Blood sugar during the night...

[DiabeticDi]

I am finding it difficult to predict what this will do! I take Lantus at bedtime around 11pm and then at breakfast.. Isn't your blood sugar supposed to only drop or rise up to 2 mmol from bed to breakfast?

For example, I go to bed on 10, at 3am I was 5. So I thought hmmm that is a bit low and I had 2 CP i.e. 20g worth of Lucozade. At breakfast I was back to 10. What is going on? Another time I was 11 at bed, 5 at 3am and had 2 cp and was 7.9 at breakfast. I am scared of going to bed below 10 in case I go lower than 5 at 3am!

And it seems that my readings are more stable if I DO go to bed around the 10 mark.

I have kept a diary of nighttime readings and they are all over the place. I have been told that it is unlikely to be the menopause so the only other thing i can think of is digestion i.e. carb amount in evening meal. I don't really go out after my evening meal. I do suffer from IBS. I have normal readings sometimes at breakfast to it is not dawn phenomenon.

I'm really at a loss!

 

[Rokaab]

I seem to have exactly the same problem, my bs seems to head downwards until about 3am after taking Lantus (3am being about 9 hours after last eating so its shouldn't be the fast acting insulin by that time), and from 3am it either stays low all night or sky rockets.
I'm changing to Tresiba in the next week to see if that helps.

 

[evilclive]

I am scared of going to bed below 10 in case I go lower than 5 at 3am!

An entirely reasonable fear, and one I shared till I got the miaomiao on Libre so I now have alarms. The result is I can be rather more aggressive with my insulin and I can experiment to work out what works best for me.

Libre without miaomiao will tell you more about what it's doing through the night - ie when things are changing. Which might then help you adjust doses.

 

[DunePlodder]

I am finding it difficult to predict what this will do! I take Lantus at bedtime around 11pm and then at breakfast.. Isn't your blood sugar supposed to only drop or rise up to 2 mmol from bed to breakfast?

For example, I go to bed on 10, at 3am I was 5. So I thought hmmm that is a bit low and I had 2 CP i.e. 20g worth of Lucozade. At breakfast I was back to 10. What is going on? Another time I was 11 at bed, 5 at 3am and had 2 cp and was 7.9 at breakfast. I am scared of going to bed below 10 in case I go lower than 5 at 3am!

And it seems that my readings are more stable if I DO go to bed around the 10 mark.

I have kept a diary of nighttime readings and they are all over the place. I have been told that it is unlikely to be the menopause so the only other thing i can think of is digestion i.e. carb amount in evening meal. I don't really go out after my evening meal. I do suffer from IBS. I have normal readings sometimes at breakfast to it is not dawn phenomenon.

I'm really at a loss!

Have you tried decreasing your evening basal? It may be that it is too high & you are in fact going low around 2:30, your liver then dumps glucose into your body causing your bgs to rise steeply. Sometimes you wake up after the low when it is actually going up & naturally eat carbs sending it even higher.
My experience of Lantus was that it would dip around 2am, this only became obvious when I got my Dexcom CGM. I tried changing injection times but eventually moved to Levemir which was a big improvement for me.

 

[Fairygodmother]

I found Lantus had a dip 5 - 6 hours after injecting and this led to a number of nighttime hypos. I’ve also changed to Levemir. I use a libre and have set my targets at 5 - 8 as I din’t like being above 8.

 

[PseudoBob77]

I found Lantus had a dip 5 - 6 hours after injecting and this led to a number of nighttime hypos. I’ve also changed to Levemir. I use a libre and have set my targets at 5 - 8 as I din’t like being above 8.

If you read up on medical journals insulin has a cycle which varys with each type of insulin. I think lantus can peak between 2 to 5 hours after injecting then the next 15 hours it gradually tails off

 

[WuTwo]

I use Levemir but find I get much better results if I split the dose than when I took the whole lot in one go. At the moment I'm on 9 at about 7.00 a.m. and 9 at bedtime. It works well for me but sometimes the amounts need to be changed. I will never know why, but I end up doing the whole basal testing thing to get the new totals to give.

 

[DiabeticDi]

Have you tried decreasing your evening basal? It may be that it is too high & you are in fact going low around 2:30, your liver then dumps glucose into your body causing your bgs to rise steeply. Sometimes you wake up after the low when it is actually going up & naturally eat carbs sending it even higher.
My experience of Lantus was that it would dip around 2am, this only became obvious when I got my Dexcom CGM. I tried changing injection times but eventually moved to Levemir which was a big improvement for me.

 

[DiabeticDi]

Thank you, I will experiment with the dosage but is 5 at 3am too low? Should I take some carbs or not? As I said I tend to panic when it's the middle of the night that I will go hypo and not wake as I have lost some awareness. What is an acceptable level at 3am?

 

[DiabeticDi]

I seem to have exactly the same problem, my bs seems to head downwards until about 3am after taking Lantus (3am being about 9 hours after last eating so its shouldn't be the fast acting insulin by that time), and from 3am it either stays low all night or sky rockets.
I'm changing to Tresiba in the next week to see if that helps.

 

[DiabeticDi]

Nightmare isn't it? Thanks for that, I will mention Tresiba to my doctor. Good luck!

 

[Fairygodmother]

Thank you, I will experiment with the dosage but is 5 at 3am too low? Should I take some carbs or not? As I said I tend to panic when it's the middle of the night that I will go hypo and not wake as I have lost some awareness. What is an acceptable level at 3am?

It depends. For me, a 5 at 3 am is good, but only you will know the patterns of your own insulin needs.

 

[DunePlodder]

Thank you, I will experiment with the dosage but is 5 at 3am too low? Should I take some carbs or not? As I said I tend to panic when it's the middle of the night that I will go hypo and not wake as I have lost some awareness. What is an acceptable level at 3am?

Sorry, I've only just seen this.
It seems sensible to take some carbs as you don't know what is really happening - better safe than sorry.
It would be useful to try a Libre or similar if you can afford it. This would give you a lot more information.
Have you talked to your diabetic nurse about this?

 

[endocrinegremlin]

If possible I would do a test when you are not working (if you do) and are able, where you test hourly from 3am and see just what your bg does. Does it stay at 5? Or rise or fall and by how much? You may be able to change when you take your lantus to avoid dips at certain times. In some diabetics there is only a 2mmol shift but in others it is naturally a far wider spectrum.