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needing too much insulin & Night Time lows/highs

Discussion in 'Type 1 Diabetes' started by Matty_Type1, Aug 16, 2019 at 8:31 AM.

  1. Matty_Type1

    Matty_Type1 Type 1 · Member

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    Hi Guys,

    I am currently on Fiasp and Tresiba.

    I also have the libre machine.

    over the past few months when using libre I seem to be going low in the middle of the night and then shooting up and come morning I am in the teens when I test my blood sugar reading.

    I also think that I am needing to much fiasp to keep me right...

    when diagnosed at 12 through to early 20s I was taking 10-12 units per meal and can see now that I am sometimes needing 20+ units per meal to keep me right.

    My eating hasn't really changed and I am taking this into consideration.

    Any ideas?

    I have tried reducing my Tresiba but doesn't seem to work, I have also tried reducing fiasp at evening meal but this doesn't work either as I run high come bed time.

    anyone else went through something like this?
     
  2. helensaramay

    helensaramay Type 1 · Expert

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    @Matty_Type1 Diabetes is a pes, isn't it?
    I have a few thoughts about your situation which may or may not help ...
    • Are you sure you are going low in the night? Libre is reknowned for reporting "compression lows" in the night when you lie on your sensor. Before making any changes, I recommend setting an alarm to wake yourself in the moddle of the night and confirming the Libre lows with finger pricks.
    • Going high in the morning is probably Dawn Phenomenon. Use the Search function (top right of the page) and you will find loads of threads on Liver Dump/Dawn Phenomenon/DP. It is common - most people (including those without diabetes) do it. For some it is the motivation for an insulin pump.
    • I do not eat a low carb diet but I have (begrudgingly) found that lower carb evening meals are easier to manage through the night. I do not always do this but I have reduced the number of times per week I eat pasta at 8:30. You could take a look at your diet and consider whether there is anything you could change.
    • Have you gained any weight as your insulin needs have risen? Larger people need more insulin.
    • Tresiba is a great basal because it is long lasting. However, this could also be causing problems if your basal needs differ through the day. You could talk to your diabetes team about switching basal to something which could be split between morning and evening doses.
    I think that's all I can think of before work on a Friday morning.
     
    • Agree Agree x 5
    #2 helensaramay, Aug 16, 2019 at 8:52 AM
    Last edited: Aug 16, 2019 at 9:10 AM
  3. Knikki

    Knikki Type 1 · Well-Known Member

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    Just to add to what @helensaramay has said is that you may need to consider what your eating of an evening time, for example some food take much longer to digest so although you may go to bed at an OK level it might rise throughout the night, which mixed in with Dawn Phenomenon could be making you go high.

    Also Tresiba is very long lasting in the system so you may change your dose, it could take 4 - 5 days for it to make and significant changes to your BSL, that's what I have found using it.

    Do you carb count?
    Also have you thought about Basel Testing? there are plenty of Google links and on this forum to testing Basel, get that right and it might help with some of your other issues.

    Take care :)
     
    • Agree Agree x 3
  4. MeiChanski

    MeiChanski Type 1 · Well-Known Member

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    Hello, I second that it could be compression lows, only way to find out if you're actually hypoing is by finger pricking or set an alarm to test half way through the night. I have experienced a 4-5 hr hypo in my sleep and when I do wake up, I finger prick to confirm it and write a note to say I did hypo and tell my consultant when I get round to seeing him. Tresiba is quite a flat line basal, you need to give it 4 days to settle before making any adjustments, it doesn't have a peak like levemir and lantus. If you haven't done a carb counting course, you need to speak with your team about it so you can adjust your insulin according to your food. You might be given the knowledge to have a different ratio at evening meals. DP might be a cause for your high morning readings, so I don't know whether a different basal insulin is better for you. My DP is quite mild, so tresiba does it's job except when it's hormonal week or I'm going through stress or I didn't take enough bolus for my evening meal, it'll carry that high blood sugar until morning. Also are you in any way insulin resistant? Some type 1s do suffer some level of insulin resistance, you might not be. Do you keep a food diary of what you are eating? Some carbs break down sooner than others and greasy food delays the rate at which the stomach empties, which slows down the absorption of glucose from digestion. A high-fat meal can also make it more difficult for your insulin to work well, resulting in your blood-glucose level after your meal being higher than expected.
     
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