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Blood glucose levels dropping in the night.

A

anniehi41

Well-Known Member
Messages
79
Location
Midlands
Type of diabetes
Other
Treatment type
Pump
Hi everyone,
I have been a secondary diabetic for about 18 months sinceI had a pancreatectomy operation. I wasnt a diabetic at all before and I have such a lot to learn.

I have a problem with my BG dropping during the night. I usually have my last meal about 7 pm and carb count. I have Humalog post meals and give 9 units of my long acting Lantus in the morning about 8am, my DSN switched it to the morning in the hope that my BG would not drop so much as the Lantus was running out, but it has not helped, it has also been lowered from 10 to 9 about three weeks ago.

My blood glucose can drop up to 9 in the night so being scared of Hypos I tend to go to bed making sure my BG is about 14, by eating a snack. I have done a no carb meal test of omelette and that did not affect my BG much, only rose about 1 to 2 mmol in 5 hours during the afternoon.

I wonder if anyone else has experienced this problem? Any advice would be welcome.

Thanks
Annie.
 
First off your BG levels are not low. A hypo is technically 4 and below ("4 is the floor"). 9's/10's are respectable for a diabetic; especially where there are no Beta cells presents.

I am not a human Dr but if an animal was presented to me with similar (equivalent for that species) BG levels I would up the insulin dosages (I'm a Vet). I can go to bed with 9/10 depending on meal and wake up at 4/5. Some nights I need a snack before bed as already down at the 5-7 level.

Just think rough 4-7 starving values and try and keep to up to 10/11 post meal (very difficult some times). Please correct me on those values folks but that's the adv given by my Endocrinologist.

D
 
Thanks Dazza 1984 for your reply. The problem I have is that if I went to bed at say 11mmol and my BG dropped 9 in the night I would be down to 2 in the morning and in Hypo. How would giving more insulin help? Wouldn't that just make it worse? I thought the background insulin was supposed to 'hold' your blood glucose steady through the night, maybe its different for people without a Pancreas.

Annie
 
You need to wake up at 3am for a few nights and see what your blood levels are.

Your last meal is 7pm- do you eat any snack before bed?

What are your going to bed times? Do you test immediately before getting out of bed in morning or once you are up?

All these factors can have an impact on actions that may need to be taken.
 
anniehi41 said:
Thanks Dazza 1984 for your reply. The problem I have is that if I went to bed at say 11mmol and my BG dropped 9 in the night I would be down to 2 in the morning and in Hypo. How would giving more insulin help? Wouldn't that just make it worse? I thought the background insulin was supposed to 'hold' your blood glucose steady through the night, maybe its different for people without a Pancreas.

Annie
Click to expand...

Ah, your original post never said you were in the 2's in the morning. It read like you were waking up at 9mmol, not dropping by 9, and hence me saying about more insulin. My average wake up value is 5. I will wake up and test before getting out of bed; that way if I am very low will eat something quick before doing much else.

I would agree in that you unfortunately need to do a test during the night. Either that or snack on more carbs before bed. Yeah it will raise your sugars a bit but you'll be overall better. Remem a temporary rise in BG is not too bad, it's when it is prolonged that causes probs. If a 'normal' person eats a bag of haribo then their sugars will spike; but their body just deals with it (guits lol)

I don't know much about the insulin you're using; nor the regime. I use Humalin M3 and inject BID; more in the evening than morning due to dinner being a bigger meal and more sedentary in the eve compared to work during the day. I know tho that anything below 6mmol just before bed will mean I need a snack to ensure I wake up with good levels. I once woke up with bloods at 2.5 and felt quite weak so the munchies came out.

D
 
Hi Annie!

Some people's insulin needs are very sensitive to hormones etc. - in particular some women find that the amount of insulin they need varies with their monthly cycle. You also tend to need less insulin if you lose weight or exercise more. Sometimes there is no real pattern, and you just adjust to what your body seems to need.

So just because a Lantus of 10 worked for a while doesn't mean it's still the right level!

Personally I need to adjust my dosages frequently; in the last month my Lantus needed to go down all the way from 10 to 3 and has now come back up to 6. Changing it is a pain as my other dosages need to change too, but it's what I need to do for good control.

I find that adjusting my Lantus dosage to get stable sugars overnight seems to cover my needs during the day as well. But some people need more insulin during the day than at night or vice versa. If that is happening to you, then Levemir is a good alternative to Lantus - it lasts 12 hours and is generally taken twice daily, so you can give yourself a different amount for the day and the night.

One thing you can try is skipping a meal. For instance, skip lunch one day and monitor your sugar. If it goes down during that time, it would indicate your Lantus is reducing your sugar too much both during the day and at night. In which case reducing your Lantus is probably the right thing to do. (I don't advise making any changes without consulting your DSN. But I make such changes all the time because I have to.)
 
Start at the basics... Do some 3am tests!!x
 
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