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Below 4 overnight

V

VioletViolet

Well-Known Member
Messages
424
Type of diabetes
Type 2
Treatment type
Diet only
Hello

I'm a newly diagnosed Type 2, diet only no insulin or other meds. Ive been lowering carbs since diagnosis a month or so ago (been prediabetic for years prior to that) . I've just got a free trial glucose monitor for a fortnight and I've been lowering carbs further now I see what spikes me.
My aim is to keep it steady around 5/6 ideally. However first thing (5/6 am) my levels drop below 4 . What's the easiest way to prevent this? A planned snack before bed? More carbs in my meals so it hovers closer to 6 after food? Just wondered what worked for others.


Thank you x
 
It’s a great idea to use a free trial CGM. It can give so much information about glucose trends after food/ exercise etc.
have you checked with a fingerpick because sometimes compression on the sensor can cause a low reading.
Also how are you feeling when this happens. Are you shaky or have blurred vision or any other signs of a potential hypo?
I would do a finger prick test, if you have the kit beside your bed, it saves you rousing yourself fully.
Most of us keep a jelly baby or glucose tabs beside the bed to use if needed.
It’s scary at first but you’ll get lots of reassurance on this site about what’s normal and when to panic.
CGMs do have accuracy limitations at very low/ high numbers so it’s always best to check with a finger prick.
If after checking you find you are dropping a bit low then you can look at the other things you’ve suggested. It’s good to experiment while you’re on the trial.
Best wishes going forward.
 
Ah, I think you might have found exactly what I did when I tried a CGM.

What I found from the CGM was that somewhere between 3 and 5am my BG would abruptly drop off a cliff. Prior to that it would normally be getting very gradually lower. The drop is into the 3s and sometimes lower. I would really like to find some way of preventing this (because of disturbed sleep, not because of the BG changes) and I've tried just about everything I can think of. Any food eaten at say 11pm wiill have been dealt with and digested long before 5am.

This sort of thing can happen with compression lows, where you lie on the sensor, but what doesn't happen with compression lows and does happen consistently with my abrupt drops is nightmares, heavy sweating, and (usually) waking with an adrenaline rush. The nightmares etc correlate perfectly with the CGM lows.

I've had these nightmares etc for about ten years, but it wasn't until trying a CGM that I realised it had anything to do with BG. After the drop, my liver wakes up and decides I need some glucose, which it then provides and the dawn pheniomenon starts and will continue until I eat something (eg three almonds will stop it).

You can't really keep BG steady because your liver is in charge of that, and it will do what it thinks best. This means dumping glucose from its glycogen stores if it thinks you need it.

On a previous similar thread someone (can't recall who) had the sensible idea that this might be triggered by a rise in insulin production, rather than something initiated by BG levels. An insulin dump would be consistent with the sudden drop in BG, and then a rise as the liver starts glucose production. There is no way to test for this, and it begs the question of why the insulin dump?
 
That may have been me, and the answer is because .. dreaming..
Huge brain activity, possibly significant emotional effect also, but essentially a sudden call for energy, resultant insulin spike, resultant BG drop.

However, unless your sleep is being affected by it, I'm not sure that it!s anything to worry about.

Just for context.. I use a sleep analysis mat, and while I was using a CGM, I could often map periods of low BG to periods of dream sleep. Or, REM sleep to be specific.
 
The first night it happened I felt fine , it was the cat that woke me up . (Not exactly an assistance animal type are they? If she was worried about my health it would be as 'who's going to get my breakfast if she's ill?"
) But today I woke up with a migraine and it was in the 3s . I will try the finger prick thing next time it wakes me.

Thank you
 
That's interesting. I have had very vivid dreams the last couple of days, since I lowered carbs in fact.

