How to go to bed with lowish blood sugar levels?

[Jennofspades]

I've been a type 1 diabetic for almost 10 years and i'm almost 27 now. I have never been able to go to bed with my sugar below about 10/11 (UK measurements). If i go to bed with anything less than 9 then my partner has to wake me up and feed me before i come around.

I am starting to think about pregnancy and would have to go through IVF as we are both girls. However they will not consider you if your bloods run higher than perfect for a sustained amount of time before the pregnancy and also obviously while you are pregnant. I really want children. How can i bring my sugars down of a night without getting up multiple times throughout the night?

 

[AndyS]

It sounds like your basal insulin needs to be reduced.
What insulins are you currently taking?

I know that when I have more than a 2mmol/l drop overnight I start to consider reducing my evening levemir dose, as such my doses tend to go up and down a bit over time.

Have you considered talking to your DSN or specialist? If you are only treated by your GP I would suggest you ask for a referral since they can help you get things smoothed out with you considering having children. I think that planning a pregnancy is one of the factors that potentially makes you eligible for a pump.

But as I said, for a first step I would consider reducing your evening basal insulin if you can.

Best of luck,

A

 

[Jennofspades]

Hello,

Thanks for your response. I'm on Novorapid and solarstar for the night time insulin. I take on average about 2-6 units with meals depending on what i eat and then 20 units of night time.

When i first got diagnosed i was on 40 units of night time insulin and then over time i have lost weight and my diet has improved so now am on 20. However when i have tried to lower it more in the past (to see if this helps) i have found my average blood levels (HB1C is it called?) have been even higher again. Its as if no matter what i do my sugar just drops so fast over night.

I think though to be honest i haven't lowered it for a few years and forgot to even consider that until you've just mentioned it. I might try 18 (or do you think 16?) and take a little more novorapid with meals to balance it out?

Also a pump would be amazing. i have just changed surgeries as i have moved and went to register last week. The nurse told me 'we don't do diabetes, so i'd just carry on looking after yourself if i were you' which was a bit unsettling. I'll have a look in the area for other clinics/hospitals as i need to get it sorted ASAP really. Don't want to be waiting years for my sugar to even out to have a baby.

Thanks again.

 

[tim2000s]

The alternative that you could do, which is the simplest switch, is to take your basal insulin in the morning. Given the way you have described what is happening, you may find that this solves y our issues. I would adivse making sure that you wake up in the early morning (say 4 or 5am) and doing some checking to make sure that you aren't suffering from a rising blood glucose early in the morning though.

The nurse told me 'we don't do diabetes, so i'd just carry on looking after yourself if i were you'

With a comment like that, I'd suggest that you look for another surgery and make it very clear to the practice manager why you are leaving.

 

[Jennofspades]

I left an angry review and the practice manager messaged me back. When i rang the number rang out though.

Hmm....hadn't thought of trying the solarstar in the morning. Is that a common thing people do?


Thanks everyone.

 

[azure]

Does your blood sugar go low at random times during the night or is it always a similar time?

What's your control like the rest of the time?

 

[tim2000s]

Surprisingly large number of people do basal first thing in the morning. It alleviates the issues associated with overnight hypos as you are able to identify them when awake.

 

[Jennofspades]

As long as i don't get distracted (i.e. stressful day in work and forget to check) then its completely fine. I'm not sure really as it doesn't wake me up. My sugar is on average about 2-3 of a morning and because this has been happening for a while i can cope fine with that and feel 100%. However if it goes lower i just sleep through it and find myself coming round covered in food and throwing a tantrum to whoever is trying to help me. So i just make sure my sugar is about 12ish before bed so that it lasts the night. if its 12 (10 at the least, 9 can be a struggle and makes me too low) i'd wake up with it at about 3 and i;m functional.

 

[Jennofspades]

Hmm i think i'll give that a go then. Should i have a day off the solarstar first so that i don't go too low with it only being a 12 hour gap rather than 24?

 

[azure]

Like others have suggested, it seems like a problem with your basal. You shouldn't have to go to bed high to avoid hypos. If basal adjustments don't help, then a pump might be worth a try. I'm on a pump which I got because it was impossible to control my blood sugar on long acting insulin. If you mention you're hoping to try for a baby that'd help as pumps are quite often recommended in pregnancy to help with tight control. And control really does have to be very tight in pregnancy - the targets are strict.

(I've merged your threads so you have all the responses in one place )

 

[noblehead]

Also a pump would be amazing. i have just changed surgeries as i have moved and went to register last week. The nurse told me 'we don't do diabetes, so i'd just carry on looking after yourself if i were you' which was a bit unsettling. I'll have a look in the area for other clinics/hospitals as i need to get it sorted ASAP really. Don't want to be waiting years for my sugar to even out to have a baby.

