High BGS before bed.

[Yaya10_10]

Hi,

My BGS go up before bed ( number like 11.7 - 12)
and drops to like 3 at 3 a.m. When it goes high I can not take anything to eat just in case not to make things worse.

How can I manage the BGS before bed?

I am on NovoRapid and Levemir (take it before breakfast)

Any advise would be great
Thanks

 

[EllieM]

I assume you are on a basal/bolus regime ? Adjusting your insulin for the carbs you eat?

The basic concept is that you get the basal right (ie level should be same first thing in the morning and last thing at night) or over any long period when neither bolus or food is acting. Once the basal is right you can then alter your bolus so that it covers your meals correctly.

How long have you been T1? Have your team explained how to adjust your insulin doses? If you're not confident how to make the changes yourself, you might want to contact them for help. I, for one, wouldn't be happy with bgs of 3 in the night, though if these are from a libre instead of a glucometer you might want to check them, libres are notorious for false compression lows at night if you lie on your sensor.

When it goes high I can not take anything to eat just in case not to make things worse.

Do you know how to do correction doses?

 

[Yaya10_10]

Thanks for replying. Yes, I am on injections 1 long acting and three fast acting.
I have been diabetic for approx 12 years. I check my bg in the morning and then take my long lasting but you said something here

Once the basal is right you can then alter your bolus so that it covers your meals correctly.

how do we know if the basal is right. if the bg in the morning is in a normal range, right?


here also

"over any long period when neither bolus or food is acting".
I do not know how do I check this? any help?

Thanks again

 

[Fenn]

Hi I get 3am hypos, what is it with the 3am thing? The nurse split my long acting to twice a day instead of once and haven’t had this trouble since, might be worth a chat to see what they think of that idea. Best of luck, nighttime hypos are horrible.

 

[Yaya10_10]

Hi, it is horrible yes.

The thing is in just two hours I go from like 11 to 3. I do not know if this happens with you?

 

[Hertfordshiremum]

Hi, it is horrible yes.

The thing is in just two hours I go from like 11 to 3. I do not know if this happens with you?

What are you eating at dinner or drinking milk in the evening? Anything that maybe temporarily spiking you up to 11? Maybe when this has then been digested the basal is taking you too low. What time are you eating dinner? Have you tried having an early dinner and seeing if you return to normal range 4 hours later? Just some ideas I tried. FYI My nurse also split my basal dose in half morning and evening when I went through a phase of nighttime hypos. You do need to contact your nurse on dosage adjustment.

 

[Fenn]

I sometimes hypo like 5 hours after novo, that drop wouldn’t be unusual for me, I’m very spikey, but only because of the insulin so must be something to do with your doses I think.

 

[StewM]

Hi,

My BGS go up before bed ( number like 11.7 - 12)
and drops to like 3 at 3 a.m. When it goes high I can not take anything to eat just in case not to make things worse.

How can I manage the BGS before bed?

I am on NovoRapid and Levemir (take it before breakfast)

Any advise would be great
Thanks

When this happened to me, (and I'm not saying this is happening to you, because I don't have enough information to do so) I had set my Basal too high. As such, I was incorrectly taking too little Bolus* which was compensated for by my Basal being too active**. This was 'fine' during the day as I was regularly eating food (with as previously mentioned insufficient Bolus) to prop my Blood Sugar up. However, it became an issue at night when I was no longer doing that.

*As I couldn't tolerate the correct amount of Bolus whilst Basal was too high, as it would inevitably send me low.

**Also my incorrect Bolus ratios showed up most on the highest Carbs meals which were always my dinners.

 

[EllieM]

My guess is that you need less basal and more bolus, but this is a guess and I'm not in a position to make any recommendations on quantities. (It's actually against forum rules). That is what your diabetic team is for. I would contact them, particularly about the lows. Night time hypos are no fun. Once your basal is right (it should be keeping you level overnight) then you can work on the bolus. If you give your team a completed food and insulin diary they should be able to help you.

People on pumps can end with different basal rates throughout the day, but as I'm on basal/bolus (like you) I just concentrate on trying to get it right overnight, as I'm totally willing to adjust bolus during the day to cope with too much or too little basal, I just don't want to have to do it at night.

Good luck.

