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Checking BG during the night?

R

rjbrjb123

Member
This might sound like a stupid question - but recently I've been having horrible sugars when waking up in the morning - anywhere between 12 to 18 - obviously far too high. I've managed to check a few times during the nights (around 6AM or so usually) to see what's going on , ie. if the Levemir is not enough or I'm dropping and rebounding much higher which seemed to be the case, but even after adjusting the night time Levemir dose - I haven't seen any improvements.

I don't seem to be able to wake up more than once in a night to check - I set the alarms but wake up in the morning unaware that any of them have gone off :x and I'm getting understandably frustrated with my high morning readings as my control is normally good.

My dosing is currently 9 Levemir / Night (midnight) and 9 in the morning (noon) split dose, this is because I work late (until 1 AM or so usually) and go to sleep a couple of hours after this, and wake up around noon.

So I know the solution is to test during the night, to find out what my blood sugar is doing - but I just can't seem to wake up more than once during the night. Does anyone have any tips, how do you do it?

I really want to resolve the morning readings, I'm sure you all know it's not a nice start to the day when you wake up high :(
 
Hia - yes just woken to a 'high' morning myself. If my partner is not around to give me a shove to test at night I put my alarm somewhere where I have to get up to switch it off otherwise my hand just automatically reaches for the off or snooze button. You do need to get a louder alarm by the sounds of it though, those with crescendos, if you're not hearing it at all though. Best of luck with sugars and waking up. :thumbup:
 
Actually I use 2 phones as an alarm, but manage to miss both of them, only catch 1 per night somehow! I'll give it another go tonight, see what is causing these annoying highs in the morning !!(well, more like afternoon .. But waking time!)
 
Hi

A really good way to ensure that you get up in the night is to drink a large mug of coffee about 15mins before going to bed. Works fairly well and should ensure that you get up to use the loo so kill 2 birds with 1 stone....... do a bg test at the same time :)
 
If you can only managed to wake once in the night, pitch for around 3am as this is the generally where the lowest ebb of hormone activities... Testing at this point usually shows the lowest level you get to overnight..

To find out what's happening overnight it's better to do an fasting test overnight and test hourly... But if you don't fancy doing it all on one night.. Split it over several night, so one night you take a bg at 11pm and 6am etc, or and work your way though the hours over different nights...

You need to ensure that if you'll doing it over different nights, your exercise routine, types of food you've eaten and your BG is roughly the same... Otherwise you could get a very skewed results than don't quite reflect what's happening.

If you've got a partner, family member or housemate etc, you could always rally them into helping, get them to do one or two of your BG's overnight... While you stay asleep with instructions if the your bloods are low, to wake you up so that you can treat it..
 
Yeah, maybe I'll try and set just one alarm per night, different time each night.

As I take my Levemir late as per OP (Midnight) I think I might aim for 8 AM or so to test - as 2/3 AM I'm usually still awake, about to go to bed!
 
Updating this to post first night's results

11 PM BG 7.8 Had snack at (pear), 1U Novorapid
12 AM BG 7.6 Took Levemir
1 AM BG 7.0
2 AM BG 7.6
3 AM BG 5.1 Had small snack, as was going to sleep then and didn't want it to drop
5 AM BG 5.7
7 AM - I'm sure I woke up for this alarm , but didn't manage to test ...
9 AM - BG 7.7
12:30 PM - BG 11.5 (woke up at this time)

It looks like the BG started rising if I'm seeing this correct - I think I'd need to test again around 9 AM to make sure. I think if I dropped during the night I might have woken up higher?
 
If you hadn't had the pear I would have said you suffer from dawn Phan... Where your BG do a natural rise in the morning..

But because you had a pear at 11pm, it's faffed the results because not only have you've got the pear impacting on your blood glucose, but you've got quick acting insulin impacting on you system until anywhere to 3-5am in the morning, depending how long it takes your body to burn it out,,, Which on Adv is 4 hours but could fall short of this or even go on for another hour or so..
 
Thanks for the replies so far - I tested this again last night with slightly less Levemir to stop me dropping earlier, but the result hasn't been great to be honest.

