Hello,
My brother (23 y.o.) was diagnosed with type 1 about a month ago and it’s been a struggle to get his blood glucose levels under control ever since. He received little to no instructions from his doctors (he lives in the middle of nowhere… long story), so we have been heavily relying on the information available online, managed to get him a CGM, to learn about dosing and carb counting, etc. I’ve learned a lot from this forum as well, so thank you for all your help so far! (Long time lurker, first time poster though so bear with me, please. )
At the very beginning of starting on Dexcom (11 days ago), controlling his BG did not seem that difficult, and we would usually manage to keep it in range for most of the day. As of lately, however, he’s been getting several spikes after his last meal in the evening (around 7-8 pm) that last for up to 6 hours (until 2 am or so). I am a bit lost now and need some more help to figure out what’s causing them and how we fix this.
He is on Tresiba/NovoRapid. I am not sure if his basal dose needs to be changed or if he needs to inject more before meal or even if it’s good to add a correction dose a couple of hours after his meal to prevent the second/third spike… Normally, he would add a correction dose 2-3 hours after his meal or just before bed time, but he did not do it last evening just to see what would happen in that case. We are also afraid of hypos during the night so that’s another issue if he’s to have regular correction doses just before bed time.
I uploaded a screenshot from Nightscout showing his BG last night (roughly from 7 pm to 6 am this morning) to try to illustrate what’s troubling us. The pattern seems to be the same, or very similar, regardless of what he eats in the evening (low carbs, high protein). I assume that high protein could be causing it, but if so, how do we account for that, and how do we avoid hypos after a correction dose? (I remind that he did not take any additional insulin after his meal yesterday evening and the drop that you can see at about 1 am was not related to that, so I’m assuming that if he did take a correction dose, it would have probably ended up in a hypo at time time.)
As you can see, I’m completely lost and would greatly appreciate any help, thoughts, ideas on how to fix this from fellow type 1s or anyone really.
My brother (23 y.o.) was diagnosed with type 1 about a month ago and it’s been a struggle to get his blood glucose levels under control ever since. He received little to no instructions from his doctors (he lives in the middle of nowhere… long story), so we have been heavily relying on the information available online, managed to get him a CGM, to learn about dosing and carb counting, etc. I’ve learned a lot from this forum as well, so thank you for all your help so far! (Long time lurker, first time poster though so bear with me, please. )
At the very beginning of starting on Dexcom (11 days ago), controlling his BG did not seem that difficult, and we would usually manage to keep it in range for most of the day. As of lately, however, he’s been getting several spikes after his last meal in the evening (around 7-8 pm) that last for up to 6 hours (until 2 am or so). I am a bit lost now and need some more help to figure out what’s causing them and how we fix this.
He is on Tresiba/NovoRapid. I am not sure if his basal dose needs to be changed or if he needs to inject more before meal or even if it’s good to add a correction dose a couple of hours after his meal to prevent the second/third spike… Normally, he would add a correction dose 2-3 hours after his meal or just before bed time, but he did not do it last evening just to see what would happen in that case. We are also afraid of hypos during the night so that’s another issue if he’s to have regular correction doses just before bed time.
I uploaded a screenshot from Nightscout showing his BG last night (roughly from 7 pm to 6 am this morning) to try to illustrate what’s troubling us. The pattern seems to be the same, or very similar, regardless of what he eats in the evening (low carbs, high protein). I assume that high protein could be causing it, but if so, how do we account for that, and how do we avoid hypos after a correction dose? (I remind that he did not take any additional insulin after his meal yesterday evening and the drop that you can see at about 1 am was not related to that, so I’m assuming that if he did take a correction dose, it would have probably ended up in a hypo at time time.)
As you can see, I’m completely lost and would greatly appreciate any help, thoughts, ideas on how to fix this from fellow type 1s or anyone really.