It's useful to know you've tried many things to no avail . I wish you had found a solution , but I won't waste too much energy trying to fix what could be unfixable


Thank you
 
I had really good dream recall so it could well be that. Not nightmares just odd and vivid. My subconscious life is obviously more exciting than my daytime one


Thank you
 
I have hypo issues , not just dips, but blood sugars that drop like a stone with no sign they will recover until I intervene. I was tested for a number pancreatic related conditions , but all negative. I am insulin sensitive, meaning I do not have insulin resistance. Also my pancreas tends to be inconsistent with its insulin secretion. One of the things that my GP and DN suggested was to have Something carby before I sleep. It actually worked and, although I still get these nighttime drops they are far less frequent.

3 am would be my lowest point, which corresponds directly with my circadian rhythm cycle. Your circadian rhythms are powerful, and orchestrated from your hypo thalamus. It effectively orchestrates the master clock. All your cells have clocks too in particular, your liver and your beta cells, but your hypothalamus has the main one. These internal clock directs many different hormonal secretions which activate various bodily functions. So early morning your body is releasing growth hormones and cortisol , at night melatonin. Insulin secretion Is enhanced in the morning too, as is Insulin resistance in some people, hence the dawn phenomenon. So just prior to your DP, this increased insulin production can cause blood sugar fall, just prior to your DP. It is quite an interesting subject.

Here is One of my CGM reports . You can see the fall around 3am. Not a low , but it illustrates my point.
 

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Not you, it was @Jasmin2000.

The dreaming is I think a consequence of, and not a cause of, what's happening (whatever that is).
 
KennyA said:
Not you, it was @Jasmin2000.

The dreaming is I think a consequence of, and not a cause of, what's happening (whatever that is).
Click to expand...
Wish I could report back with a explanation @KennyA but I'm sure @Melgar is on the right track with those circadian rhythms, but how we get from there to individual solutions will be trial and error for a while.

According to my endo, my lows (about 3.0 at 2:30 am) are due to my nighttime Lantus hitting about 3h after dosing. But when I showed him the same lows on nights with no Lantus at all, he was stumped. My sports dietician thinks my body has "learned" that I do a lot of exercise and am low carb so it sucks up all the glucose when I'm asleep to be ready for a huge liver dump later. Common for all of us is the need for some carbs in the night without having to get up - glucose pump?
 
You're a diet-only T2, and newly diagnosed? Regular, run-of-the-mill type two's don't usually get proper hypo's unless there's something else going on. People without diabetes can run low without even noticing anything, because their glucose, like those of a T2 with nothing else complicating things, will have a liver dump at some point, so they don't go so low the brain goes on the fritz. When you're on insulin or gliclazide or something, you can have too much insulin in your system which your liver-dump can't do enough about, but if there's none of that about, your body should make a correction on its own to get you back to 3.5 and over. Also, a CGM can indeed cause a compression-low, just read low, not actually be low. Like I said though, usually. There'll always be exceptions to the rules.

On top of that, if you're only just starting out on this journey, being in the normal range can cause symptoms called a false hypo (when you're still above 3,5), which feels like a hypo, but isn't. And low carbing, especially in the beginning, can cause dehydration, which can cause massive headaches and migraines, besides fatigue and whatnot, until your body gets used to the new normal, which takes a few weeks.

There's a lot of changes coming at you right now. Your body needs time to adjust. If you have another headache, drink loads, and maybe add in some electrolytes. (Supplements, coconut water, bone broth etc). Might help.

I do hope you feel better. And let go of the 5-6 range. You're going to be under or over that at several points in the day, and that's perfectly normal; as long as you remain in the normal range for most of the time, it's all good.
Hugs,
Jo
 
My CGM had a 2.1 mmol/l reading followed by 'LOW' yesterday and my finger prick was 4.0. I knew my blood sugars would be normal as I did not have any hypo symptoms. My CGM came back to life and reading properly 40 minutes later.

Edited by mod to remove forum rule breach
 
Last edited by a moderator:
Thank you that's very reassuring
 
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