Higher readings before bed

[baz2107]

Hi, was looking for some advice if possible please. Have been T1 since August 2013. My last HBA1C was 45 (having been diagnosed at 118) so I know I am on the right track.

After a lot of messing around with doses in conjunction with my clinic I now normally take 1 unit apidra for breakfast (8am) 2 units for lunch (1pm) and 3/4 units with evening meal (approx 8pm) then 2 units basal (Lantus) before bed (11pm)

My average readings over last 4 months are
Breakfast 6.29
Lunch 5.78
Evening 5.97
Night 7.60

I am a bit of a perfectionist and would like all my readings to be between 4 and 7, but if I take another unit of insulin with my evening meal I know I am likely to have a hypo. Is my night time higher because there is a lesser time period between tests (3 hours as opposed to 5 and 7 earlier in day) or is there another reason.

How can I get this night average down? or should I just b satisfied with how it is?

 

[mo1905]

Hi Baz, those readings look quite impressive to be honest. When I attended DAFNE their bed time target reading was slightly higher than others as this is the most dangerous time should a hypo occur, during sleep. You could perhaps lower it slightly by possibly eating a little earlier or reducing carbs/portion size in evening meal. If it were me, I'd be happy with your readings though.

 

[novorapidboi26]

It could be because, as you described, you have taken the test before the insulin you have taken had ran out completely.........although you are on small amounts so your insulin may well have ran out before the 2.5 hours..........Apidra I think has a shorter duration than Novorapids 4.5 hours.......1-2.5 hours I believe.....

So it might be more likely that your Lantus dose, again small, has ran out by the time the night has come.........so you could try giving your Lantus in the morning to see what affect it has on the evening results....

I think you should also try targeting specific times when you are higher at night though as there could be many reasons for being high including food, illness, alcohol etc....

 

[dtennant9]

I would say your readings are quite good.
As mo1905 says, it is often reccommended that your a little higher at bedtime anyway.
I was previously higher at bedtime but this has now been sorted out.
The first thing we tried was having another dose of Lantus in the morning. Secondly we moved my evening Lantus to around 7pm as opposed to bedtime. This sorted out my higher levels.
As I said however, I would be happy with your levels.

 

[noblehead]

Your breakfast (fasting readings) look fine so I wouldn't worry too much about night reading Baz, overall your bg levels are great and you should be proud of yourself

 

[baz2107]

Thanks very much, I will leave it as it is for now, and see what they say next time I am at the diabetic clinic, to see if they are happy with it.

I thought it could be the Lantus having ended, so will discuss moving this, but then I think it will just mean I am higher at a different point in the day.

Unfortunately 8 is earliest I can eat, my 16 month old daughter goes to bed at 7 which takes a good 45 mins at the mo! and I don't get home til 6.30

 

[novorapidboi26]

That's the thing with a single dose of long acting insulin, any changes made in one half of the day can effect the other half.........

A good reason to split the dose, but at the levels your are on, there isn't much point I would of thought......

Its likely you could still be in the honeymoon period......