Type 1 Rising sugar levels through the night

[kellyb8511]

hi guys I hope you can give me a little helpful advise

I have noticed my sugar levels are rising through the night even though I am not eating from about 6:30-7:00 pm

Last night I checked my levels at bedtime 10pm and it was 4.2 woke up and tested this morning 17.7!!! I take 24 units levimir in morning approx 7am and 18 units at 7pm. I then take novarapid as and when I eat

I’m confused as me and diabetes have had a terrible relationship but this time I am really really trying to be the best I can but keep failing - I do honestly whole heartedly hate this disease it’s bloody awful

My last hba1c was 8.1 so little higher then hoped as I am trying to get pregnant and unfortunately I have suffered from 4 miscarriages and Drs have put it down to guess what bloody diabetes! So I am really really trying to get this sorted ASAP so any help and advise is much appreciated

Diabetes rules and ruins my life :-(

Kelly xx

 

[Diakat]

4.2 is low to go to bed, you may have had a hypo and liver dumped up to the 17.

When do you take your basal? Does this happen every night? Do you test overnight or have Libre readings to show the pattern overnight?

 

[EllieM]

Option 1 : Are you sure you haven't had a hypo in the night, causing your liver to dump sugar and hence go high in the morning? I personally wouldn't go to bed at 4.4 without a snack, but then I hate night time hypos with a vengeance. Google suggests that novorapid peaks at 1-3 hours but goes for up to 5, so I'd expect your blood sugar still to be going down at 10pm. So maybe you had too much bolus, and maybe too much basal???

Option 2: you need to up your basal.

In either case, I think you need to test your basal rates , but I'm not sure how you do this on a double dose.
Are you able to get access to a cgm (eg freestyle libre) so that you can tell what happening at night. Otherwise I'd suggest setting an alarm and doing some manual overnight testing....

 

[kellyb8511]

Morning, thank you for your replies

I did have a big debate with myself about if I needed a snack before bed last night usually hypos wake me up instantly BUT there is a chance I’m not noticing them as easy anymore so yes it is a big possibility. I will aim for 5ish for sugars before bed

I am not sure what a cgm is so I will have a look into it Now

Thanks again for advise xxx

 

[Tony337]

Hi
Awkward one for you.
I'm chipping in because I am on the same regime as you insulin wise but take less levimir.
Can you take your novorapid (and levimir) and eat earlier than 7pm?
If you are eating and injecting at 7 pm then going to bed at 10pm then everything is still sloshing about in your system so you are not getting an accurate reflection on your levels.

Good luck

Tony

 

[Deleted Account]

I am not sure what a cgm is so I will have a look into it Now

Currently, the cheapest CGM-type device available to self-fund is the Libre.
There is a lot of discussion abut this on the forum.

Alternatively, my diabetes team lent me a 'blind CGM" for a week to test my basal levels.
It was "blind" because I was unable to see the readings until they were downloaded at the hospital.
But they gave me information to adjust my insulin doses.

 

[HICHAM_T2]

I think you need to consult your doctor in the insulin dose to share the evening that it is a long-acting insulin

 

[EllieM]

Alternatively, my diabetes team lent me a 'blind CGM" for a week to test my basal levels.
It was "blind" because I was unable to see the readings until they were downloaded at the hospital.
But they gave me information to adjust my insulin doses.

My clinic (in NZ) did this for me too. It resulted in a much lower basal dose (which I probably would never have dared to do on my own).

A CGM is a continuous glucose monitor, by the way. I would have killed to have had one of those when I was pregnant (my kids are in their 20s now ). Good luck with it all, hopefully things will get easier for you.

 

[scotteric]

hi guys I hope you can give me a little helpful advise

I have noticed my sugar levels are rising through the night even though I am not eating from about 6:30-7:00 pm

Last night I checked my levels at bedtime 10pm and it was 4.2 woke up and tested this morning 17.7!!! I take 24 units levimir in morning approx 7am and 18 units at 7pm. I then take novarapid as and when I eat

I’m confused as me and diabetes have had a terrible relationship but this time I am really really trying to be the best I can but keep failing - I do honestly whole heartedly hate this disease it’s bloody awful

My last hba1c was 8.1 so little higher then hoped as I am trying to get pregnant and unfortunately I have suffered from 4 miscarriages and Drs have put it down to guess what bloody diabetes! So I am really really trying to get this sorted ASAP so any help and advise is much appreciated

Diabetes rules and ruins my life :-(

Kelly xx

You might have very strong dawn phenomenon and your Levemir isn't sufficiently counteracting it. I think there are people who suppliment their Levemir with NPH. Others have to wake up at 3 or 4 in the morning and take rapid. Another option might be switching to Tresiba which some people have said eliminates the dawn effect. Or you could have gastroparesis and your dinner is digesting hours later than it should.

You also might consider taking your Levemir later. It has a slight peak which can be used to counteract the dawn effect if timed right. I take mine at 9 or 10pm so that it peaks around 3-4am when my DP kicks in. Your dose might be peaking too early and then isn't strong enough when your DP starts.

 

[kellyb8511]

Hi thank you all so much for this information

I will request an appointment with my diabetes team but in the mean time I will aim to eat earlier and just take novarapid with my meal and then have my levimir at 9ish

My issue is I usually go to bed 7:30 - 8ish as I get up for work at 4:30 so I am probably waking up right in the middle of my dawn phenomenon if that’s the case

Why am I never normal!! or never have diabetes issues! grrrrr

Thanks again xx

 

[jlarsson]

In my experience it doesn't matter if you eat or not late in the evening, it still rises. I didn't even know about this stuff until I got the Libre, and have ever since countered it with Novorapid at some point before going to bed in addition to Levemir as normal to be able to fall asleep without outrageously high blood sugar that makes my already near insomniac body barely able to fall asleep.

 

[scotteric]

In my experience it doesn't matter if you eat or not late in the evening, it still rises. I didn't even know about this stuff until I got the Libre, and have ever since countered it with Novorapid at some point before going to bed in addition to Levemir as normal to be able to fall asleep without outrageously high blood sugar that makes my already near insomniac body barely able to fall asleep.

It's dawn phenomenon, it will happen whether you eat or not, but eating definitely makes it worse and can also result in highs from fat/protein that digests after your mealtime dose has worn off.