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Going to bed-levels

M

Mileana

Well-Known Member
Hi and sorry to poke you people here in the t1 thread, but I think you may be my best bet.

What level of BG are you happy enough to go to bed with on Levemir/Lantus?

This is one of the things I haven't quite worked out yet - I would not want a night time hypo, on the other hand I don't like my blood sugar above 6 generally.

I am on twice a day Levemir along with NovoRapid which should be gone well before my bedtime.

My blood glucose tends to drop very slightly on Levemir when I am not battling an infection - I have tested it a couple times, it seems to drop by about 0.2/hour or there abouts. Reducing it would cause it to rise about the same...

Just looking for someone with a bit more experience than me at the insulin thing for the finer tweaks, heh.

Diabetes Nurse says 7, but then I don't want to really see 7 on my meter... At least not if I don't have to...

-M
 
I think you have to do some middle of the night checking to see if your basal keeps your levels steady overnight.
When I was diagnosed I was on Lantus and my doctor said that for me 5mmol/l was OK for me and I tend to use that level . However, there are quite a lot of people that experience quite big falls overnight and for them that would be too low.
 
Hi,

I'm on the same as you, levemir 10u bedtime, 10u morning and Nova for carbs...I like my BG to be between 4.9 and 5.5 at bedtime and will even take a 0.5u or more correction dose of nova if needed.

bucco
 
You really need to do some night-time testing to find out what is happening overnight.. Has you need to ensure that you have enough leeway to avoid night-time hypo's as there's no guarantee's that you will wakeup during one...

As to making corrections before going to bed, this should really be avoided has quick insulin lasts around 4/5 hours in the system, so unless you are high then I wouldn't, and I wouldn't call a 7mmol/l high before bedtime needing adjustment

3am, is said to be the lowest ebb for your hormones activity, and the lowest point for your blood glucose, so taking some tests at 3am several nights should give you a good idea to your drop overnight, if you go to be at 7mmol/l and at 3am you hit 4mmol/l then you are cutting it close but to go to bed with a lower BG, will mean that you are likely to have an hypo..
 
Mileana,

I'm a lantus user and prefer to go to bed with my levels above 5.2 but below 6.5 if possible, I don't eat or inject QA insulin after 6.30-7.00pm so I know that my bolus insulin is all but exhausted by then.

As Phoenix and Jo have said, to be sure your levels don't rise and fall to much during the night you need to test a few times to determine if your basal insulin is set at the correct dose, yes it means a couple of restless nights but it's worth it in the end.
 
If you can't get up overnight to get the BG data, then you really need to follow the DSN advice and aim for 7mmol/l as a safety measure...

Is there anybody who could either wake you up or do your BG test for you while you sleep!
 
I think you need to work out how to get yourself to wake up Mileana.... you need to be able to do this anyhow. I've found I've had hypos at night where I have in fact woken up and treated it... other times I'm not so lucky and I pay for it with that aweful hypo hangover. But it's important as others have mentioned to get an idea what your body is doing during the night. For me I find my BGLs can drop quite quick anywhere between 12 - 4.30 am... so it makes it hard to control as I don't intend to stay awake that whole time. I take my endocrinologists advice and I never go to bed below 7mmol... but that still doesn't guarantee I won't have a hypo. I even adjust my basal down and I can still get hypos... :roll: It certainly gets frustrating at times as there is so many variables I guess. Maybe for you to start with aim for a safety number to go to bed on as I've already mentioned and see if this works for you. :D
 
Alright... I might 'leave' the super nice fasting glucose numbers and all that for later then.

Nah, I don't have anyone who can wake me up - I live alone...

I will ponder it a bit and see if I can do something about it somehow - may be able to talk a mate into an arrangement - he is one of those owls who will be awake all night any way most times.
 
well I live alone too... and I can understand :) I also need to reconsider my arrangements as recently I didn't reply to a text message from a family member due to just not looking at my mobile phone... and they went into a panic and thought I'd had a hypo and told me they were about to call the police to come and check my place. Talk about drama! I was so embarrassed... she only sent me the message midday and started to panic within hours as I replied to her message at 4 pm and I get "I was so worried... I was going to call the police". So I'm not sure what my plan of attack is... but I think I may need to look at something as my family just worries... and recently a friend told me I shouldn't be living alone either.... they're just saying they're concerned I guess as they know I'm on insulin too. I'm also getting told off as I haven't registered to get medi-alert either.
 
mep73 said:
I think you need to work out how to get yourself to wake up Mileana.... you need to be able to do this anyhow. I've found I've had hypos at night where I have in fact woken up and treated it... other times I'm not so lucky and I pay for it with that aweful hypo hangover. But it's important as others have mentioned to get an idea what your body is doing during the night. For me I find my BGLs can drop quite quick anywhere between 12 - 4.30 am... so it makes it hard to control as I don't intend to stay awake that whole time. I take my endocrinologists advice and I never go to bed below 7mmol... but that still doesn't guarantee I won't have a hypo. I even adjust my basal down and I can still get hypos... :roll: It certainly gets frustrating at times as there is so many variables I guess. Maybe for you to start with aim for a safety number to go to bed on as I've already mentioned and see if this works for you. :D
Click to expand...


