Type 1 Help with Tresiba and understanding my BG lows

[PolarBearGuy]

Hi all. I’m new here. Had T1 for most of my life, about 24yrs and counting!

You would think I would be a pro at this by now but I just feel so stressed by it as of late.

I’ve been on Tresiba and NovoRapid for quite some time. Just days ago I have started trialling Fiasp to combat post spikes after breakfast and evening meals. More on that another day.

What I am wanting to discuss today is my basal. I’m injecting 14u atm. I give my dosage around 8PM or just slightly after usually. By most early morning anywhere from say 5AM onwards my Libre 2 wakes me up to say my glucose is low. My alarm is set to alert when it drops below 4.5. My finger tests sometimes confirm this, other times finger test may be more in the range of 5. I usually wake up around 9.30AM as my work pattern starts at 2PM so this isn’t ideal for me. If I drop my basal then my concern is how it will impact my day time readings. Afternoons are generally good for me. Am I supposed to take my Tresiba later at night say 10 or 11PM to keep from hitting that low whilst sleeping?

Also my other concern relates to the low drop in the early hours. I keep a Yorkie bar beside my bed. I will have 3-4 squares of it to bring me up before anxiously trying to get some more sleep but then by the time I get up proper for breakfast it’s gone really high into the 12 range. Can someone explain what I’m supposed to do instead if my snack is sending me way up from my low? It’s all very confusing.

Thanks for your time.

 

[Antje77]

my other concern relates to the low drop in the early hours. I keep a Yorkie bar beside my bed. I will have 3-4 squares of it to bring me up before anxiously trying to get some more sleep but then by the time I get up proper for breakfast it’s gone really high into the 12 range. Can someone explain what I’m supposed to do instead if my snack is sending me way up from my low?

This part sounds like you need less of your hypo treatment. If it brings you up from the 4's to 12, what about trying with 1 or 2 squares instead? (Disclaimer: I have no idea what a Yorkie bar is.)
You're also getting the alarm before you're actually low, so your not treating a hypo but nudging your BG up a bit to stay away from hypo territory.
For me, being in the low 4's with a slow drop I want to stop takes a different treatment than a full on hypo in the low 3's.

Am I supposed to take my Tresiba later at night say 10 or 11PM to keep from hitting that low whilst sleeping?

Tresiba works for a lot longer than a day, the timing shouldn't make a difference really, and it doesn't make a difference for me. I aim to take it any time between 10 pm and 5 am and I don't notice a differece even switching between those times.

If I drop my basal then my concern is how it will impact my day time readings. Afternoons are generally good for me.

You have a CGM which will show you if lowering your basal means you'll need some adjustment to your mealtime insulin or not.

Remember, Tresiba is so long acting and stable that it will take some 3 days to notice the full effect of a dosage change, be patient!