Very Low Bg During The Night - Late Snack ?

[ivan 2]

Injected insulin at 7 PM (mixed).

Had dinner, and at 10 PM a medium apple and a handful of hazelnuts.

Obviously not enough - woke up around 4 AM in the morning with Bg 2.3.

Managed it according to kind advices in this forum.

(When I was admitted to the hospital we were given a glass of milk or yoghurt and a slice of brown bread to be consumed at 10 PM).


Does it happen to you ?

What late snack am I supposed to have to prevent low during the night ?

Any suggestions ? Thank you.

 

[alphabeta]

Maybe you should decrease your dose if you are going that low

 

[EllieM]

What medication are you on?
Sorry, I've just seen you are on insulin.
Have you been given advice on reducing your insulin dose as appropriate?

 

[ivan 2]

What medication are you on?
Sorry, I've just seen you are on insulin.
Have you been given advice on reducing your insulin dose as appropriate?

Rather vague advice by the endocrinologist in regard of insulin dosage: `` plus minus 2 units depending on actual blood glucose level``.
Can probably reduce it from 16 to 14 units in the evening. But it`s been uneventful for 6 months: hypo started to occur only lately. Lost almost 50 lb in the meantime, and HbA1c dropped to 23 (4%). Because of heart attack and 4 stents I am on many medications already (statin included) and I feel very comfortable with insulin and low carb diet. So, I would prefer to manage hypo with snacks rather than decreasing insulin.

 

[Juicyj]

Hello @ivan 2 I would consult your DSN in regards to any changes with your insulin doses, as you've done so well with your weight loss then this would also affect your insulin requirements but it's best to catch up with them and see what they suggest.

 

[alphabeta]

What premix insulin are you using?

 

[ivan 2]

What premix insulin are you using?

Mixtard 30 contains both fast-acting (soluble) and long-acting (isophane) insulin: soluble insulin 30% and isophane insulin 70%.
Thank you

 

[alphabeta]

Mixtard 30 contains both fast-acting (soluble) and long-acting (isophane) insulin: soluble insulin 30% and isophane insulin 70%.
Thank you

I used this insulin for 9 years and I did experience nocturnal hypoglycemia mainly around 4 AM

 

[ivan 2]

Exactly what happened to me last night, i.e. at 4 AM.
Will have a glass of milk and tiny slice of brown bread around 11 PM.
Fortunately, I am well bellow 50 g. carbs daily.
Thank you.

 

[alphabeta]

Exactly what happened to me last night, i.e. at 4 AM.
Will have a glass of milk and tiny slice of brown bread around 11 PM.
Fortunately, I am well bellow 50 g. carbs daily.
Thank you.

I suppose full fat milk is better because fat sits in the body longer and releases slowly

 

[iHs]

Exactly what happened to me last night, i.e. at 4 AM.
Will have a glass of milk and tiny slice of brown bread around 11 PM.
Fortunately, I am well bellow 50 g. carbs daily.
Thank you.

That's a good idea Ivan. Maybe think about eating something with a bit more protein in it. Can you do a bg test about 2am just to see when you start to drop towards being low.

 

[alphabeta]

How did it go?

 

[ivan 2]

How did it go?

Possibly hypo last night again (did not test), and rebound Somogyi effect in the morning (lab test 6.25 one hour after usual mixed insulin dose), no food (waited for lab to be done).
HbA1c today 4.3 % (24 mmol/mol).
Average glucose 4.3.
I am so scared of any result close to 10, probably I need counseling.
Thank you.

 

[alphabeta]

Possibly hypo last night again (did not test), and rebound Somogyi effect in the morning (lab test 6.25 one hour after usual mixed insulin dose), no food (waited for lab to be done).
HbA1c today 4.3 % (24 mmol/mol).
Average glucose 4.3.
I am so scared of any result close to 10, probably I need counseling.
Thank you.

Hba1c 4.3!!!! Wow congrats!!

 

[ivan 2]

Hba1c 4.3!!!! Wow congrats!!

Thank you.I did my best with low carb and lost 50 lb. in 6 months after heart attack and 4 stents.
Changed completely my lifestyle.It was simply to be or not to be.