Can't seem to get overnights sorted

[LaughingHyena]

I seem to be struggling to get my overnight levels sorted, at the moment I'm waking up too high, seemingly whatever I do. I have experimented with snack/no snack and changing my doses but so far nothing seems to make much of a difference. I wake up with levels over 9 most days recently, and after a correction dose with breakfast the rest of the day seems OK so I think my morning levimir is set right.

I aim for a level of 7 - 9 before bed, if it's on the low end I'll have a snack of 10 - 15g carb (usually a sandwich/couple of crakers or a few crisps). On the higher end I'll skip the snack.

At the moment I'm taking 9 units of levimir before bed. I tried upping this to 10 but that led to a lot of night time hypos so dropped it back down. I do wonder if I'm still having some hypos as I don't feel I'm sleeping that well, but I also wonder if it's just because waking up at the levels I am is making me feel very sluggish in the morning.

 

[angieG]

I seem to be struggling to get my overnight levels sorted, at the moment I'm waking up too high, seemingly whatever I do. I have experimented with snack/no snack and changing my doses but so far nothing seems to make much of a difference. I wake up with levels over 9 most days recently, and after a correction dose with breakfast the rest of the day seems OK so I think my morning levimir is set right.

I aim for a level of 7 - 9 before bed, if it's on the low end I'll have a snack of 10 - 15g carb (usually a sandwich/couple of crakers or a few crisps). On the higher end I'll skip the snack.

At the moment I'm taking 9 units of levimir before bed. I tried upping this to 10 but that led to a lot of night time hypos so dropped it back down. I do wonder if I'm still having some hypos as I don't feel I'm sleeping that well, but I also wonder if it's just because waking up at the levels I am is making me feel very sluggish in the morning.

Hi,
I'm relatively new to insulin (6 months so far) but have you tried varying the time you take your evening levimir? I'm on lantus in the evening and I have found if I take it late just as I go to bed my levels often don't go down but if I take it earlier say about 9pm (couple of hours before I go to bed) very often my levels drop nicely overnight
I mostly have a low carb snack for supper, frequently a homemade low carb muffin (made with ground almonds) and double cream. If I have a carby snack my levels tend to go high for bed and then drop in the night drastically or stay too high for morning depending on what my body seems to decide!! It's all trial and error I've found and for me no two days are ever the same roblem:

Regards
Angie

 

[iHs]

Hi

Have you tried eating slightly less carb like 10g before going to bed? A sarni is about 32-34g carb just for the bread !!. You will have to test bg levels during the night to find out the effect though. Also, Novo do a 0.5u pen that could be used with Levemir. Im sure lots of diabetics have gained slightly better control from using these types of pens as 0.5u can make a difference.

A really good tip was posted ages ago from noblehead and that is to get your insulin to carb ratio for eve meal sorted so that when bedtime comes, the bg level is always about the same level. If its not and its lower, then have 1 or 2 tsp sugar in a cuppa or 1 or 2 jellybabies to bring levels up to the target (bg test to confirm) and then eat the carb.........

 

[noblehead]

At the moment I'm taking 9 units of levimir before bed. I tried upping this to 10 but that led to a lot of night time hypos so dropped it back down. I do wonder if I'm still having some hypos as I don't feel I'm sleeping that well, but I also wonder if it's just because waking up at the levels I am is making me feel very sluggish in the morning.

I'm afraid the only way of knowing what your bg is doing throughout the night is to test, try setting your alarm for one/two o'clock then again for three/four o'clock and test your bg each time and record, you might have to do this over a couple of nights to establish a pattern but your bg shouldn't rise or fall much more than 1.5mmol if your basal is correct, whilst carrying out the basal test you should skip the bed-time snack and aim for a level of 9 (if you feel safe) and test as above, if your levels drop then you should treat as with any other hypo and reduce the dose the following night.

I don't take levemir although I did change to it briefly but couldn't get my bg stable on this insulin, on lantus I found bringing my evening injection back a few hours almost erradicated my night-time hypo's, I now inject early evening as opposed to just before bed.

As ever, if unsure or concerned then you should consult with your diabetes care team who will advise you of the best way forward.

Good luck!

 

[iHs]

At the moment I'm taking 9 units of levimir before bed. I tried upping this to 10 but that led to a lot of night time hypos so dropped it back down. I do wonder if I'm still having some hypos as I don't feel I'm sleeping that well, but I also wonder if it's just because waking up at the levels I am is making me feel very sluggish in the morning.

