Night lows, help please, need to sleep

Doing battle with 2am drops in BG, catching most at 4mmol ish. Looking back through notes trying to find a pattern. My husband is on Detemir was on 6.5 night 9pm and 6 day 9am. Have reduced the night twice now on 5. The day one is now 5.5 after a couple of days of late afternoon 4.4mmol BGs. The balance of slow to fast is usually between 13 and 16 fast and the 10.5 slow. Carb intake between 120 and 150.

Cheese and nuts before bed seemed to work for a couple of days then not. I'm now wondering about overall calorie intake?? Would a day of less calories cause this?

My lovely husband has just been diagnosed with early Altzeimers with the added stress of the diabetes our life is a nightmare at the moment, I just want to go to bed and sleep all night without worrying he's going low. Any and all help gratefully received.

Jaylee said:

Hi,

I have a non D mum with early Altziemers..

OK.. Not familiar with detemir.. (I use Lantus.)
Have you recently opened a new vial/started a new cartridge of the insulin...? Sometimes a fresh batch can be "fresh" causing issue with lows..

Carers need time out too.. There will be nothing wrong with a longer acting carb snack to allow you some rest..
My mum used to be up at 2am cooking me bacon....

Click to expand...

Sorry about your Mum - it's hard isn't it. Not a new batch of insulin. It doesn't happen every night. Last night he went to bed on 7.1 with 30g cheese and 30g almonds. 2am tested 5.3 and steady (Libra). This morning woke on 5.8 then I noticed the graph. He hypod at 2.30 for half an hour then again at 3.30 for an hour.

catapillar said:

If less calories meant less carbs then it's possible that will have caused the lows.

You have mentioned in another thread that you have been told by your DSN that your basal might be "picking up the slack" for boluses. That to me suggests that your basal dosage might potentially be a little too high - the basal is supposed to keep you flat and steady when you aren't eating or taking on any bolus doses. Then you've got flexibility to change diet or just have a day when you aren't eating a lot without having to feed your insulin.

Have you done a basal test if your adjusting your basal doses. I don't love basal testing, it's no fun and it won't give you an immediate good nights sleep cos you've got to test every other hour through the night. But once you've done it and you can be content the basal dose is doing what it's supposed to do and keeping you flat overnight hopefully that will mean you won't have to worry about dropping overnight.

Edit: to add link on how to basal test - https://mysugr.com/basal-rate-testing/

Click to expand...

Because we've got a Freestyle we're sort of basal testing in the night every night! I dropped the basal because of lows in the nigh but it doesn't happen every night. He always drops at 2am but not always hypo low. We can get a three day stretch where he goes to bed on 8 drops to 5 at 2am but then wakes on roughly 8 (not more than 1.7 drop. I asked about the calories because I'm trying to see if that could be causing the nights like last night when he went to bed on 7.1 with nuts and cheese was 5.3 at 2am then hypod half an hour later. Woke then on 5.8 without the Freestyle I wouldn't have even seen the hypo.

The comment by the DNS was when we were talking about reducing the insulin for low GI food, she said reduce by 20%. I said but surely he still needs x amount of insulin for x amount of carbs won't he then end up high? She said the basal would 'pick up the slack'.

You said 'if less calories meant less carbs' it could cause lows. His carbs stay pretty steady 120 - 140 but depending on how many nuts and how much cheese he has the calories vary.

Jaylee said:

Thanks. My mum? Yep...

It's great that you have the Libra. How low did your husband drop at these times.?
I hazard a guess his liver dumped enough glycogen into the system to carry him through till morning..? Could he have woken at these points too?

Click to expand...

Looking at the graph the first which lasted about half an hour looks about 3.9ish then presumably a liver dump took him up to 4ish then again an hour later a bit lower for an hour. Unfortunately he's hypo unaware at those levels he did have the shakes a couple of weeks ago on 3.3 tho.

He starts dropping at 2am.

azure said:

Any improvement @ChrisM28 ?

Were you able to do any basal testing?

Click to expand...

What we've ended up doing is increasing his calories including more cheese and nuts at bedtime, it seems to be working atm! 4 nights with no lows. He's waking with BG on more or less what he went to bed with tho not a proper test I suppose with the nuts and cheese.

azure said:

Any improvement @ChrisM28 ?

Were you able to do any basal testing?

Click to expand...

Scared to drop the cheese and nuts at night as they seem to be working but not a proper basal test if food taken?