Is this right? (hypos and insulin)

JustLucky said:

I always try to eat dinner at 7 so the insulin stops working at 11 or close. I feel pretty relaxed when having 5-6mmol reading before bed, if it's lower I eat a bit.

Usually my night time glucose is between 4 and 5 mmol, I sleep pretty good... I should be ok with that kind of numbers? I have a Libre.

I did have some night time lows a few months ago (3.5 not lower) but then adjusted my basal a bit and now they are gone... There should be no reason for blood glucose to go dangerously low unless bolus injection was within 4-5 hrs, or am I missing something...?

Thanks

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Sounds amazing. Be aware of the dawn phenomenon though, having carbs too close to bed time or too many carbs during the day can cause spikes in dawn

JustLucky said:

I always try to eat dinner at 7 so the insulin stops working at 11 or close. I feel pretty relaxed when having 5-6mmol reading before bed, if it's lower I eat a bit.

Usually my night time glucose is between 4 and 5 mmol, I sleep pretty good... I should be ok with that kind of numbers? I have a Libre.

I did have some night time lows a few months ago (3.5 not lower) but then adjusted my basal a bit and now they are gone... There should be no reason for blood glucose to go dangerously low unless bolus injection was within 4-5 hrs, or am I missing something...?

Thanks

Click to expand...

Hi

Only you can decide what is right for you…. The main risk is always hypos in the night.. but you’ve already spotted and adjusted for that..

You have the libre.. well done that’s good you can spot any risk area’s with that

Time of evening meal depends on your lifestyle.. wouldn’t work for me as I’m in bed by 8 most nights (up early). But if your up until 10/11 time that your bolus for you meal has finished and your happy then that’s ok.. obviously if lower than you are comfortable with then a small snack. And time an experience you’ll start to know if it’s ok to go to bed

I struggle when I eat late with morning highs but I’m on a pump which autocorrects this.. if you find the same you could try eating a little earlier see if it helps.. depend how high the high is..

The other issue mentioned is the lower you are and for the longer your body will get to accept this and you may not feel a hypo coming on.. so ideally you don’t want to sit in the 3&4 ranges every night.. losing hypo awareness can cause other problems in life like driving

And of course don’t forget this is diabetes… so just when you think everything is right.. something changes and you need to figure out the ‘new way’ of dealing with it.

JustLucky said:

My logic tells me it's good, I just wanted to check if there is something I'm missing, as I these night hypos can be a serious thing

I'm still a newbie and so far it's not been too complicated to stay within the target range, hope it stays like that...

I've not had any morning effects, just a flat line except after meals. My basal i Toujeo 8-10 units and I bolus 2-4.

Thanks for your help, I overslept this morning so I'll go make nice spike now...

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ok ive read a couple of your past posts.. and it appears your probably LADA/T1

The only reason i say that, is remember you are currently producing some insulin yourself, all be it a low amount.. this gives you a sort of buffer zone.. if you take 'slightly' too much insulin the body will release slightly less..

also it works in reverse in that you take slightly too little, it has some in reserve to release and help keep that 'flat line'

just be mindful of the fact this can change.. the less insulin your body produces the less of a buffer zone, and the more erratic control can become..

so just keep monitoring, and adjusting either by yourself or with the aid of your care team as required

JustLucky said:

I always try to eat dinner at 7 so the insulin stops working at 11 or close. I feel pretty relaxed when having 5-6mmol reading before bed, if it's lower I eat a bit.

Usually my night time glucose is between 4 and 5 mmol, I sleep pretty good... I should be ok with that kind of numbers? I have a Libre.

I did have some night time lows a few months ago (3.5 not lower) but then adjusted my basal a bit and now they are gone... There should be no reason for blood glucose to go dangerously low unless bolus injection was within 4-5 hrs, or am I missing something...?

Thanks

Click to expand...

Hi there, you are right basically and you sound very much like me. The problem I sometimes have though is that even when I have had my bolus 4/5 hours previously with a meal, I STILL find that on occasions I will go low/hypo for no apparent reason in the evenings, just before bed or during the night. My basal is spot on in that it keeps me level between 4 & 5 in between meals and during the night the majority of times, but I feel that we will always be prone to some random drop, especially when we are in the honeymoon period. During the day I'm not so bothered as chances are I will recognise and treat this. It's not just about the insulin either, when you factor in exercise or stress or just about anything else, that too can contribute to an unexpected drop, so although there should be no reason 4/5 hours after bolusing there are so many non insulin factors that come into it. You seem to have a handle on it so I would just say keep checking, I always take a 15 carb snack before bed if I am under 5, or if I am over 5 but have exercised that day for example, as I know my levels will be lower on average for the next 24 hours if I've exercised. A buffer level before bed is ideal. x