Nightime lows

[Yaya10_10]

I used to have hypos at nights but I found out I have too much basal insulin.

to treat hypo I have cola

 

[KK123]

Maybe not a solution, but have you tried some carbs before going to bed????

The problem with that is you don't know you are suddenly going to go hypo in the middle of the night. If you start taking carbs before bed on the off chance then you are more likely to be high all night long every night and you don't want that either. Your suggestion isn't a bad one but it all depends on the person and their 'usual' pattern...which can change anytime. If I am in the 4s before bed I take a 10 carb snack and mostly that seems to keep me stable overnight but sometimes for no apparent reason whatsoever, I wake up and am in the low 2s, no rhyme no reason and therefore no inclination to automatically take carbs before going to bed.

 

[ert]

Both are hypos, I think anything below 3.6 (or maybe 3.8 , cant remember) is classed as a hypo
Though people without diabetes and blood-glucose lowering medicine can drop that low naturally - but that's generally not an issue (RH can also drop it too low as well)

Hypos are defined as anything less than 3.5 mmo/l on DAFNE.

 

[ert]

You are woken at 2.30am with a 2.2low, you take 20g carb (yoghurt). You then wake up at 5am with a reading of 11. So, annoying, it’s so difficult to make a recovery from a low without going to a high, especially in those early hours?

Have you tested your basal insulin recently? Libre is good for trends but it certainly misses events like this due to accuracy.

 

[chrisbug]

I never ask them to be specific. But for me when they ask if you've had any hypo's, I consider that to mean have you had instances of needing assistance to recover from low bg.
I sometimes don't even immediatly react if say I'm 3.5, but food is not for 30 minutes for eg.
I even sometimes think that will help the average numbers and hbac1 a bit.

My DN was pleased with my recent HBa1C, but immediately followed with 'how many hypos are you having though?' I can't fool them!

Totally agree with what you say about needing 3rd Party medical assistance to treat a hypo, that is one of the benchmarks for the DVLA isn't it?

If I have a BS of 3.5mmol/L, I'll treat it regardless if I'm about to eat, and I'll include those carbs with my meal, and work out if I need to allow insulin for it. It all depends on which way the arrow is headed, and if my libre is behaving accurately!

 

[Zinadane]

Have you tested your basal insulin recently? Libre is good for trends but it certainly misses events like this due to accuracy.

Tested?
Yes basal level is crucial. Mine is slightly low atm, currently being tweaked day by day.
When it's low I get spiking due to higher bolus doses.
I get my basal spot on and everything is so much easier.
But then it drifts off again. Rhyme or reason, none, as you all know.

 

[annliggins]

Lets be fair ....its great when its great ,its low, its high , im stable , its rubbish , need to be lower oops to high , oops to low .
Just normal t1 day/ night then ???
Must keep trying ( another day ,another dollar ) itll be all worth it in the end methinks. X

 

[Hopeful34]

Hypos are defined as anything less than 3.5 mmo/l on DAFNE.

DAFNE was run by the same endo team I still see, yet a recent questionnaire from them for pump Clinic had hypo's defined as under 4.0. Interesting, I'd forgotten what DAFNE said.

 

[MeiChanski]

Hello for me, I would define my hypos as below 5.0mmol, this gives me a chance to treat it with a piece of fruit or a biscuit. So in this case, a yogurt would be fine.

You lose hypo unawareness if you’re constantly going low.

I would reconsider the yogurt for your hypos, hypos are classified as an emergency and you need fast acting carbs.

Depending on your basal, it takes more than a day to see results if you’re tweaking it.


I would take into consideration if your before bed glucose is between 4-5mmol, I’d have a nibble before bed to avoid the hypos. Depending on when you had your evening meal, taking into account your evening meal bolus

I can vouch for brain damage and memory loss, it’s not fun.

You can buy mini party cans of coke, its small enough so you don’t go over board.

 

[TypeZero.]

You are woken at 2.30am with a 2.2low, you take 20g carb (yoghurt). You then wake up at 5am with a reading of 11. So, annoying, it’s so difficult to make a recovery from a low without going to a high, especially in those early hours?

I find that eating food before sleeping totally messes up insulin sensitivity and I always wake up high if I have eaten someone 2-3 hours before sleeping

 

[becca59]

I can down a jelly baby in my sleep!

 

[Jaylee]

Yeah, you get asked, have you had any hypo's lately.
Well, you think.. please can you quantify what you mean by the term 'hypo'!

Hi,

Interesting topic. am I right in thinking your night hypo was a basal low..? (No fast acting insulin on board.?)

To be frank, I find my basal lows can be a slow creeper. (Lantus.) which can be treated with what others term as slower acting carbs. I find just hitting it with anything fast acting sugar wise can cause a reoccurrence an hour later?
Not what one needs during a day's graft.. So I have been known to sucessfully use milk, a biscuit or even utilising the carbs & protien from a mini pork pie.. Pending on how low & which direction I maybe heading.. Sometimes I can settle just under the "official" number wich looks like I could be cruising at..? But then, we got some reasonable BG monitoring tech these days..

