Levels at bedtime

JayCee6828 said:

I am T2 on Metformin (2 x 500gm daily) and Gliclazide (2 x 80mg daily) and have also now been on Humulin I for about 15 months - 26 units a day.

My question is, after reading loads of advice on here and looking particuatrly at blood sugar evels I see a lot of news etc and guidelines that say we should aim for under about 8 howevere a diabetic nurse from the local hospital has told me that I should check my level before I go to sleep and should not go to sleep unless it is over 8.

Would anyone be able to comment or advise further on this as although most nights it is around about 10 some nights it is maybe 6 or so. In the last 6 weeks I have had about 4 hypos, the lowest being 2.9 and others in the 3 area. These I dealt with with a can of coke and some biscuits and that helped althogh I also supplemented it with a mars or crunchie bar as I had been advised to do.

These forums seem to have more and better advice than you get from the 'specialists' so I would welcome any general advice especially in regard to the night time stuff.

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I have to check my bsl before bed because if I don't I am more likely to have a hypo overnight. I know my condition is different but around 7 is fine.
The thing that concerns me is you are using high levels of sugar to counteract a hypo. In my experience that will only help you into a state of rebound and your bsl levels will fluctuate. I found that a low carb substitute say an Apple or low g bread will help raise your bsl you will control it better. Having a coke is probably the worst you can drink, keep it to a diet coke or similar.
If you have no reason to keep checking, don't, you will only stress yourself.

I refused to see a diabetic nurse because she couldn't grasp what constant hypos do to you and the doctors only know that diabetes is different for everyone. They are only recently doing studies on hypos etc. In my experience hypoglycemia is something that can be regulated but feeding it more sugar and high carbs are not the right way to treat them. But we are all different. You will discover than eating low carbs regular with a diet of food that keeps your bloods normal is better than what is recommended by nurses. Ask your doctor if you can see a specialist dietician, if you struggle. I have one now and she is what I needed. She has understood my condition more than all the so called medical people I have met but then my condition is different from most diabetics.
Keep on to them and don't give up.

Firstly, I am T2, and don't take any medication, so I have no experience of insulin, or hypos, but a few things caught my eye.

Eight seems quite high, as a threshold for safely going to sleep, when a hypo is considered to occur at under 4. That's 100% tolerance. That seems a wide window.

Secondly, for someone on gliclazide and insulin, testing four times a day doesn't seem much. Do you drive? Notwithstanding driving, I can't see how testing four times a day really gives you a realistic picture of what your levels are doing. Couple that with the hypo/coke/Mars bars routine, and I'd imagine your bloods would map like a roller coaster ride.

My instinct, and in your shoes I would go through a period of intensive testing; fasting, before and 2 hours after meals and before bed. Of course testing before driving, if that's appropriate. That will then provide a bit more of a picture of your bloods. If they are very up and down, you could consider modifying your diet to smooth the higher and deeper peaks and troughs. I would think that could help with hypos too.

Again, to reiterate, these comments are my instinct and how I would tackle the sort of situation you find yourself in, but my personal, actual experience, not taking any medication means I can't be utterly sure. Hopefully someone with better knowledge and experience will comment soon.

I hope you find some answers.