Hello,
I'm new to this forum but have enjoyed reading it with interest over the past few months, and already learnt a few new things, even though I'm an 'experienced' diabetic.
I've been a T1 for 43 years and now a retired young 70 year old! I have always taken my diabetes seriously and as a consequence have been well controlled over all these years and have never had any complications. But my biggest problem, which started a few years ago, is the really large drop in BG that I experience over night ... every night
My overnight BG drop is really large, about 8 - 10 mmol/l, so I have to ensure pre-bed reading of 12-14 mmol/l or else I'll be really low (<3) on waking. The attached screenshot is taken from my detailed spreadsheet where I monitor BG, carbs and insulin/carb ratios and any relevant data. It shows the BG Night Drop, and BG pre bed and on waking, all averaged over last 3 days to smooth out the trend. It covers the last approx 6 months since Feb.
I take Lantus 12u am and Humalog before each meal, calculated using my insulin/carb ratios, of about 50u in total. Usually I have Humalog before breakfast and evening meal, since lunch is just a single sandwich or fruit and doesn't require any insulin. Lantus is about 20% of total insulin intake. My carb intake is typically 140g.
Typical HbA1c is 7.5% which is higher than ideal but my consultant believes this is due to the higher BG prior to bedtime in order to compensate for the large BG overnight drop.
In conjunction with my diabetic consultant, I have tried various changes and tests to see if we can overcome this problem, but nothing seems to work ...
1) Since I was not using Lantus several years ago, we introduced Lantus ... made no difference.
2) Tried changing Lantus level ... made no difference, and current level of 20% of total seems right based on BG 2hr after meals.
2) Tried changing fast acting insulin, from Humalog to Apidra, ... made no difference.
(Now back on Humalog since Apidra production problem in late 2011).
3) A variety of different blood tests plus MRI scan of pancreas to check for any abnormalities .. all OK.
Control of BG during the day is typically fine, but very infrequently (every 4 to 6 weeks) I can get a totally unexplained large BG drop during the day or late evening and I have to eat 40-80g carbs to compensate even though no extra exercise or insulin taken. That level of carbs will raise my BG by 6-8 mmol/l. My insulin overnight appears to last a VERY long time, since I inject at 7pm, pre-bedtime BG measure at 12 midnight, and then again on waking at 7am, and sometimes have to eat even more carbs before breakfast at 9am.
I would welcome any suggestions that you knowledgeable posters have to offer which might help me overcome this issue ...... many thanks ....Jon
I'm new to this forum but have enjoyed reading it with interest over the past few months, and already learnt a few new things, even though I'm an 'experienced' diabetic.
I've been a T1 for 43 years and now a retired young 70 year old! I have always taken my diabetes seriously and as a consequence have been well controlled over all these years and have never had any complications. But my biggest problem, which started a few years ago, is the really large drop in BG that I experience over night ... every night
My overnight BG drop is really large, about 8 - 10 mmol/l, so I have to ensure pre-bed reading of 12-14 mmol/l or else I'll be really low (<3) on waking. The attached screenshot is taken from my detailed spreadsheet where I monitor BG, carbs and insulin/carb ratios and any relevant data. It shows the BG Night Drop, and BG pre bed and on waking, all averaged over last 3 days to smooth out the trend. It covers the last approx 6 months since Feb.
I take Lantus 12u am and Humalog before each meal, calculated using my insulin/carb ratios, of about 50u in total. Usually I have Humalog before breakfast and evening meal, since lunch is just a single sandwich or fruit and doesn't require any insulin. Lantus is about 20% of total insulin intake. My carb intake is typically 140g.
Typical HbA1c is 7.5% which is higher than ideal but my consultant believes this is due to the higher BG prior to bedtime in order to compensate for the large BG overnight drop.
In conjunction with my diabetic consultant, I have tried various changes and tests to see if we can overcome this problem, but nothing seems to work ...
1) Since I was not using Lantus several years ago, we introduced Lantus ... made no difference.
2) Tried changing Lantus level ... made no difference, and current level of 20% of total seems right based on BG 2hr after meals.
2) Tried changing fast acting insulin, from Humalog to Apidra, ... made no difference.
(Now back on Humalog since Apidra production problem in late 2011).
3) A variety of different blood tests plus MRI scan of pancreas to check for any abnormalities .. all OK.
Control of BG during the day is typically fine, but very infrequently (every 4 to 6 weeks) I can get a totally unexplained large BG drop during the day or late evening and I have to eat 40-80g carbs to compensate even though no extra exercise or insulin taken. That level of carbs will raise my BG by 6-8 mmol/l. My insulin overnight appears to last a VERY long time, since I inject at 7pm, pre-bedtime BG measure at 12 midnight, and then again on waking at 7am, and sometimes have to eat even more carbs before breakfast at 9am.
I would welcome any suggestions that you knowledgeable posters have to offer which might help me overcome this issue ...... many thanks ....Jon
