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Getting the balance in the night, right!

S

shop

Well-Known Member
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665
Hi Guys,

I have recently been learning how to do carb counting. I am a T1 on levemir and Novo Rapid. 18 units of levemir at night. I have been having some success and my sugars have been lowered and withing the said guidlines the majority of the time. The odd learning curve here and there.

My question is....My Consultant said that my evening reading should be between 7 and 10. last night it was 5.6 I was concerned about having a hypo in the night so ate a few peanuts andd had 2 teaspoons of hummus. My sugars this morning were 12.5

The previous night was 7.6 and the following morning 7.1 ( didnt need to eat anything before going to bed.)

Is it better to eat something when sugar is that low before bed regardless of the high sugar in the morning?

Thanks

Lucy.
 
Hi shop, I'm also on levermir and novorapid. I think you should set your alarm and do some night-time testing for a couple of days. High morning readings can depend on various things and to really know what's going on you'll need to know your night numbers.
 
Lucy,

If your basal dose is set correctly your bg should move that much during the night say within +/- 1mmol, as Fenix suggest in order to determine if it is set at the right dose you would need to incorporate some bg testing throughout the night.

I know consultants do advise slightly higher pre-bedtime readings for those with brittle diabetes or who are hypo-unaware, sometimes people living on their own feel much safer with higher than average readings before bed, so if you fall into these categories then I understand his logic.

Personally I'm happy to go to bed on 5.6 provided my previous novorapid insulin is exhausted, but I will admit that anything below 5.2 then I would have a 5/10g snack as a precautionary measure.

If in doubt then I suggest you follow your consultants advice.
 
My opinion is that is in line with DAFNE recommendations.

Thing is... 2 teaspoons hummus contain 2g of carbs, and I would not expect that to cause high BG, and certainly not the following morning.

Given the data, my best guess would be that did not eat enough carbs to prevent a night time hypo, resulting in a liver dump and high fasting reading. But really, we'd need some night-time readings
 
Thanks Guys!

Noblehead I dont have either brittle diabetes and i always get warnings for hypos. In fact the few times I had a nocturnal hypo they woke me up. My previous novorapid was at 5pmish.

AMBrennan what is a Liver Dump?
 
Your liver has considerable glucose reserves (stored as glycogen), which is normally released in response to the glucagon hormone in the case of low blood sugar. For reasons I don't understand this works less well in diabetic patients, resulting in the need to have fast-acting glucose (or glucagon injection in an emergency).
In practise, this slow response tends to result in elevated glucose after (untreated) night-time hypos.

Edit to add: It's (apparently?) called the Somogyi Effect if Wikipedia can be trusted
 
Thank you I understand a little now. How can one have a hypo in the night. Not be aware of it,Untreated and it not continue to a state where you are unconcious?
 
Before I got myself onto an insulin pump, every now and again I found myself being bought back to planet earth by my partner giving me some hypostop and then some lucozade. Often my bg levels had gone very very low and often found myself waking up dripping wet with sweat and the bed soaked as well BUT, ............ things did get much better when I started to figure out using insulin to carb ratios and sensible bg targets to aim to so when going to bed I got my bg levels to be more or less the same and then it was easier for me to know how much carb to eat (small snack about 5-10 grams carb) and then be able to inject the same amount of background insulin before bed instead of adjusting it all the time and everything going a bit hit and miss.

Even now with a pump I do make sure that my bg levels are about 7mmol before going to bed as my bg tends to drop down from midnight to about 3.30am and then they start to slowly rise. I've also altered my basal rates downwards and then upwards according to how my liver is overnight. Sometimes the basal rates stay the same and then sometimes I find I need to adjust one or two of the hourly rates. I've given up now trying to figure out a reason and just get on with it all as and when the change happens.
 
Hi iHs,

Luckily I have never been that far into a hypo. I have been adjusting my basal the last few weeks as I had lost a stone and a 1/2 and was still injecting the same basal etc. Didnt have the confidence or knowledge to do myself HOWEVER!! I am learning carb counting and think I have done well so far. ( I was the same as you being a bit hit and miss ) I am also waiting to go on a face 2 face carb counting course that should be useful. Its good that you are just able to adjust accordingly. Thats what I am hopeing to learn. Thanks for the reply.. :)
 
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