Abasaglar & Nocturnal Hypos

[RogerRam]

Hi, I have Abasaglar long acting insulin pre sleep. Problem is if the dose is too low I get a waking HI. However, if I increase the dose typically it will be perfect for a couple of nights then, like last night, I will get a LO.
I use a Libré & contemplating a MiaouMiaou to give me alerts & also after 53 years MDI have a RDV with a diabétologue here in France perhaps to have an OmniPod pump.
Experience or suggestions welcome.
Estimated A1C 5.8% (40 mmol)

 

[Deleted Account]

What is the profile like for Abasaglar?
I only know about Lantus which, although the profile is supposed to be flat, there is a peak after 2 or 3 hours.
When I was taking Lantus, I used to hypo at night until I moved my dose a few hours earlier (with evening meal rather than just before going to bed) so the peak is whilst I was awake.
I also used to go to bed with a BG between 7 and 8 to ensure I did not hypo even if I went lower. This worked for me because I graze during the day and the background basal helped keep my BG level.

However, are you sure you are hypoing at night?
I ask because I see many people mentioning the Libre reads low when they lie on it at night.

 

[RogerRam]

Thanks. I do trust the Libré unless the results are crazy in which case I blood test. I could experiment with taking Abasaglar earlier so that I could avoid the LO. I think Abasaglar is a cheaper version of Lantus-sorta out of patent. "Abasaglar (previously known as Abasria) is biosimilar to Sanofi's Lantus as it has the same active ingredient, insulin glargine. "
My local doc who is not a specialist prescribed it after I complained of night hypos. Tricky with him due to my French not being that good-said 'non' to a pump 'cos I was too well controlled-'no need'. Am really pleased with how things are going thanks to Libré (free here) & Low-Carb that is tricky-SO many Glucotabs! No docs here seem to have heard of Dr.Bernstein so discussion is impossible. We love France but in some ways it is like a 3rd-world country. Before we moved, before completion, I fell off the roof of the Hymer 30#s & the surgeon advised against going to France before discharge since they did not believe in the use of an Ilizarov Frame. This had enabled me to walk 2 days after surgery. TMI.
Thanks,
Roger

 

[urbanracer]

What's your injection / food / sleep timing?

I am using Abasaglar - I inject about 19:00 but I usually eat my evening meal (and bolus) an hour or so afterwards.

I've been using this insulin since January this year and started with morning injections. I was experiencing overnight highs (up to 15mmol) so moved the injection time to the evening. It took a while to settle down but at the moment it seems to be working quite well. Libre shows a flat(ish) line overnight and I wake up around 6:00 with glucose levels around 7mmol, which I am content with for the time being.

 

[scotteric]

Hi, I have Abasaglar long acting insulin pre sleep. Problem is if the dose is too low I get a waking HI. However, if I increase the dose typically it will be perfect for a couple of nights then, like last night, I will get a LO.
I use a Libré & contemplating a MiaouMiaou to give me alerts & also after 53 years MDI have a RDV with a diabétologue here in France perhaps to have an OmniPod pump.
Experience or suggestions welcome.
Estimated A1C 5.8% (40 mmol)

Try splitting it and taking it at night and in the morning. That way you can take different doses for night and day which helps avoiding both highs and hypos. You could also consider switching to Levemir which is made for splitting since it lasts ~12 hours on smaller doses. Splitting is an effective approach for most type 1s, as basal needs differ throughout the day and it's hard to meet them taking 1 dose over 24 hours.