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Levemir and night sugars

Hello all,

this is my first post here and I will make an introduction in the relevant area later, but I thought I'd post this issue here before I'm off to a practical at my uni

I take two doses of levemir each day, one with breakfast, and one around 10-11pm at night. I have 14 units at night, and at breakfast my sugar is fine. However, during the night my sugars are high, and this usually causes me to have to use the toilet at least once. Whilst my levemir is combating the sugar over this time, and it returns to normal at breakfast, I can't help feeling I shouldn't just accept this is the way it works

So, I've thought of three things to do a) increase my levemir dose or b) take the levemir earlier, say 8pm or c) both. I know everyone's different and that with this it can be a case of trial and error to see what the right thing to do is, but for reassurance, what would you guys do in this position?

Thanks for any and all help :)
 
What do you eat after tea we had this problem with our daughter.She can no longer have toast or cereal for supper, we try and keep her carbs to only 20g and it keeps her below 10 during the night.
 
Well, practically nothing. Sometimes I hypo after dinner, but I'm adjusting my Novorapid for then as well. Perhaps what happens is I hypo, and then the carbohydrate after that stabilises my blood sugar, but continues to break down and thus I go hyper at night. I'm going to keep your strategy, because I don't often get hungry after dinner anyway. Hopefully, if I keep a tight monitor on my sugars after dinner and during the night, I can see where it is I go wrong. Looks like I might have to wake up on purpose during the night to test myself

Around what time does your daughter have the night insulin? I've changed the morning dose of Levemir from 8 to 10 and had fine sugars all day, I'm hoping this will go through the night too, and if it does I'll continue this for a couple of days to see if a better pattern comes out
 
Sophie takes her levemir at 8.15 each night and she nows wake up with b/s between 5 and 7 most mornings, apart from the odd morning that she may just be over 10.
 
My suspicion is that it's not a basal insulin issue. From what you described, your bg rises at night (before bed?) then falls as you sleep. That suggests your basal may even be set too high as, ideally, it ought to be keeping your bg at a stable level as you sleep, not causing it to fall.
I reckon you ought to look at the pattern your bg levels are following throughout the day and particularly after your evening meal. You say you occasionally hypo in the evenings, so is the subsequent rise a consequence of your having to eat to raise your bg and overshooting a little? That's not uncommon and suggests you might look at reducing your bolus at dinner to prevent this from happening.
The other question would be what sort of diet are you eating? As you know it's carbohydrate which raises bg levels the most, but when fat is added the effect is to slow the release of glucose such that rapid acting insulin may cause a hypo initially but as it wears off and glucose continues to be metabolised, bg levels will rise again later.
Hope you get to the bottom of it soon.

All the best,

fergus
 
try to eat at bedtime a meal of full carb + fat. that can help preventing the liver to produce glucose from fat. many times it helps.

Iris Peleg
 
Also, just for my tuppence worth

After hypos, your bg continues to react (ie rise, due to the treatment AND the stress hormones) for some time after that so it may be post hypo in the evening it is doing this but then comes back down naturally over time

The other thought is yes, timing might not be right. Is the high bg waking you up for the toilet, or is that incidental and you are then testing when you are up?

I do think however it may be what you are eating before bed , or all of the above combined
 
Thanks for the suggestions and advice guys :)

I found the other day that with 10 units of levemir during the day, all my bg's were fine. After dinner, I was fine too. However during the night with 14 units I hypo'd again, and woke up with another low sugar. What I will try first is decreasing my dinner units, and if this results in bad bg's after dinner I will change back and drop the levemir instead. Or, perhaps, I shall try eating food on this regime at night in order to keep my sugars stable over night. That is probably best. There are so many things I could do, but I will only try one at a time to avoid too much change

I appreciate your replies guys, thank you, nothing has gone unread or unconsidered :) Cheers
 
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