I'm afraid the only way of knowing what your bg is doing throughout the night is to test, try setting your alarm for one/two o'clock then again for three/four o'clock and test your bg each time and record, you might have to do this over a couple of nights to establish a pattern but your bg shouldn't rise or fall much more than 1.5mmol if your basal is correct, whilst carrying out the basal test you should skip the bed-time snack and aim for a level of 9 (if you feel safe) and test as above, if your levels drop then you should treat as with any other hypo and reduce the dose the following night.

I don't take levemir although I did change to it briefly but couldn't get my bg stable on this insulin, on lantus I found bringing my evening injection back a few hours almost erradicated my night-time hypo's, I now inject early evening as opposed to just before bed.

As ever, if unsure or concerned then you should consult with your diabetes care team who will advise you of the best way forward.

Good luck!

Hi

Am I right in thinking that by moving the background jab to earlier in the evening, also meant that you changed your bolus carb ratio for the meal or did you keep it the same?

 

[noblehead]

Am I right in thinking that by moving the background jab to earlier in the evening, also meant that you changed your bolus carb ratio for the meal or did you keep it the same?[/quote]


No my bolus dose remained the same iHs, I only inject lantus once a day if that's any help.

The suggestion about moving my basal dose back a few hours from bed-time came from my DSN, been injecting this way for a few years now and as I say it drastically reduced my episodes of night-time hypo's, that's not to say it works with everyone though.

 

[iHs]

Just goes to show how there can many ways of achieving the same result and that it pays to explore them until you get some satisfaction............. Bring back the good 'ole days' :lol:

 

[LaughingHyena]

So last night, went ot bed with a reading of 7.6, and took 9 units of levimir. Decided not to have a snack as I wonder if that's making it more difficult to work out what is going on.

Woke up at 4 to go to the loo, felt OK but tested while I was awake. 3.5! ate a couple of jelly babies and went back to sleep. Got up with morning with a reading of 6.2.

Will try the same tonight and see whether that was a one off, but I'm begining to think I might be still talking too much levimir at bedtime.

 

[Belzedar]

This has been an ongoing frustration for me for a year. It seemed no matter what I tried, my reading in the morning was going to be around the 13 mark. I figured it was a consequence of my daily exercise, that weight training was bound to cause a flood of HGH and that would knock insulin into a cocked hat.

Then, a month ago, I decided to split my evening shot and keep 8 units in reserve for bed time. That made no difference.

Now, there was another issue that was causing me frustration. I mentioned I weight-train and if I'm pushing myself it becomes anaerobic. Typically, anaerobic exercise will start a chain reaction that ends with the liver doing a sugar dump and me ending up with a hyper. I read that some Type 1s had found that HIIT (High Intensity Interval Training) had afforded them the level of intensity without the post-workout hypers. I also read that it had dramatic beneficial effects on insulin sensitivity. That seems to be holding true as I have reduced my Humalog by a quarter and everything is steady.

What had initially drawn me to HIIT was the promise of it being very effective in reducing visceral fat. I've been doing it for three weeks now. My morning levels are considerably improved, being below 10 without exception. Three days ago, the reading was 7.9 (amazing, given the target for a morning reading is 8) and this morning it was 8.4

I do my HIIT on an elliptical trainer: three minutes warm-up, hell-for-leather for 30 secs, recover for 3.5 minutes and do that four times. All that, including the cooldown takes twenty minutes. (Then I do twenty minutes of weight-training and an easy cooldown to mop up any excess blood sugars).

 

[candiloo]

Hi - I take Lantas, and I take it at 7pm every day. I do this because I work nights and I remember to take it as I get up to go to work at that time, and take my other Novorapid with my evening meal. I then go through my work hours and when I come home to go to sleep, I make like to have 2 boiled eggs and Danish bread, which is 15g or carbs, so enough to take me through sleep but not really enough to require any Novorapid - it would be 3 units for me for that - so I leave that for the Lantas to deal with whilst I sleep. This seems to stop me having a hypo and also means that when I wake up, my level is ok. When I am not working and I still have to take the Lantas at 7, and I find it isn't as settled - I may crave carbs which is annoying as I won't be working them off, or my level will be too high as I won't have worked the evening meal off. My suggestion therefore is, taking it when you are up so it can work throughout with your activity, of course take into account that you might want a lie in at the weekend. A lot of people take it before bed, but I find mine works better before activity. I have to sit on the exercise bike for an hour on my nights off to get the results!

 

[Roberto]

I always take my lantus at 9pm - around a hour it so before my bed. About 1-2 times per week I will wake with a higher reading of about 7.5 -8.5. Whilst not overly concerning would like it sorted.

Will try to take lantus earlier tonight, before going to the gym.

Always had it in my head that if you take the lantus early you will end up too high during the night......even though I know it's a 24hr insulin