Help! Hypoglycaemia Mornings.

Hi Megan (@MooncakeDEM1812) , you should probably tell us about your diet (what you eat, when), insulin amounts and timing of your Lantus. What you're describing should have a very simple solution, but if you can provide the background we can help you understand what to do more effectively.

Hi. Your diet is not very good. You need to have a breakfast and sandwiches, crisps, sausage rolls etc are very carby so need to be kept under control. Do you have some excess weight as 32 units of Lantus might indicate that? If so you may have some insulin resistance and all of that can cause peaks and troughs. Try to have less carb and more protein and fat and smooth the meals during the day. It may be that your Basal needs to be reduced slightly?

What I'd normally recommend is that you do some basal testing. It sounds like your Lantus injection is causing you to have a hypo overnight on a regular basis (I had similar problems a few years back and my partner had a couple of mornings where I wasn't aware of what was going on when I woke up) and she ended up calling an ambulance). In any case, you should be discussing this with your Diabetes Care team.

So, going back to basal testing, this is the guide to it: http://www.salforddiabetescare.co.uk/index2.php?nav_id=1007 and it will help yo understand whether you are taking too much Lantus. This is a process well worth doing properly as it will help you understand what is going on.

Your diabetes care team is likely to either reduce your Lantus or tell you to eat something with slower release carbs before bed to counter the drop overnight.

Ultimately it is in your hands as to how you choose to approach this.

Honestly, if it were me, and I were having that kind of drastic hypo in the mornings, I would cut my Lantus by 4 units straight away. It isn't feasible to do a basal test when you are regularly hypoing. Cut it and drink milk or eat something before bed. If you end up with high blood sugars for a few days in the morning, so be it. That's better than killing your boyfriend while you're hypo!

You can then do the basal testing and if necessary gradually increase the basal by 1 unit every three or four days until you get a morning reading you are happy with. If it is not possible to achieve that, and keep your evening blood sugars flat before your evening dose of Lantus, then you can ask to change your insulin.

MooncakeDEM1812 said:

I had a look on that website and I am completely clueless on basal testing I actually believe it or not have never heard of it is there any other tips or options I could use?

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I'd suggest that you do as RuthW suggested first. When I was having hypos overnight caused by Lantus I reduced the amount I took before I went to bed.

MooncakeDEM1812 said:

I had a look on that website and I am completely clueless on basal testing I actually believe it or not have never heard of it is there any other tips or options I could use?

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The following offers a good explanation on basal testing and why it is important to get the dose right, the guy that wrote is the author of the book Think Like a Pancreas which comes highly recommended on the forum :

http://integrateddiabetes.com/basal-testing/

First of all do the night time basal, and then the day time ones as it suggests. After that, you may find that your insulin:carb ratios need changing (or you may not), but you cannot possibly get those right until the basal is sorted. Once you get the night time one right, you will feel MUCH better. Come back and tell us as you work your way through the process, and we can help with whatever comes next.

MooncakeDEM1812 said:

Hello my name is Megan and I need help with low blood sugars in the morning. Unfortunately I have been waking up in the morning with really low blood sugars. They are actually so low that I can't remember everything I do in the morning. I have also started becoming violent towards my partner when this happens and he can't handle it anymore. I need help to save my relationship.

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MooncakeDEM1812 said:

Hello my name is Megan and I need help with low blood sugars in the morning. Unfortunately I have been waking up in the morning with really low blood sugars. They are actually so low that I can't remember everything I do in the morning. I have also started becoming violent towards my partner when this happens and he can't handle it anymore. I need help to save my relationship.

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MooncakeDEM1812 said:

Hello my name is Megan and I need help with low blood sugars in the morning. Unfortunately I have been waking up in the morning with really low blood sugars. They are actually so low that I can't remember everything I do in the morning. I have also started becoming violent towards my partner when this happens and he can't handle it anymore. I need help to save my relationship.

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Hi Megan. Do you test your bloods regularly? If so are you high during the day? I had this problem recently turns out I was having too much night time insulin then hu in the n

MooncakeDEM1812 said:

Thank you I'll try that tonight and get back to you in a few days.

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Hi Megan. I had this problem a while back. Was too much night time insulin. When you have a night time hypo if you don't wake up your body naturally kicks out any stored glucose to bring you up if your blood sugars are running high during the day it's a sign this could be happening to you so keep an eye on day time levels too. Night time insulin stays in your system for 24 hours so you may not see an improvement tomorrow morning if you lower it tonight or even for a few days but I would take it down at least 2-4 units tonight and for the next few days. I also wouldn't go to bed lower than 8 sorry chick you may have to do quite a few blood tests for a few days to get a picture of what's going on but if you see an obvious pattern and adjust your insulin to suit this could all be over by this time next week! Relationship intact!!! Alex xxx

I had this problem when I was a little younger and I dropped my Lantus slightly and started eating a small bowl of cereal before bed.

good to hear

Oh, so sorry, Mooncake! Help came a bit late, didn't it! But whatever happens, whether you are reconciled or find someone with more patience for your struggles, you need to sort out this problem. Getting your diabetes under control will make you more resilient, as well as safer in yourself and to others, so have a good cry, but don't give up!
Cut your basal a bit more. 2 more units.
And try to get an appointment with your DN. You should be able to talk to her about this.

Hi Ms Cake . . .

If I understand the thread so far correctly, you still don't know if your Basal dose is too high in general, or if the Lantus is acting incorrectly and delivering its dose in a large peak quite soon after injecting. Is this correct?

If so . . .

there is something you can do to determine this, and it may help in general:

You could switch the timing of your Lantus injection to the morning, rather than before bed.

This would enable you to easily monitor how you feel, and how your levels are, at 2 and 4 and 6 hours after the Lantus injection.

Previous responses have stressed to perform Basal testing, to understand if your Basal dose is right. I don't disagree with this suggestion at all. What I suggest is additional to that.

I had big problems with morning Hypos, over a number of months, a few years ago. Like you, I couldn't remember all my actions. To try to understand the problem better, my girlfriend and I set up a camera, so that if a Hypo occurred we could save the footage and analyse. I was totally shocked at how mean and unpleasant I could be, to the girl that I love. Unless I'd seen it, I wouldn't have believed it possible.

I made a big step forward in understanding the situation, when I moved my Lantus injection timing to the morning. On the first day, I had a significant Hypo in the hours afterwards, and it was very clear that the Lantus was delivering its dose in a spike, rather than evenly over 24 hours. With this knowledge, I then could make specific research and understand this. (I discovered that Lantus Insulin can act like a Rapid Insulin, in certain circumstances).

This may not happen for you. But if not, at least it eliminates 1 possibility which then gets you 1 step closer to the solution.

Regards
Antony

MooncakeDEM1812 said:

Thank you so much and I did cut it down by two last night but I woke up with another hypo however I wasn't violent and I made and appointment for Tuesday 20th

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MooncakeDEM1812 said:

Thank you so much and I did cut it down by two last night but I woke up with another hypo however I wasn't violent and I made and appointment for Tuesday 20th

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32 units sounds a lot. How many of novorapid on average do you take per day? I would personally cut it further. Have you ever tested in the middle of the night?