Blood sugar drops during night?

[Little_Lucy]

Hi, I’ve had this struggle for a while now and I’m still unsure on why it’s happening

Please ignore the awful blood sugars I’m working on trying to fix it. But for whatever reason my blood sugar seems to go down massively during the night and it never stays steady. I don’t know why this happens so if anyone has any sort of explanation I’d be grateful if u could let me know

 

[Antje77]

At what time did you last have a dose of quick acting insulin before midnight?
The drop during the night looks pretty much the same as the other two sharp drops after sharp rises. Can it be you are overtreating your hypo's and then overtreating your hypers, leading to this uncomfortable rollercoaster?

 

[Little_Lucy]

At what time did you last have a dose of quick acting insulin before midnight?
The drop during the night looks pretty much the same as the other two sharp drops after sharp rises. Can it be you are overtreating your hypo's and then overtreating your hypers, leading to this uncomfortable rollercoaster?

For my levels during the day I would completely agree with this explanation. But I’d normally eat around 8ish and have fast acting insulin then but won’t have anymore till morning, everything else is just the basal in the background. I also dont treat the hypers before bed because I know it would lead to a hypo in the morning.

The only insulin that is going into me from around 10pm latest till morning is just the slow basal from my pump.

(I am on pump so technically all is fast acting insulin)

 

[Antje77]

The only insulin that is going into me from around 10pm latest till morning is just the slow basal from my pump.

Can it be you need a lower basal rate at night than during the day?

 

[Hopeful34]

Have you done a basal test(s) to find out where you need to tweak your basal insulin? It's the first place to start to resolve peaks and troughs.

 

[kvetiny]

Sounds like too much basal and not enough bolus insulin. Figure out ur basal by basal testing then figure out ur ratio to carbs and reduce carb intake.

 

[Hertfordshiremum]

Hi, I’ve had this struggle for a while now and I’m still unsure on why it’s happening
View attachment 49536

Please ignore the awful blood sugars I’m working on trying to fix it. But for whatever reason my blood sugar seems to go down massively during the night and it never stays steady. I don’t know why this happens so if anyone has any sort of explanation I’d be grateful if u could let me know

I had the same thing at one point, I agree with Kvetiny lower basal and up bolus before eating Hope you sort it, as I know this makes you feel awful

 

[Daibell]

Hi. I started using Libre 2 two weeks ago and have seen the same thing. I've been gradually reducing my night-time Levemir and it does appear to be caused by too much late evening Basal. I've increased my morning Levemir instead as that appeared to be too low. Aren't Libres amazing.

 

[Jaylee]

Hi, I’ve had this struggle for a while now and I’m still unsure on why it’s happening
View attachment 49536

Please ignore the awful blood sugars I’m working on trying to fix it. But for whatever reason my blood sugar seems to go down massively during the night and it never stays steady. I don’t know why this happens so if anyone has any sort of explanation I’d be grateful if u could let me know

Hi,

You have no criticism from me regarding your graph. Yer 'avin a go. That's all that matters.
It would help if you let us know what insulin you use in your pump?

Now I'm on a basal bolus regime & oddly what I'm seeing in your graph from the late morning on, is similar to how I'd be if id forgotten my basal the night before & attempted bang in corrections to wing it?? I empathise things don't always go to plan.
It's great you have a sensor. Basal testing first should be looked at to set your foundation.

What i will do, Is tag a few pump users in which may help regarding your particular insulin regime.
@searley @Juicyj @NicoleC1971

Best wishes.

 

[searley]

To me it looks like you basal is wrong then you are correcting

You are in for a bit of hunger I think.. as what you really need todo is some extended basal tests..

Basically no food.. or liquid with carbs…. And you need to see whether your bg stays stable.. if it’s going up or down then your basal is wrong (slight changes in bg ok). But if it’s moving quite a bit the you need to tweak your basal

Also you can have multiple basal settings.. my basal rate at night is quite different to that in the day.. so you may need to setup some periods with different rates

Once you have the basal right you can look at tweaking the bolus

But as suggested above I would guess you basal is too high

If you look at this chart you will see my basal is about right.. the bg is a little high but the bg has had no big rise or fall

The rise at 10am is the effect of the COVID jab..

I assume you are under the care of a consultant being on a pump... when i saw mine they were quite good at setting up the initial profiles, and discussing the best way to make changes.. it might be worth contacting them to run through it with you.. im on a tandem pump and i was also provided a direct number to my rep at tandem that would be able to assist with any changes i need to make.. were you provided similar details? i also have a direct email address for my pump team where i can discuss issues..

obviously they should be your first port of call as we/i are/am not qualified to offer direct medication advice,

the basal testing will help put them in the right direction for adjustment, so that's needed whether you seek their help or attempt yourself

 

[Little_Lucy]

Sounds like too much basal and not enough bolus insulin. Figure out ur basal by basal testing then figure out ur ratio to carbs and reduce carb intake.

That’s a good idea I’m going to start tomorrow

 

[Little_Lucy]

Hi,

You have no criticism from me regarding your graph. Yer 'avin a go. That's all that matters.
It would help if you let us know what insulin you use in your pump?

Now I'm on a basal bolus regime & oddly what I'm seeing in your graph from the late morning on, is similar to how I'd be if id forgotten my basal the night before & attempted bang in corrections to wing it?? I empathise things don't always go to plan.
It's great you have a sensor. Basal testing first should be looked at to set your foundation.

What i will do, Is tag a few pump users in which may help regarding your particular insulin regime.
@searley @Juicyj @NicoleC1971

Best wishes.