Have you thought about moving your basal injection time to reduce your nighttime hypo's?
 
noblehead said:
Have you thought about moving your basal injection time to reduce your nighttime hypo's?
Click to expand...

I take Lantus same time every night and I picked a time I know I'll be either home or out somewhere where I can inject. So it's been 8.30 pm every night. I can't really make this any earlier as I'll be working, driving, or whatever. Sometimes I get a good run and I'm fine... other times I have a hypo every second or third night. I keep dropping my basal units when this happens... then I see my endo and he tells me to increase basal units... and so it goes on. Last visit he told me to decrease basal units... so that was a change. I don't do my own thing with the basal that much because my endo is still monitoring me closely. If I want to change anything, I have to call the clinic to get the ok from my endo. If I wasn't seeing my endo I'd probably just do my own thing.
 
Hi

A fairly good way to prevent hypos that occur during the night is to eat a small amount of carb before going to bed - something like a cracker with a knob of cheese is ok. Like Mep, I am the type of person who has lower bg levels from midnight to about 3.30am and then my levels slowly start to rise so I always ate some carb before bed when using twice daily insulins and lantus and levemir and then my low bg levels from midnight to 3.30am were sorted with the carb and lantus and levemir could then carry on dealing with the slow rise up in my bg levels.
 
@iHs - yeah I do eat a bit of carb too before bed (just as endo told me to do also).... but I still get mixed results... even when I eat the exact same thing night after night. :roll:
 
What happens when you increase and decrease your lantus over a 24 hour period!

If you increase do you get hypo's over night, but reasons results during the day..

When you decrease you stop the hypo's over night, but your BG's go up during the next day!

If this is happening, then it's likely that you'll need to split your dose, so you can adjust evening injection to prevent hypo's, then adjust a morning injection to keep the day time levels in check..

I know it's a pain having two timed injections a day, but when it comes to it, if you'll driving/working you just have to either pull over and/or stop working to do the injection...

Pre-pump days, I had split injections 11pm&11.30am, bit of a pain more so when tired and all I wanted to do is go onto bed... And yep I've pulled over to the side of the road while driving, down tools at work or discretely injected in a shop/cafe while shopping etc because it was 11.30ami Didn't totally resolve my problems but did improve things a lot for me.
 
yeah I asked my endo if I could split the Lantus dose for better results (coz I get what you mentioned, lower the basal and higher BGLs during the day, increase the basal and hypo at night and good BGLs during the day)... and he said I couldn't. I've read that others have done this. My endo just keeps saying that one injection lasts for 24 hours... but I really don't think it does. He just told me to increase bolus slightly during the day instead... but I find this is risky too. It sure is frustrating.
 
mep73 said:
I take Lantus same time every night and I picked a time I know I'll be either home or out somewhere where I can inject. So it's been 8.30 pm every night. I can't really make this any earlier as I'll be working, driving, or whatever.
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You could take lantus first thing in the morning if you wanted to as long as you leave 24 hours between injections. Reading what you've said I think a change to levemir might be a better solution as lantus seems to be unpredictable in your case, we have had members do this for similar reasons and found a big difference, whatever you decide to do you had better do so in conjunction with your diabetes care team.
 
Hey mep73!

I was having similar problems with my basal (Insuman basal). In the end I moved the split dose to 6.30am and 6.30pm. It means that I sometimes wake with a higher fasting level than I would really like, but it has got rid of the nightime hypo issues I was having when my evening dose was 10pm. I have also found that my optimum night time level is 5.5 to 6. Any higher and I wake up with higher levels, any lower and I wake up with higher levels :roll: The 6.30am dose is a bit of a pain at the weekend, but I think it's been worth it.

Smidge
 
Hiya

I have had a similar dilemma with during the night sugar levels when i was injecting. I tried a small snack before bed, but that just made my sugars higher than I wanted on the evening. I also tried getting up during the night to check, but found that I couldnt figure out the pattern very easily. My DSN recommended that I borrowed one of the hospital's blood sugar monitors where there is an electric probe type thing attached to you for around 5 days which sends information to a hand held reader. This meant I had a reading taken every 5 mins the whole 5 days! I could then print off graphs to see exactly what my blood sugar did during the night, during exercise and meals etc. It was a massively useful exercise although I dont know if that is common practice in all hospitals in all areas?

For me though I am now on an insulin pump so I can make adjustments to an hourly basal rate during the night to counter the changes in my sugars whilst I am asleep.
 
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