 

[Yaya10_10]

What are you eating at dinner or drinking milk in the evening? Anything that maybe temporarily spiking you up to 11? Maybe when this has then been digested the basal is taking you too low. What time are you eating dinner? Have you tried having an early dinner and seeing if you return to normal range 4 hours later? Just some ideas I tried. FYI My nurse also split my basal dose in half morning and evening when I went through a phase of nighttime hypos. You do need to contact your nurse on dosage adjustment.

yes, I have my dinner late at 10. I eat bread with cheese

I think I will try to eat early and see how it goes.
The problem is that after 4 hrs my sugar drops. Maybe because of the basal and I will look at this

 

[Yaya10_10]

I sometimes hypo like 5 hours after novo, that drop wouldn’t be unusual for me, I’m very spikey, but only because of the insulin so must be something to do with your doses I think.

yes same here, I have the same issue I got hype after 5 hrs. I will try to see my basal maybe this helps.

Thanks

 

[Yaya10_10]

My guess is that you need less basal and more bolus, but this is a guess and I'm not in a position to make any recommendations on quantities. (It's actually against forum rules). That is what your diabetic team is for. I would contact them, particularly about the lows. Night time hypos are no fun. Once your basal is right (it should be keeping you level overnight) then you can work on the bolus. If you give your team a completed food and insulin diary they should be able to help you.

People on pumps can end with different basal rates throughout the day, but as I'm on basal/bolus (like you) I just concentrate on trying to get it right overnight, as I'm totally willing to adjust bolus during the day to cope with too much or too little basal, I just don't want to have to do it at night.

Good luck.

Thanks after reading this , I will look at the basal.

This is the starting point

 

[Yaya10_10]

When this happened to me, (and I'm not saying this is happening to you, because I don't have enough information to do so) I had set my Basal too high. As such, I was incorrectly taking too little Bolus* which was compensated for by my Basal being too active**. This was 'fine' during the day as I was regularly eating food (with as previously mentioned insufficient Bolus) to prop my Blood Sugar up. However, it became an issue at night when I was no longer doing that.

*As I couldn't tolerate the correct amount of Bolus whilst Basal was too high, as it would inevitably send me low.

**Also my incorrect Bolus ratios showed up most on the highest Carbs meals which were always my dinners.

Thanks StewM and I will try first look at the basal. It might be the problem,

Thanks a lot guys

 

[Antje77]

yes, I have my dinner late at 10. I eat bread with cheese

To me, it sounds like you're still seeing your dinner spike to me before bed.

 

[Yaya10_10]

To me, it sounds like you're still seeing your dinner spike to me before bed.

Sorry I did not get that.

could u please explain what you mean by this?

 

[Soplewis12]

Hi, try a full day of a tiny amount of carbs at each meal, substitute with no carb/low carb alternatives, this will help you assess if your basal is correct.

 

[Antje77]

Sorry I did not get that.

could u please explain what you mean by this?

You've eaten (and presumably injected) for your meal at 10PM. You say you are high before bed, but you don't say at what time this is.
But seeing as you go low at around 3, which is only 5 hours after your last meal, I'm guessing your high before bed reading is somewhere between 11:30 and 1:30, at which time you still have your 10PM meal actively digesting and raising your numbers.

So I have a feeling the high number before bed is because of your meal, not because of your basal insulin.
The low at 3 could either be the last of the tail of your mealtime insulin, or it could be your basal is too high.
It's hard to say anything about the basal when you still have active bolus insulin on board.

 

[StewM]

To me, it sounds like you're still seeing your dinner spike to me before bed.

This could be the reason also. It’s also not outwith the realm of possibility that your Bolus was incorrectly timed, and missed the spike and then hit after the spike.

There’s various contextual information you’ll have (and which we don’t) which will help you assess which is most likely.

 

[Yaya10_10]

Hi, try a full day of a tiny amount of carbs at each meal, substitute with no carb/low carb alternatives, this will help you assess if your basal is correct.

Thanks that is a great idea
I will discuss it with the nurse

 

[Yaya10_10]

You've eaten (and presumably injected) for your meal at 10PM. You say you are high before bed, but you don't say at what time this is.
But seeing as you go low at around 3, which is only 5 hours after your last meal, I'm guessing your high before bed reading is somewhere between 11:30 and 1:30, at which time you still have your 10PM meal actively digesting and raising your numbers.

So I have a feeling the high number before bed is because of your meal, not because of your basal insulin.
The low at 3 could either be the last of the tail of your mealtime insulin, or it could be your basal is too high.
It's hard to say anything about the basal when you still have active bolus insulin on board.

Yes, dinner time is a bit late and yes the rading is at 1:30 am. The novorapid still active at this time and it may still active.
I had my dinner tonight at 9 am and I had a bit of spike also.
I took less novorapid but I took note of that. Bg was better all the day and before dinner was 7 I had 2 units of novo I thought I needed less but the good thing I had corrected it and I will have some snack before going to bed.

Thanks a lot