuate by more than 1.7mmol/l, as suggested do some basal checks.

 

[Jackie006]

Hi brownie 1993 I was also diagnosed last June I am on 22 of lantus before bed I was told by diabetic nurse as long as levels are 10 or 11 at night that's fine but on those levels I hypo thru night so find I have to take mine a bit higher like u I also find that I am always hungry between meals I am on apidra through the day

 

[Diamattic]

I used to have to do this until i lowered my Lantus dose. Now i go to bed around 6.5 and wake up between 5.5-6.

Its not ideal that you have to eat before bed. The ideal situation is you can go to bed at a stable reading, and wake up 8 hours later at just about the same reading. Perhaps you should try lowering your dose?

Also, something that really helped me was getting a Lantus Junior Star Pen because it was able to give me half units, so i found that 11 units was too low, and 12 was too high... 11.5 worked perfectly for me and kept my sugars stable with a SLIGHT drop of about 1mmol/L over about 6 hours.

 

[Brownie1993]

So last night I lowered my lantus to 13 units.. When to bed at 8.2... Woke up at 4.8. Looks like it needs to be lowered more still!

I don't think that's good though jackie. I was told the same by my diabetic nurse, but a reading of 7+ every day, for a few hours, can't be good. The aim for us type 1s is ultimately to gain normal readings at all times. Constant readings above 7 isn't going to be good for long term health issues.

 

[gemma6549]

I found lantus works much better as a split dose, half in the morning and half in the evening.

I used to have a lot of night time hypos, I still always test my sugars at 3am.

I don't like to eat before bed so gradually over time reduced my night time lantus.

Now that I'm pretty much always low carbing I miss my night time lantus completely.

I now go to bed at around 6 and wake up around 4.5-5.5mmol

 

[Diamattic]

So last night I lowered my lantus to 13 units.. When to bed at 8.2... Woke up at 4.8. Looks like it needs to be lowered more still!

I don't think that's good though jackie. I was told the same by my diabetic nurse, but a reading of 7+ every day, for a few hours, can't be good. The aim for us type 1s is ultimately to gain normal readings at all times. Constant readings above 7 isn't going to be good for long term health issues.

Thats the best way to think about things! Our goal is to be as normal as possible with eating habits and sugars. It takes a while to figure out what works best, not just what works. For months after my diagnoses i was taking 13 or 14 units of Lantus and always had to eat before bed until I started to lower it and ended up around 10 units, and noticed that if i don't eat for 8 + hours i don't need insulin, and i don't need carbs. My sugars stay flat.

Its fantastic. I can sleep for 12 hours on weekends and never have to worry lol

Start to bring down your lantus and see where you level out, don't be afraid to go 1 unit below that and see what happens, it may just what you need - or at least the worst is you have a day thats a bit high but at least you will know for sure where your balance point is!

 

[pinewood]

Thats the best way to think about things! Our goal is to be as normal as possible with eating habits and sugars. It takes a while to figure out what works best, not just what works. For months after my diagnoses i was taking 13 or 14 units of Lantus and always had to eat before bed until I started to lower it and ended up around 10 units, and noticed that if i don't eat for 8 + hours i don't need insulin, and i don't need carbs. My sugars stay flat.

Its fantastic. I can sleep for 12 hours on weekends and never have to worry lol

Start to bring down your lantus and see where you level out, don't be afraid to go 1 unit below that and see what happens, it may just what you need - or at least the worst is you have a day thats a bit high but at least you will know for sure where your balance point is!

Same thing happened to me .... I was started on 12 units of Lantus and would drop 6-8 mmol over night! Always had to make sure I had a snack and went to bed with a high reading. Could not understand why the DSN put me on this dose but since I was newly diagnosed and didn't know any better I just stuck with it for a few weeks.

I then gradually reduced the dose (thanks to advice on here!) and ended up on 6 units per night. This lasted me well for a couple of months and allowed me to go to bed at 4-6mmol and wake up the same. Also kept my levels steady during the day. Unfortunately my sensitivity then seemed to reduce and now I need 8 units each night for the same effect. It's great going to bed at X and knowing that you'll end up very close to the same when you wake up! And I hated having to have a pre-bed snack, so that's another bonus.

I also find that exercise (even very intensive exercise) doesn't really seem to affect my Lantus. I know lots of people have reported bad hypos when exercising with Lantus but I find no material difference in my basal levels on days when I exercise against days when I don't. Despite all the complaints you hear about, Lantus has been great for me.

 

[Brownie1993]

So again last night I went to bed on 13 units of lantus... My reading was 7.2. Didn't eat anything, and I've just woken up on a reading of 9.... What's that about? This diabetes ting is rather puzzling sometimes!

 

[gemma6549]

So again last night I went to bed on 13 units of lantus... My reading was 7.2. Didn't eat anything, and I've just woken up on a reading of 9.... What's that about? This diabetes ting is rather puzzling sometimes!

Is there a possibility you went low during the night?