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Night Time Blood Sugars

D

DiabeticDi

Well-Known Member
Messages
260
Type of diabetes
Type 1
Advice please! At bedtime, at what level do you say you are too low? I was always told that lower than 7 you have extra carbs. So if you were at 6, what would you take? Also if you were 5 at 3am would you do anything? I know it is all personal but just wanted some general advice. I can go to bed on 6, 7 and wake up on 13. Is that because I am going too low and so shooting up? But 13 is not what I call a real spike? If I took 1-2 CP at bedtime would that cause a spike? I don't have the best digestion either. I take Lantus at bedtime. Anyone who can help it would be much appreciated.
 
Hello @DiabeticDi

Personally if I was below 4.8 then this is too low for me at night time, I don't like eating carbs before bed as the knock on effect can leave me high upon waking so will have a few spoons of full fat greek yoghurt instead which keeps me flat during the night, I wouldn't do anything if I was 5 at 3am either as would be quite happy with this reading - at 3am you are at your lowest BG point during the night so 5 is perfect.

Your ideal target is to go to bed at around 5.5-7.5mmol/l (as an example) and wake within 2 mmol/l of this.

As you are going high at 13 upon waking there are 2 possible reasons, the dawn phenomenon which is your liver doing a glucose dump upon waking or your basal insulin needs adjusting, are you taking lantus twice daily ?
 
I would say "it depends".
For example, when I was on Lantus, I would aim for about 7 or 8 when I went to bed. I knew this would fall whilst I was asleep and I would wake at about 5 or 6. Then during the day, the basal was about right.
Now, I have a pump, the basal should be set to maintain a steady BG when I am not eating at any time. Therefore, I aim for about 5.3 when I go to bed. If I am lower than 4.5, I would take one GlucoTab before I go to bed.

Obviously, this also depends on whether I have been exercising that day and whether I have eaten a cheeky chocolate (for example) in the last two hours.

I just noticed you take Lantus at bedtime. I used to do this.
However, when you look at the profile of Lantus, there is a peak after 2 - 3 hours which would lead to a night time low. Therefore, I changed the time of my Lantus dose so that I took it with my evening meal and was awake for the Lantus peak.

If you get a chance to trial a Libre, you may find it useful to see what happens to your BG throughout the night.
You may be able to see if you get a Dawn Phenomenon rise before waking as @Juicyj suggests or whether you remain high from your bed time snacks.
 
DiabeticDi said:
Advice please! At bedtime, at what level do you say you are too low? I was always told that lower than 7 you have extra carbs. So if you were at 6, what would you take? Also if you were 5 at 3am would you do anything? I know it is all personal but just wanted some general advice. I can go to bed on 6, 7 and wake up on 13. Is that because I am going too low and so shooting up? But 13 is not what I call a real spike? If I took 1-2 CP at bedtime would that cause a spike? I don't have the best digestion either. I take Lantus at bedtime. Anyone who can help it would be much appreciated.
Click to expand...
Juicyj said:
Hello @DiabeticDi

Personally if I was below 4.8 then this is too low for me at night time, I don't like eating carbs before bed as the knock on effect can leave me high upon waking so will have a few spoons of full fat greek yoghurt instead which keeps me flat during the night, I wouldn't do anything if I was 5 at 3am either as would be quite happy with this reading - at 3am you are at your lowest BG point during the night so 5 is perfect.

Your ideal target is to go to bed at around 5.5-7.5mmol/l (as an example) and wake within 2 mmol/l of this.

As you are going high at 13 upon waking there are 2 possible reasons, the dawn phenomenon which is your liver doing a glucose dump upon waking or your basal insulin needs adjusting, are you taking lantus twice daily ?
Click to expand...
 
Thanks for your reply. Yes it could be dawn phenomenon but I do sometimes wake up within range, so....it is very confusing. I think that I have been going to bed too high for fear of going hypo and also having extra carbs at 5 and 6 at bedtime which won't help. Yes I am on Lantus twice a day, breakfast and bed.. You have been helpful, I didn't know that your sugar was at its lowest at 3am. So now I won't panic at seeing a reading of 5 at that time! I have been diabetic 38 yrs and if i wake up at a reading of 10 and under I am happy..
 
helensaramay said:
I would say "it depends".
For example, when I was on Lantus, I would aim for about 7 or 8 when I went to bed. I knew this would fall whilst I was asleep and I would wake at about 5 or 6. Then during the day, the basal was about right.
Now, I have a pump, the basal should be set to maintain a steady BG when I am not eating at any time. Therefore, I aim for about 5.3 when I go to bed. If I am lower than 4.5, I would take one GlucoTab before I go to bed.

