Advice on night time hypos

[philly1991]

So last night I was tossing and turning for much of the night and was absolutely exhausted when I woke for work, checked my bg using my libre and it turns out I'd been hypo much of the night. With DAFNE principles I'll be reducing my basal by 10%-20%
However I currently have 34 units of Tresiba and have been told this can last upwards of 36 hours so will reducing it really make that much of a difference specifically during the night?

 

[Juicyj]

Hello @philly1991 Have you had other night time hypos ? On the basis of one night I’d be inclined to leave it as I only adjust basal based on a pattern of lows, also as it lasts 36 hours it would take 2-3 days to see any changes if you do change it.

 

[Jollymon]

I’ll agree that unless this happens all the time, that one night is not a trend. One night of issues could be an absorption problem.

 

[philly1991]

I've only had them two other nights within the last two weeks but it isn't everynight. With DAFNE they say to wait for a 48 hour pattern unless it's a night time hypo which they say you should address immediately.
I've been struggling all day to bring them back up so I'm not sure what that's all about either. Very worried today as this isn't normal for me.

 

[kaylz91]

when had you last injected bolus insulin? had you done more exercise than usual? what did you have to eat? what were you when you tested before you went to lie down and sleep? there are too many factors to rush in and reduce Tresiba immediately when you cant say for certain the Tresiba is to blame xx

 

[philly1991]

Everything else was done as normal, if anything I ate a little later than normal. Was 8.7 before I went to bed and I usually anticipate it'll drop about 2 during the night. With the reduction it'd literally just be going off what they said on DAFNE where if you can rule out the other factors, which I have, then reduce.

 

[philly1991]

Probably a little less activity than usual yesterday too. I'm positive I calculated correctly for dinner last night which was at 6.30pm.

 

[kaylz91]

DAFNE isn't the be all and end all bible I'm afraid, I believe they teach you that you don't need to inject for certain things for instance whereas many do need to cover those things with insulin, I would never reduce based on 1 evening and without comparative finger pricks there is no definite evidence you were in fact hypo all that time, only if it recurs and formed a pattern would I reduce, perform a basal test to see if it does need adjusting, could've been a delay in absorption from bolus dose, maybe bolus ratio's are changing etc

 

[philly1991]

This is true, though they do teach that what is right for one might not work for another with regards to what you're injecting for so like you say it's more about looking for patterns and what applies to you.
Based on this I probably won't reduce tonight but I will do a 3am blood to be safe. Can't imagine another day like I've had today though.
Thanks for the advice @kaylz91