The question about hypos. My answer to date. Is, "none I can't handle myself."
The old regime with Porcine insulin in the late 1970s as a kid was a pretty tough "training ground."
I was raiding the milk in the fridge going full on "Steel magnolia" whilst the house slept.. At least these days I've learned to leave enough for a cup of tea for my wife.. Lol, my dad wasn't so lucky when he got up for work..

 

[StewM]

Hi,

Interesting topic. am I right in thinking your night hypo was a basal low..? (No fast acting insulin on board.?)

To be frank, I find my basal lows can be a slow creeper. (Lantus.) which can be treated with what others term as slower acting carbs. I find just hitting it with anything fast acting sugar wise can cause a reoccurrence an hour later?
Not what one needs during a day's graft.. So I have been known to sucessfully use milk, a biscuit or even utilising the carbs & protien from a mini pork pie.. Pending on how low & which direction I maybe heading.. Sometimes I can settle just under the "official" number wich looks like I could be cruising at..? But then, we got some reasonable BG monitoring tech these days..

The question about hypos. My answer to date. Is, "none I can't handle myself."
The old regime with Porcine insulin in the late 1970s as a kid was a pretty tough "training ground."
I was raiding the milk in the fridge going full on "Steel magnolia" whilst the house slept.. At least these days I've learned to leave enough for a cup of tea for my wife.. Lol, my dad wasn't so lucky when he got up for work..

That’s interesting. Never would’ve thought to try this, but the logic for how that all works makes sense.

 

[KK123]

Instead of a carby snack before bed I often have a handful of salted peanuts. It sounds strange and there are only about 7 carbs in the handful but what they seem to do is keep the glucose levels topped up quite nicely (around the 5s/6s for me), no highs or lows just a nice smooth graph.

 

[ert]

Tested?
Yes basal level is crucial. Mine is slightly low atm, currently being tweaked day by day.
When it's low I get spiking due to higher bolus doses.
I get my basal spot on and everything is so much easier.
But then it drifts off again. Rhyme or reason, none, as you all know.

I change my basal on a daily basis.

 

[Zinadane]

I change my basal on a daily basis.

Interesting!
So, how do you calculate tomorrow's dose?

 

[ert]

Interesting!
So, how do you calculate tomorrow's dose?

I'm running for 1.5 hours in the morning with a lot of speed training. So I need to take a lot less all around - fasting acting and basal) and it will have a lag of 24 to 36 hours. It's a bit like jetlag.

 

[Zinadane]

I'm running for 1.5 hours in the morning with a lot of speed training. So I need to take a lot less all around - fasting acting and basal) and it will have a lag of 24 to 36 hours. It's a bit like jetlag.

Ah right, thought you were about to tell me you had a magic algorithm that told you what to dial in for tomorrow. I wish!
Basal level is key for me. I'll, do up to 2hr hardish bike rides. But the outcome on levels is not always that predictable.
Anyway, off topic a bit. Enjoy your run!

 

[ert]

Ah right, thought you were about to tell me you had a magic algorithm that told you what to dial in for tomorrow. I wish!
Basal level is key for me. I'll, do up to 2hr hardish bike rides. But the outcome on levels is not always that predictable.
Anyway, off topic a bit. Enjoy your run!

It's a lot of guesswork isn't it. But you have to keep trying. Every day is different. I just posted how I only had 2 hypos a month last week, then I had 4 bad days in a row this week due to not cutting back enough when I knew better. I'm better on a Dexcom, which is silly accurate. The Libre was good for trends, but I often found myself with a hypo and it still was reading 6 (which is in the range of its accuracy.)

 

[Zinadane]

Hi,

Interesting topic. am I right in thinking your night hypo was a basal low..? (No fast acting insulin on board.?)

To be frank, I find my basal lows can be a slow creeper. (Lantus.) which can be treated with what others term as slower acting carbs. I find just hitting it with anything fast acting sugar wise can cause a reoccurrence an hour later?
Not what one needs during a day's graft.. So I have been known to sucessfully use milk, a biscuit or even utilising the carbs & protien from a mini pork pie.. Pending on how low & which direction I maybe heading.. Sometimes I can settle just under the "official" number wich looks like I could be cruising at..? But then, we got some reasonable BG monitoring tech these days..

The question about hypos. My answer to date. Is, "none I can't handle myself."
The old regime with Porcine insulin in the late 1970s as a kid was a pretty tough "training ground."
I was raiding the milk in the fridge going full on "Steel magnolia" whilst the house slept.. At least these days I've learned to leave enough for a cup of tea for my wife.. Lol, my dad wasn't so lucky when he got up for work..

I don't tend to get night basal lows. Usually always caused by by a miscalc on bolus after a higher exercise day.
When my basal is just on the border of perfect, it may cause lows late afternoon. (tresiba once at night with fiasp bolus).
My basal needs tweaking quite regularly, can be up to ±10%. I get it right, it stays for 4-5days and then it needs tweaking again. Usual stuff!