''We don't do diabetes''......... Well I suppose it was honest of them although it's somewhat surprising.

@Jennofspades, I strongly suggest you ask for a referral over to a hospital diabetes clinic, they are more specialised in dealing with type 1 related issues and you will receive the best support up to and during your pregnancy.

If your unsure how to do a basal check then have a look at the following, its for pump users but the basics are the same where it explains how to do a basal check in different time frames:

http://www.salforddiabetescare.co.uk/index2.php?nav_id=1007

Good luck and hope all works out well.

 

[AndyS]

Agree with what Tim said about moving your basal to the morning. I used to be on Lantus and when I switched I did a half dose on my last evening and then started on a normal dose of levemir (initially my total basal divided by 2) the following morning. I guess the same may work for moving your dose to the morning but bear in mind that while you may go high overnight you may get lots of lows during the day.

The GP I am with are not exactly diabetes specialists so I am mainly treated out of the diabetes clinic at a hospital near where I work. I think given their admission you should ask for a referral to a diabetes specialist unit at a nearby hospital, if there are a few then it may be worth doing a bit of research (or as on here) to find one that has a good reputation and possibly is a pumping centre as well.
If you tell the DSN and specilaists at the hospital about your plans for pregnancy then they should help you out.

Another thing to try and get if you haven't yet is ask about a structured training course like DAFNE since it is quite key to learning about basal and bolus adjustment.

For changes to your basal, if you aren't able to calculate it then I would make a small change (I believe the usual recommendation is 10% changes) and then monitor for a couple of days. Before making other changes.

Though as has been said, given your plans get yourself a decent specialist team since they will help you start to finish.

 

[Ali H]

Have you tried Levemir which most of us split morning and evening? I use that alongside Novorapid with meals and it is steady as a rock. Strip it back to basics, do a basal check for each period of the day, maybe lower your carbs if you can to keep your insulin needs down and lessen the risk of peaks and troughs, and work from there.

 

[mammamia2006]

I was strongly advised NOT to split Lantus but lil old me went & did it anyway, best thing I ever did! Hardly any hypos, no hypers & everything has been a LOT better since.

 

[ButtterflyLady]

I've been a type 1 diabetic for almost 10 years and i'm almost 27 now. I have never been able to go to bed with my sugar below about 10/11 (UK measurements). If i go to bed with anything less than 9 then my partner has to wake me up and feed me before i come around.

I am starting to think about pregnancy and would have to go through IVF as we are both girls. However they will not consider you if your bloods run higher than perfect for a sustained amount of time before the pregnancy and also obviously while you are pregnant. I really want children. How can i bring my sugars down of a night without getting up multiple times throughout the night?

This is a bit off topic, but I would have thought that artificial insemination by donor would be the first choice, ahead of IVF, unless you had fertility issues? Might be worth looking into as it would be considerably easier.

 

[Jennofspades]

Hi Everyone,


Just wanted to say thank you to everyone for your help and suggestions. I've been taking slow acting insulin of a morning since friday and last night and gambled and went to bed with sugar at 7 and woke up with it at 2.8 (conscious and happy!) so it seems to be working. Heading in the right direction anyway.

Thank you so much to everyone. I didn't expect to get anything back from this post but the support has been overwhelming. Very grateful i have found this forum as i'm sure i'll need it again...and again.

 

[Jennofspades]

I think you might be right! I have an appointment next week to hopefully get the ball rolling.

Thank you

 

[himtoo]

Hi there @Jennofspades
just stumbled on this thread today and have noticed the thread is quite old.

has the shift to morning basal had the positive results you were looking for ?

all the best !!

 

[Jennofspades]

Hi there @Jennofspades
just stumbled on this thread today and have noticed the thread is quite old.

has the shift to morning basal had the positive results you were looking for ?

all the best !!

1. Jennofspades Hello. i saw a massive improvement at first. However, by coincidence on the last three occasions i went to the doctors i had a hypo. Sugar was about 2-3 and i gave the wrong address for my house on 2 occasions
   Wednesday at 9:56 AM EditDelete Report
   
   
2. 
   Jennofspades and then on the third i felt the low so asked for some sugar. This left a bad impression and they rang me the following day saying i'm not advised to drive....
   Wednesday at 9:56 AM EditDelete Report
   
   
3. 
   Jennofspades so now i am waiting to hear from the hospital about being referred for a pump/ hypo awareness stuff before i can drive - very frustrating

 

[himtoo]

sorry - didn't realise you were posting updates on your forum profile