Obviously, this also depends on whether I have been exercising that day and whether I have eaten a cheeky chocolate (for example) in the last two hours.

I just noticed you take Lantus at bedtime. I used to do this.
However, when you look at the profile of Lantus, there is a peak after 2 - 3 hours which would lead to a night time low. Therefore, I changed the time of my Lantus dose so that I took it with my evening meal and was awake for the Lantus peak.

If you get a chance to trial a Libre, you may find it useful to see what happens to your BG throughout the night.
You may be able to see if you get a Dawn Phenomenon rise before waking as @Juicyj suggests or whether you remain high from your bed time snacks.
Click to expand...
 
Thanks for your reply. Does Lantus really peak? I thought the whole point of it was it stayed at a steady level throughout the day or night?
 
DiabeticDi said:
Thanks for your reply. Does Lantus really peak? I thought the whole point of it was it stayed at a steady level throughout the day or night?
Click to expand...
It is flattish but not entirely flat.
This is the profile:
lantus.jpg

Depending on your sensitivity, you may or may not notice the peak - I did.
Everyone is slightly different - for example, some people find it does not work for the complete 24 hours whereas I found it stayed in my system for 4 days (when I changed to a pump, I had to be aware of it).
 
Hi Diabetic Di, I have similar issues with yourself. the problem I find is that there is no consistency. Some nights I go to bed at 6 and wake up at 12, others bed at 6 and wake up with a 6.

I used to take Lantus but was switched to Levemir insulin which is twice daily with less peaks than Lantus, maybe that could be an option
 
helensaramay said:
It is flattish but not entirely flat.
This is the profile:
lantus.jpg

Depending on your sensitivity, you may or may not notice the peak - I did.
Everyone is slightly different - for example, some people find it does not work for the complete 24 hours whereas I found it stayed in my system for 4 days (when I changed to a pump, I had to be aware of it).
Click to expand...
 
Thanks for that, no I don't notice a peak, I think it's just going to be trying to work out the right dose during the night to try and combat dawn phenomenon and 3am readings. Sounds like fun!
 
smc4761 said:
Hi Diabetic Di, I have similar issues with yourself. the problem I find is that there is no consistency. Some nights I go to bed at 6 and wake up at 12, others bed at 6 and wake up with a 6.

I used to take Lantus but was switched to Levemir insulin which is twice daily with less peaks than Lantus, maybe that could be an option
Click to expand...
 
Hi thanks for reply. Yes that sounds just like my experience. I did try Levemir but It wasn't any different. So frustrating because my nurse says if I could get the breakfast reading ok then my hbA1c would be within range! I am trying but it seems such an irregular pattern.
 
To be honest I used to aim for 9.5-12 range an I would wake up below 7.0 every time or 90% of the time. Now my Lantus is messed up but I appear to be on lower dose than before.
 
Perhaps your Lantus was to high and you were waking up too low so it was reduced? , it's interesting that the other night I was 12 at bedtime and I though right I won't do anything and see what it is in morning, and I was 10, which for me is great. Last night I went to bed at 10 and woke up at 10 even after a heavier meal then usual! My blood sugar seems to have a life of its own.
 
DiabeticDi said:
Perhaps your Lantus was to high and you were waking up too low so it was reduced? , it's interesting that the other night I was 12 at bedtime and I though right I won't do anything and see what it is in morning, and I was 10, which for me is great. Last night I went to bed at 10 and woke up at 10 even after a heavier meal then usual! My blood sugar seems to have a life of its own.
Click to expand...
Heaven knows! Diabetes is all about eliminating the variables but have fun doing so. Or at least trying to do so.
 
Juicyj said:
Hello @DiabeticDi

Personally if I was below 4.8 then this is too low for me at night time, I don't like eating carbs before bed as the knock on effect can leave me high upon waking so will have a few spoons of full fat greek yoghurt instead which keeps me flat during the night, I wouldn't do anything if I was 5 at 3am either as would be quite happy with this reading - at 3am you are at your lowest BG point during the night so 5 is perfect.

Your ideal target is to go to bed at around 5.5-7.5mmol/l (as an example) and wake within 2 mmol/l of this.

As you are going high at 13 upon waking there are 2 possible reasons, the dawn phenomenon which is your liver doing a glucose dump upon waking or your basal insulin needs adjusting, are you taking lantus twice daily ?
Click to expand...
@Juicyj can I ask where you got the night time figure from 5.5-7.5? Sounds about right to me but just wondered
 
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