Need advice to control highs during the night

[chocoholicnomore]

My last hba1c was 81. The consultant referred me to diabetic nurse to start insulin but she said I have too many low readings in a week for me to start insulin (I had to take readings 4 times per day in the week prior to my appointment) Instead she has increased the glicizade to 160 in the morning and the same at night. I bought a CGM to see what's happening and realised my levels are going up to 15 or 16 during the night and tends to stay above 10 until around lunchtime. It then stays down all afternoon, rises again after dinner and then comes back down again, sometimes as low as 3.6 at midnight. Then it goes way up about 3am. I'm at my wits end trying different solutions of when to eat and what to eat. Also, my diet is fairly restricted due to having an ileostomy. Obviously the high figures are impacting the average figure. And I really need to get the average down. Any advice is much appreciated. Thank you

 

[KennyA]

I think you need to talk to your medical team about this. If you can't link the results you're seeing to (say) food intake or medication then there is something else in play. No idea what that might be. The variation you report, which - if I've understood you correctly - can be 3.6 at midnight to 15 or 16 in the next few hours is quite large, particularly if you've not eaten anything or taken any medication that might help explain it.

Incidentally, I think you need to focus on your actual high and low readings, rather than an "average" which can present a false picture. For example, four readings at 5.0mmol/l and four readings at 15.0 average to 10.0mmol/l - but none of the actual results is 10. The HbA1c isn't an average of anything, by counting glycated red blood cells it gives you a longer term idea of what your blood glucose has been doing over the last three months, with a big skew towards the most recent few weeks.

 

[chocoholicnomore]

Thanks for your reply. My hba1c is continuously in the high 70s and my latest was 81. My nurse wants me to get it down. Years ago I used to low carb and control the sugars that way. But now I have an ileostomy and also on dapafliglozin and glicizade meaning low carb is no longer an option for me.

 

[ellesangel]

You sound a little like me as my last HBac1 was also 81 and I think it might be time for me to get a CGM as well. I know I need to keep motivating myself though also like you I don't have as much sugar as before. I agree with the above that it's super important for you to speak with your medical team because of the complications you're having though I would also like to wish you all the best.