Type 1 Can someone explain to me what could have happened here?

[ojp89]

At 6pm last night I ate my evening meal and injected my fast acting insulin (apidra). From 8pm-9pm I played football. The combination of a slight overestimate on my insulin dose and excercise brought my blood sugar levels down to a reasonable level at 9pm.

Since then, I have not eaten or drank anything. At around 11pm I injected my daily slow acting insulin (lantus).

So why, from 9pm last night to 7am this morning, when not a single carb has entered my body, have my blood sugar levels gone from 6 to 16?

I know sometimes when you sleep through a hypo your blood sugars can shoot up, but I only went down to 5 and was awake then.

Any help or insights are massively appreciated

 

[therower]

@ojp89 . Welcome to the forum.
I see you’re new to the forum are you new to being type 1? Things can become quite erratic when we are recently diagnosed.
Apologies if you’ve being doing this for years.

 

[ojp89]

Are you confident your Libre is correct? The first thing I would do is check against a finger prick as Libre can become inaccurate, especially below 4 or above 8 and anomalies can be exaggerated.
What did you have for your evening meal? If you had a high fat meal (such as curry or pasta with a cheesy sauce), the carb absorption can be delayed by 5 hours ... by which time you had no fast acting insulin on board.
Have you done a basal test recently to check that your basal dose is correct? A continuous rise may suggest insufficient basal.
Is it possible that your Lantus insulin or pen is misbehaving? You may want to look at changing your cartridge and/or pen.
Are you feeling ok or are you stresses or coming down with something? Stress and illness will raise our BG.
Finally, (not another question) when our BG gets high, we experience insulin resistance and need more insulin to bring down our BG. Therefore, a high may become exaggerated at night because we have a fixed amount of basal in our bodies which may not . be enough which results in a continuous rise.

And, if it is not any of these things, the standard response is to blame the wrong socks! Our bodies are not machines so we do not behave the same every day; sometimes, BG rises and falls cannot be explained.

Hi,

First off, thank you for your detailed response!

So i did indeed have a high fat meal (a pepperoni pizza). I knew that fat makes carb absortion slower, but only really thought of it in smaller portions of fat, I.E, if having a hypo or close to a hypo, sweets are better than a piece of chocolate. I never really appreciated that its all relative, so a high fat meal can make carb absortion exponentially longer. That would definitely seem to be a factor behind the rise!

I am also a bit under the weather at the moment, having had a cold come on 2 days ago. Nothing major, but definitely feeling groggy in the last 24 hours. Not technichally an illness, but i assume this could have effected my blood sugar levels to make them rise also?

 

[Antje77]

Pizza is notorious for making diabetes misbehave all night!

 

[ickihun]

View attachment 36257

At 6pm last night I ate my evening meal and injected my fast acting insulin (apidra). From 8pm-9pm I played football. The combination of a slight overestimate on my insulin dose and excercise brought my blood sugar levels down to a reasonable level at 9pm.

Since then, I have not eaten or drank anything. At around 11pm I injected my daily slow acting insulin (lantus).

So why, from 9pm last night to 7am this morning, when not a single carb has entered my body, have my blood sugar levels gone from 6 to 16?

I know sometimes when you sleep through a hypo your blood sugars can shoot up, but I only went down to 5 and was awake then.

Any help or insights are massively appreciated

I'm on insulin but insulin resistant.
For me this can happen from liver dumping and maybe cortisol reaction to a fast use of your insulin stores from exercise etc. Your body felt in danger from how fast your insulin was being used up and anticipated that to continue but it stopped..... Maybe too abruptly.
In the past I've eaten a fatty protein before getting ready and swimming with exhertion in dressing too. (I was 22-23st). Now 17st I'm not back to full swimming not even stretching yet due to suspected gallstones pain/discomfort. Infection maybe too a few months after Roux-en-y operation.
Exercise can either make or break my progress. It has to be a military operation before and after to avoid heavy spikes and delay dumps from the liver.

 

[Juicyj]

I'd agree with the pizza, it's notorious for delayed carb absorption, I can only eat a couple of small slices now when I do eat the stuff, otherwise I have to set my alarm for a wake up call at 3am to correct and get my levels back down, also your cold won't be helping either as you're body produces sugar in response to the infection, hope you're ok today.

 

[ojp89]

So it seems the consensus is that pizza is a bit of mischievous food type, due to the high amount of fat in it. If having a pizza means thats carb absortion rates will be a few hours longer than normal, would injecting bolus insulin AFTER eating, rather than before, be ok? Does anyone do this?

Ill be honest i dont ever remember being told by the nurses about injecting after eating, ive always been told to do it within 15 mins before eating, but there is some logic there...

Looking at the screenshot in my first post, it seems the carbs from the pizza didnt kick in until 9pm (3 hours after i ate it)

 

[novorapidboi26]

People tend to favour a split dose of insulin for things like pizza, as there is still some glucose entering the blood stream straight away.......its only later on that there is a burst of carbs.....

 

[Antje77]

If having a pizza means thats carb absortion rates will be a few hours longer than normal, would injecting bolus insulin AFTER eating, rather than before, be ok? Does anyone do this?

Good thinking!
Lots of people try to tackle pizza with a split bolus, taking part of your insulin before eating, like usual, and the rest at some point later.
I'm more of a 'sugar surfer' myself, and add some insulin when I see the expected rise starting. Which obviously doesn't work when asleep. Haven't yet found a solution for that one.

(edited for wrong word. I definitely don't try to attack people with a split bolus...)