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Type 1 Does this happen, and has it happened to anyone else?

A

Alex_B

Well-Known Member
Messages
168
Type of diabetes
Type 1
Treatment type
Insulin
Recently I have been taking a higher insulin dosage (20 Novorapid), and since then, even though I take my sleeping tablet every night. I have had sleeping issues, not being able to sleep, waking up during the night. Since this higher dose I have had lower BG levels sometimes lower than 7.1! Since taking the insulin I just can't get to sleep no matter how hard I try.

I have been having constant nocturnal hypos every night since upping my insulin dose, I am not lowering it as I DO NOT want to go back to being high all the time. Is there anything I can do to help my sleeping and to stop the hypos?

Is this because im subconsciously scared of the hypos I have been having at night, or if its the insulin reacting to the Mirtazapine? I am on 30mg Mirtazapine.
 
I am sorry that you are having thesse problems; it can be difficult balancing insulin doses.
Mirtazepine can make folk very sleepy (made me very sleepy with ravenous appetite), so I don't think this is the culprit for poor sleep and is probably helping.
How low do you go overnight? Do your glucose levels follow a regular pattern, or are they all over the place?
What insulin regime do you take? Analogue insulins as basal or bolus decrease risk of nocturnal hypos compared to traditional human insulins.
Do you take any other medication? ACE inhibitors for hypertension and alcohol increase risk hypos
If folk are getting lows and highs, the low glucose levels often lead to high levels, so that if one gets rid of the lows, the highs often do not get worse, although I note that you had the highs before increasing the novorapid to take care of them, hence the lows.
Best wishes
 
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@SimonCrox I am just on Mirtazapine. I don't drink much alcohol at all, I have the odd beer at the weekend but mainly just one, depends on how im feeling (depressed, anxious etc) I have Novorapid and Tresiba, 20 on Novorapid and 22 on Tresiba, but this is what I have been told to take and I am enjoying getting low BG levels as it makes me really proud of myself. I just want advice on how to stop them as with the sleeping tablet I can't wake myself up at 3 am to check them. I am gonna get on the phone Monday morning and see if my mum can talk to the diabetes nurse at the doctors and see what they suggest.
 
Your insulins are the best ones for avoiding hypos - sorry - that is not a very helpful statement.
There is the FreeStyle Libre system for glucose testing which should be available for select folk on NHS in NOvember - it might suit you very well and give valuable information.
Is that 20 units Novorapid with each meal ie three times per day and tresiba 22 units once per day?
Are you being seen at the General Practice or in specialist hospital service?
best wishes
 
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Hi. I can only guess that your Tresiba may need to be tweaked to get the balance right and also your DN needs to instruct you on how to carb-count your NovoRapid. This means adjusting the number of shots at each meal for the carbs you are having rather than having a fixed dose of 20. I can only suggest you ask the DN for advice on both.
 
Edited Alex,

I'm sorry you are feeling so awful with the lack of sleep. I googled Mirtazapine; there is lots of information about it online. Mirtazapine does have side effects and you should report these to your doctor. Mirtazapine also has interactions with many other drugs. But it appears to not have an interaction with Insulin which is a hormone and not a drug. Do you take a sleeping pill or any other medication in addition to Mirzapatine that could be causing an adverse interaction?

You haven't mentioned whether you inject a long acting basal Insulin like Levemir, Lantus or the newer Tresiba? Tresiba is designed for people who have frequent hypos. It lasts for 42 hours and is injected at the same time each day. My son has been changed to Tresiba and he finds it very steady in its action. He is tall and quite active at work and in leisure. He only needs small bolus injections of fast acting insulin for food. The bolus injection is out of the system in about 4 or 5 hours. The tresiba carries on keeping his blood sugar level during the night and he can sleep peacefully. He says it is the best combination of insulins that he has ever had.!

It sounds as though you need to ask your GP to be referred to an Endcrinologist to sort out a new regimen for you. Hope you get it sorted soon.

Best wishes,

AS
 
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Alex_B said:
Recently I have been taking a higher insulin dosage (20 Novorapid), and since then, even though I take my sleeping tablet every night. I have had sleeping issues, not being able to sleep, waking up during the night. Since this higher dose I have had lower BG levels sometimes lower than 7.1! Since taking the insulin I just can't get to sleep no matter how hard I try.

I have been having constant nocturnal hypos every night since upping my insulin dose, I am not lowering it as I DO NOT want to go back to being high all the time. Is there anything I can do to help my sleeping and to stop the hypos?

Is this because im subconsciously scared of the hypos I have been having at night, or if its the insulin reacting to the Mirtazapine? I am on 30mg Mirtazapine.
Click to expand...

Hi Alex have you tested yourself during the night to check for hypos ? The only sure fire way to know is to either set your alarm or to wake if feeling low and check, as your on sleeping tablets it would be hard for either of these to happen so getting a cgm on loan from your Dsn would really determine if this is the case.
 
Snack before bed may help too. Milky drink to block hypo and help relaxation?
Talking to your DSN is best, but until you can this may help.
 
Ok...lets start at basics...

How late are you eating to have this 20 unit novorapid?

Really you should get youself in a routine.. and try to have your last meal / food / bolus 5 hours BEFORE you go to sleep.
You need to take a test before sleep and ideally around 3 or 4am.. but if not as soon as you wake. And another before breakfast (if you have it).

You need to approach things differently.. get in your head that 5 - 6.5 is your ideal levels.

Ask your DSN if you can get a free libre for two weeks if you are finding it difficult for night testing.

Realise that if you restrict your eating/bolus to 5hours before you sleep.. then its your bolus that needs adjusting for sleeping levels.

Highs or lows are jyst as bad as each other. Your aim and target should be to get yourself in norma levels at all times.
 
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