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Low readings every morning

G

grahamrb

Well-Known Member
Messages
112
Once again my wife who was diagnosed wit Type1 in her late 70's is getting lows ( readings of 4 or less) EVERY morning.
We haven't a clue why this is happening .
We try to off set it by ensuring that she has a reading of over 14 each night but this does not seem to work.
If, before going to bed she has a reading of 10 or less she is extremely worried about going to bed so eats lots to get the reading up.
Clearly this is not the way to proceed but thius has been the case for several months now.
We don't know what to do!

Any ideas?
 
Are these fingerprick readings or CGM, if CGM they could be compression lows.

How does she feel? I'm usually not too worried if I wake up with a BG of around 4mmol/l, I can then eat breakfast.

Can you refresh our memory regarding her insulin types please?

If she has a CGM it would be interesting to see her readings overnight, it's hard to know whether it's a case of too much basal (background/long acting) insulin vs too much bolus (short acting) taken with supper which is then driving her down overnight.

I'd guess it's a case of too much basal though as it would be quite unusual for the bolus insulin to both act for so long and for her to have not woken up earlier in the night with low blood sugar, though if on one of the intermediate insulins this certainly wouldn't be unusual - I spent most of my youth doing this trade-off.
 
Thanks for your reply
They are CGM readings libre
What are compression lows?
When she gets these lows she certainly knows about it, I think that the lowest was 2.7.
Also she sometimes gets lows in rhe early hours

Tresiba is the long acting basal
Novorapid is the short acting bolus
She recently (5 months ago) reduced the Tresiba from 20 to 18

The current reading at 11.55 pm is 20 so hopefully the low may not come in the morning

The diabetes nurse said if we sort the lows highs will look after themselves
 
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We aren't allowed to give dosing advice but has your DN said anything about reducing the tresiba some more if she keeps going low overnight?

I suspect that when you are diagnosed at her age long term complications may not be too relevant, and hypos are more of a concern than highs, but a blood sugar of 20 would make me feel unwell, so getting the insulin right so as to avoid the big drops would seem to me to be pretty critical.

Can you talk to the nurse again and get some input?
 
Dear EllieM,
Just to let you know that I have advised the Nursing team and await a response.
 
I am T2 but following this with interest I too am on 2 Insulins (the newer versions of your wife's) Toujeo Basal and Trurapi Bolus
thank you
 
My wife had the annual review over the phone and the doctor advised to reduce the Tresiba insulin to 16 units

This seems to have worked inasmuch she is not getting so many lows during the night
The nurse said that she should have 4 units before breakfast,6 units before lunch and 6 units before dinner. Carb counting seems to be a thing of the past
Thats a total of 32 units, when she started insulin it was 40 units a day
 
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