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Correcting at night time but still waking high

Juicyj

Juicyj

Expert
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Worcestershire
Type of diabetes
Type 1
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Hypos, rude people, ignorance and grey days.
Hi all, I keep having the same blip that if I test my BG before bed and over 7 I correct so for example last night I was 11.9 so took 2 units of novorapid, but woke at 10.5. However if I test before bed and am say 6.5 I wake at around 6.5, so I know my background is working ok but just seem to get insulin resistant when running higher, I see this pattern a lot so does anyone have any advice please ?

Thanks ;)
 
I'm the same as you. Will be interesting to read people's opinions on this!

Indiana x


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Take more insulin when correcting a high? Remember, all the various rules (e.g. Rule of 100) only give you a starting point so you don't have to guess completely blind.
 
I am the same, I corrected a level of 11.6 with a unit at 12.30am and woke up at 12.6! only thing i can think of was if i was on a rebound from a hypo, but i do experience the same thing quite often, I react more to insulin when Im awak but i guess that is because we are using more energy
 
Whatever you ate earlier to make you high at bedtime might still be having an effect on your BGs (pizza, pasta?). Any clues in the events leading up to the highs?
 
AlexMBrennan said:
Take more insulin when correcting a high? Remember, all the various rules (e.g. Rule of 100) only give you a starting point so you don't have to guess completely blind.
Click to expand...

What's rule of 100 please?

Indiana x


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Indiana91 said:
What's rule of 100 please?

Indiana x


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Click to expand...
100 rule is for correction dose (in mmol/l)

Add up your total daily dose of insulin (basal and bolus) and divide that into 100.

The result is the number of mmol/l that 1 unit of quick-acting insulin will reduce your BG by.

If you take 25 units of insulin a day then 1 unit of insulin would drop your BG by 4 mmol/l
If you take 33 units day then 1u would drop you by 3 mmol/l
If you take 50 units day then 1u would drop you by 2 mmol/l

This formula is meant as a starting point only and you may need more if trying to tackle a higher BG.
 
Brill thanks

Indiana x


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What about if your insulin is different day to day? I can take 45 units some days and 60 on another. should you try and work it out an average?
 
nikki_legg said:
What about if your insulin is different day to day? I can take 45 units some days and 60 on another. should you try and work it out an average?
Click to expand...
Then yes, I'd go with an average - but it's only a starting point so you will need to try it and make adjustments if necessary.
 
What ended up helping me get better levels b4 bed was to alter my eve meal carb ratio for food so that my bg levels would be more or less at the same bg like 7mmol. It was then a bit easier to get the basal correct as I didnt need to use a correction and then risk going too low with a hypo whilst asleep

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Hi thanks for the comments, I am on a low carb diet and had 2 mouthfuls of my daughters yoghurt which possibly sent me high but had eaten a good while earlier so quick acting would of been used up, I always test before bed so see this as the opportunity to adjust and correct and also am very careful to try and avoid the night time hypo, I just find even when correcting I still wake high, I tend to know if I'd had a hypo in the night as I wake up shattered with a headache and wasn't that way this morning, I know I have to take more QA but don't know how much is ok...
 
Talking from my own experience and what I've read on here over the years the standard correction dose don't always work the same when bg levels are really high, for example 1 unit of insulin may bring bg down by 2.5 when under 10mmol but over this level it might only bring it down by 1.5mmol, only by testing do you find this out for yourself.
 
In DAFNE terms this could suggest that you have a different correction ratio at night. DAFNE suggests you discover different insulin :: carb ratios for different mealtimes, and also that you work out different correction ratios for different times of day. Pumps let you set these too. I have never bothered as it seems too complicated.

Also I agree that in my experience the normal correction ratios don't apply to higher BG levels. More insulin is required. This could be because high BG increases insulin resistance.

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noblehead said:
Talking from my own experience and what I've read on here over the years the standard correction dose don't always work the same when bg levels are really high, for example 1 unit of insulin may bring bg down by 2.5 when under 10mmol but over this level it might only bring it down by 1.5mmol, only by testing do you find this out for yourself.
Click to expand...

Thanks Noblehead this makes a lot of sense, am going to try and record my results on this, I tend to find if I run above 10 it's generally harder to get back down unless I exercise, now I know this it gives me more confidence to try and adjust, it unfortunately becomes a vicious circle for me when I run high.

I do take a few units generally for protein as I have got efficient at converting this to sugar, think it was the opportunity to finish off my daughters yoghurt that didn't help :sorry:
 
Ok conundrum continues !

I ate last night at 6.40 and had just a bolognaise (no pasta), was high already at 12.4 as gave in to some sweets at the cinema with my daughter so took 5 units, 3 to correct and 2 to cover any carbs from veges and tomato sauce, I tested again at 10pm and was 6.5 (perfect!) but woke up at 7.30 at 12.4.

I had some bad dreams so could of hypo-ed but still with levels within target range at 10pm still can't fathom why I woke so high as novorapid was out of system by bed time, my last HbA1c came back as significantly higher so need to really try and understand the anomalies - any help gratefully appreciated ! ;)
 
It's possible this pattern is caused by going low in the night and having rebound BG, rather than by going high in the night due to a ratio problem or an overnight basal problem.

Try checking your skin and the sheets for signs of sweat, that would indicate a night hypo.

As this is continuing I would set an alarm for say 3am and do a middle of the night blood test to see what's happening.

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Juicyj said:
Ok conundrum continues !

I ate last night at 6.40 and had just a bolognaise (no pasta), was high already at 12.4 as gave in to some sweets at the cinema with my daughter so took 5 units, 3 to correct and 2 to cover any carbs from veges and tomato sauce, I tested again at 10pm and was 6.5 (perfect!) but woke up at 7.30 at 12.4.
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High fat meals such as bolognaise can result in high bg levels several hours after eating, take a read of the following:

http://www.sciencedaily.com/releases/2013/03/130327190328.htm
 
noblehead said:
High fat meals such as bolognaise can result in high bg levels several hours after eating, take a read of the following:

http://www.sciencedaily.com/releases/2013/03/130327190328.htm
Click to expand...

That's with fat and carbs in combination though (the study was done with pizza). It's long been known and taught that fat will delay processing of carbs. The study is talking about some different mechanism, but still in conjunction with carbs. High fat on its own is never going to cause high BG. The OP's bolognaise was low carb, no pasta.

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