BG levels before bed

[Emma2589]

How high should levels be before bed? I've just tested mine at a 4.5 which is the lowest pre-bed reading I've had, although my levels always seem to shoot up overnight and I will probably wake up about 15 tomorrow. I have also just given myself my evening 20 units of Lantus.

Would a pre bed snack be advised? I'm only just getting used to lows so any advice/experience gratefully received.

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[picklebean]

I personally wouldn't go to bed with a level that low and I know others that wouldn't either. Some people with very tight control of their blood glucose might be ok but I know I probably wouldn't be.... I'd almost certainly end up hypo. If it was me, I'd eat about 20-30g of carbs without taking any fast-acting insulin (eg 2 plain biscuits or a slice or two of granary toast). That's what I've been taught to do but other people may have different opinions.


Maybe take your blood sugar again in 30mins and see if you're going up or not. And then decide about eating carbs if you still need them? Depends on if you're eager to go to bed or not.

 

[Daibell]

Hi. My reaction to what you say is that perhaps the Lantus needs to be increased? It should roughly maintain your level during the night which it isn't doing. The morning fasting level should be around 5 - 7mmol. Any adjustments should be only 1 unit at a time and leave a few days between changes; watch out for hypos. After the Basal Lantus is right then you can adjust the Bolus (assuming you also have Rapid insulin) to match mealtime carbs. Do discuss changes with the DN if you can as I can only comment from a distance and as an amateur. BTW if you have excess weight then reducing this by reducing carbs a bit should help with insulin stability, but again watch out for hypos.

 

[Emma2589]

Thank you for replying. I panicked a bit, had some oatcakes with a thin bit of peanut butter after posting.. just checked and am on 5 so will check again soon.

I think I'd like it to be 6-7. I'm still getting control as am newly diagnosed and haven't experienced a situation like this before bed yet.

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[Spiker]

To be honest if I was 4.5 at bedtime I might have a very light snack like one oatcake. But, given that your blood sugar is rising overnight anyway, I wouldn't bother at all. But I seem to be lucky with night hypos - I rarely have them, and if I do, I wake up all sweaty and confused and grab some glucotabs from my bed side table.

But you do need to take a look at why that Lantus isn't working.

 

[Broa87]

My night reading just now was 23.

I've added a couple of extra units to my long lasting as I've been reading this is the one you need to get right if you want tight control.

I'm two years in to the journey of type 1 and I don't even understand it sometimes.

Best of luck.


From there to here, from here to there, funny things are everywhere!

 

[this is too difficult]

Are we talking medicated here?
It is quite confusing.
I am new to all of this and cant tell if we are talking medicated or not.
It seems to make a huge difference

 

[AndBreathe]

These guys appear to be T1, or on insulin at least. If you look at the thread header, it's been posted in the Type 1 forum.

I agree, it's not always easy to tell whether people are T1 or 2.

 

[clifft]

Thank you for replying. I panicked a bit, had some oatcakes with a thin bit of peanut butter after posting.. just checked and am on 5 so will check again soon.

I think I'd like it to be 6-7. I'm still getting control as am newly diagnosed and haven't experienced a situation like this before bed yet.

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HI, Just watch out for any un-expected spikes in the morning, this can sometimes happen. Your hormones come in to play first thing in the morning so dont worry too much. Record and check for a few days and make any adjustments then. Check with your DN at next appointment.

 

[clifft]

My night reading just now was 23.

I've added a couple of extra units to my long lasting as I've been reading this is the one you need to get right if you want tight control.

I'm two years in to the journey of type 1 and I don't even understand it sometimes.

Best of luck.


From there to here, from here to there, funny things are everywhere!

HI Each unit will give you 2-3 mmol change so dont over adjust too quickly. To get your BI right you will need to do some carb free meals and record vigorously so you can see what is happening and when. You may even need to split your basel insulin at some point, but you need to discuss these with your DN. Dont forget your diabetic team are there for you. Dont be frightened to give them a call and ask questions or arrange an earlier appointment. It is important to get your BI right, so well done for recognising that. Ask your DN about DAFNE course, this is a brilliant course and will teach you how to get all this stuff into perspective and work it out for yourself.

 

[Spiker]

Each unit will give you 2-3 mmol change so dont over adjust too quickly.

This will vary depending on your body weight, your insulin sensitivity, and the type of quick acting insulin you are using. And whether you are still producing any of your own insulin. This 2-3 range is a conservative estimate for a typical diabetic - whatever that is!


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