I still seem to be going low between 3-5 AM, but even if I correct this and don't drop under 4.5 or so, with less Levemir my BG starts rising quicker in the morning .. ie. around 9 my 7 AM, then up to 13 an hour later, and then higher ...

So it looks like less levemir, still drops me during the night but results in even high morning BG .. I don't want to increase my Levemir to go lower during the night, and I don't want to decrease Levemir so I wake up even higher :shock:

Is there any ideas how to tackle this? Never used to be an issue in the past really. I know waking up early every day might be a better option, but this is a bit difficult as I don't sleep until late, and work until 1AM or later every weekday (but from home, at least) so would be lacking sleep if I was to wake at 8AM or so every day!
 
I've dropped the Levemir another 1U tonight just to see if it stops me needing to top up my BG at around 3-5AM

It's now 2:40 (took Levemir at midnight)

At 23:00, BG was 6, Midnight 8.4, and now its gone up to 12.9 .. so have taken 2U of Novorapid to bring this down.

Lets see how the readings are later during the night, and when waking up.

This is really frustrating me , bad start to the day when you see high BG when getting out of bed :evil:
 
It might be worth considering splitting your levemir to give you better coverage. levemir does not always work for 24 hours and it also does take a few hours to get working to it's peak capacity. By splitting the dose you can minimise these shortfalls to allow more even background cover.

I would speak to your DSN about splitting it if you can't resolve the problems you are having.
 
leggott said:
It might be worth considering splitting your levemir to give you better coverage. levemir does not always work for 24 hours and it also does take a few hours to get working to it's peak capacity. By splitting the dose you can minimise these shortfalls to allow more even background cover.

I would speak to your DSN about splitting it if you can't resolve the problems you are having.
Click to expand...

Thanks for the reply - I am splitting my insulin at present 50/50. Now just need to resolve it so the morning / night BGs are acceptable. Just recently started waking up high and trying to get this resolved! Once I correct the morning high, the daytime levels are stable.
 
Another idea may be to alter the split to see if that makes a difference. I know it is easier said than done!! Also would a half unit pen help so you could decrease / increase by 1/2 a unit at a time.

We are having difficulty controlling my kids during the night right now and we have insulin pumps which can be programmed hourly..

I hope you can resolve this problem quickly as I know now how frustrating it can be!
 
You could ask your diabetic team for a continuous blood glucose monitor so at least you can see what you blood sugars are doing through the night. They will let you have one temporarily, perhaps for about 3 weeks.
 
rjbrjb123 said:
Thanks for the replies so far - I tested this again last night with slightly less Levemir to stop me dropping earlier, but the result hasn't been great to be honest.

I still seem to be going low between 3-5 AM, but even if I correct this and don't drop under 4.5 or so, with less Levemir my BG starts rising quicker in the morning .. ie. around 9 my 7 AM, then up to 13 an hour later, and then higher ...

So it looks like less levemir, still drops me during the night but results in even high morning BG .. I don't want to increase my Levemir to go lower during the night, and I don't want to decrease Levemir so I wake up even higher :shock:

Is there any ideas how to tackle this? Never used to be an issue in the past really. I know waking up early every day might be a better option, but this is a bit difficult as I don't sleep until late, and work until 1AM or later every weekday (but from home, at least) so would be lacking sleep if I was to wake at 8AM or so every day!
Click to expand...


how about increasing the levemir to cope with the rise up in bg levels but also eating some food before going to bed and not bolusing. The increase in Levemir should sort out your bg problems as long as you eat a small carb snack before going to bed that will deal with the way you go low.
 
It does sound like a classic case of Dawn Phenomenon to me. I had the same prob before going on the pump. The only way I got some kind of control was to set my alarm for 6.45am every day regardless of my routine to do my morning Levemir. And then try and go back to sleep if I was off work! Maybe just as a trial you could try waking at 7am and taking your Levemir then, and maybe taking it an hour earlier at night to space the doses a bit? But maybe speak to your nurse/doc first to get their thoughts. That's the tricky thing with Levemir/Lantus etc - if you get the dose right to keep you steady and not go low overnight, it's often not enough to keep your readings in a good range in the morning. Hope you get it a bit more sorted! :)
 
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