Thank you! I use nova rapid insulin in my pump, I’m going to try basal testing tomorrow to set a foundation and start changing things

 

[Little_Lucy]

To me it looks like you basal is wrong then you are correcting

You are in for a bit of hunger I think.. as what you really need todo is some extended basal tests..

Basically no food.. or liquid with carbs…. And you need to see whether your bg stays stable.. if it’s going up or down then your basal is wrong (slight changes in bg ok). But if it’s moving quite a bit the you need to tweak your basal

Also you can have multiple basal settings.. my basal rate at night is quite different to that in the day.. so you may need to setup some periods with different rates

Once you have the basal right you can look at tweaking the bolus

But as suggested above I would guess you basal is too high

If you look at this chart you will see my basal is about right.. the bg is a little high but the bg has had no big rise or fall

The rise at 10am is the effect of the COVID jab

Thank you for your help I already have multiple Basal settings but am going to try and change some things in the upcoming week!

 

[searley]

Thank you for your help I already have multiple Basal settings but am going to try and change some things in the upcoming week!

as per my above post if your pump team has not suggested you 'tweak' settings yourself then it may be worth contacting them for advice.. mine leave me to it and they are happy they know what im doing... but there are other people that the hold their hands through everything

 

[NicoleC1971]

Thank you for your help I already have multiple Basal settings but am going to try and change some things in the upcoming week!

If this is a consistent happening and your short acting bolus has petered out at 2am it is either not doing what it says on the tin i.e. that last dose is lasting a little longer but yes more likely to be basal rates. Hopefully you can tweak hour by hour and tweak the hours 11-12, 12-1, 1-2 and 2-3 AM .
I had the same issue at about 4 am onwards and I just tapered down the insulin before and after. If I know that a unit of the insulin takes me down 3 mmol then I will take 0.25 units off my insulin for 4 hours.
That is the theory anyway and my night time is usually a boring flat line. Daytimes (when I start to eat and move!) it looks more like a Lord of the Rings' mountain hellscape!!
FYI I am applying for the Tandem iq pump + Dexcom cgm so that the pump can do the legwork on this kind of issue whilst I sleep through (it picks ups a sugar drop and auto corrects the insulin to prevent you going below 4).

 

[searley]

FYI I am applying for the Tandem iq pump + Dexcom cgm so that the pump can do the legwork on this kind of issue whilst I sleep through (it picks ups a sugar drop and auto corrects the insulin to prevent you going below 4).

Unless @Little_Lucy has had their pump 4 years then tandem probably won't be an option.. even then getting it with dexcom is quite tough.. FYI its still quite possible to go below 4 during the night if the basal is too high this is because tandem only suspended if it thinks you will go low in the next 30 minutes but humalog/novorapid works for upto 5 hours.. ive had a few 2's overnight so as with all pumps having the right basal to start with is key.. in fact with tandem having the basal slightly low and allowing it to auto-increase seems to work slightly better

 

[NicoleC1971]

Unless @Little_Lucy has had their pump 4 years then tandem probably won't be an option.. even then getting it with dexcom is quite tough.. FYI its still quite possible to go below 4 during the night if the basal is too high this is because tandem only suspended if it thinks you will go low in the next 30 minutes but humalog/novorapid works for upto 5 hours.. ive had a few 2's overnight so as with all pumps having the right basal to start with is key.. in fact with tandem having the basal slightly low and allowing it to auto-increase seems to work slightly better

That's good to know - thanks. I've been warned that the basal is key and you can't replace a functioning pancreas with this kit but I know 2 people who've had excellent results with it when it comes to further smoothing out the troughs and spikes which I get from HIIT or forgetting to do my bolus in time etc. I thought sleep and exercise modes helped too?

 

[searley]

That's good to know - thanks. I've been warned that the basal is key and you can't replace a functioning pancreas with this kit but I know 2 people who've had excellent results with it when it comes to further smoothing out the troughs and spikes which I get from HIIT or forgetting to do my bolus in time etc. I thought sleep and exercise modes helped too?

We are wandering a little off topic now, i assume OP doesn't have a tandem so this is a little irrelevant to her.. we could create a thread of our own in pumps section if you want to discuss the pro's and cons of the tandem & g6 combo.. if you'd like todo that and tag me in it, i can share my thoughts and experiences with you, and that may help others thinking about the tandem system..

and don't get me wrong i get great results... but basal/control iq has its limits so like any pump user having the right base settings is important.. and as @Little_Lucy will also discover even if you get it right now, it will still change and need tweaking further over time

 

[NicoleC1971]

We are wander a little off topic now, i assume OP doesn't have a tandem so this is a little irrelevant to her.. we could create a thread of our own in pumps section if you want to discuss the pro's and cons of the tandem & g6 combo.. if you'd like todo that and tag me in it, i can share my thoughts and experiences with you, and that may help others thinking about the tandem system..

and don't get me wrong i get great results... but basal/control iq has its limits so like any pump user having the right base settings is important.. and as @Little_Lucy will also discover even if you get it right now, it will still change and need tweaking further over time

Thanks and I might just do that IF I get my Dexcom funding approved. Also following a Canadian lass on YouTube who uses one.

 

[Little_Lucy]

as per my above post if your pump team has not suggested you 'tweak' settings yourself then it may be worth contacting them for advice.. mine leave me to it and they are happy they know what im doing... but there are other people that the hold their hands through everything

It’s okay, my team encourages that we do it ourselves, in fact I often get told off for not doing it. They’ll be pleased I’m making some changes!