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Night time rise in blood sugars

H

heronbrook

Member
Messages
6
Type of diabetes
Parent
Treatment type
Insulin
Hi everyone, my 14 year old daughter is T1. Over the last 7 or 8 days her sugars are trending up over night. I have a clear picture as we use Dexcom CGM. The trend regardless of her BS at bedtime, is a steady rise right through until morning. The rise is only at night, during the day her levels are as normal? We use glargine background insulin and apidra at meal times. Has anyone experienced this? And if so how is it treated.
 
What time is her Lantus taken? If AM perhaps it's not lasting 24 hours any more and that could explain the gradual rises overnight.
 
Thanks for reply, she takes her lantus before bedtime normally around 9pm? I am told there is a delay in the dose becoming active.
 
heronbrook said:
Thanks for reply, she takes her lantus before bedtime normally around 9pm? I am told there is a delay in the dose becoming active.
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There is, but not that much. What time is she eating before bed and what is she eating?
 
tim2000s said:
There is, but not that much. What time is she eating before bed and what is she eating?
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Before this pattern she would have a snack before bedtime carbs depending on her BS. Teatime is around 6pm. Since this new trend she has gone to bed on sugars as low as 4.8 had no snack and still risen to 10/12 by 12pm, so it's not carbs causing it.
 
Is her evening meal higher fat and/or higher protein than previously? Either of those can cause a slow rise over up to 8 hours, and they each double the effect, so for example, 30g protein will cause a long, slow rise, and add 30g fat, you will get an additional rise of approximately the same amount.

It is also true that teenagers' insulin requirements can be quite high so it may just be a marker of puberty - or a phase in her menstrual cycle.

If her daytime readings are not just flat but in the right zone (not too high), while her nighttime ones are rising, she might need to change to two shots a day of Levemir (I am sure, having been a teenage diabetic, that won't be popular) or ask to move onto a pump.

But look at what she's eating for dinner first.

(And look under the bed for the sweetie wrappers (kind of a joke, but I really was a teenage diabetic, secret runs to the biscuit tin and all that). Going from 6pm till morning without eating at all is a long time for anyone, let alone a teenager. Might even be best to give her a bedtime snack and another bolus.)
 
RuthW said:
Is her evening meal higher fat and/or higher protein than previously? Either of those can cause a slow rise over up to 8 hours, and they each double the effect, so for example, 30g protein will cause a long, slow rise, and add 30g fat, you will get an additional rise of approximately the same amount.

It is also true that teenagers' insulin requirements can be quite high so it may just be a marker of puberty - or a phase in her menstrual cycle.

If her daytime readings are not just flat but in the right zone (not too high), while her nighttime ones are rising, she might need to change to two shots a day of Levemir (I am sure, having been a teenage diabetic, that won't be popular) or ask to move onto a pump.

But look at what she's eating for dinner first.

(And look under the bed for the sweetie wrappers (kind of a joke, but I really was a teenage diabetic, secret runs to the biscuit tin and all that). Going from 6pm till morning without eating at all is a long time for anyone, let alone a teenager. Might even be best to give her a bedtime snack and another bolus.)
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Thanks Ruth plenty to think about there, whilst I know snacking is always a possibility I am as confident as I can be it isn't that. The fat and protein is really interesting and could well be a cause, her snacks do often include proteins and fat e.g chicken skewers/ Low carb etc. she hates the idea of a pump but 2 injections of Basel would be better is that what you were referring to when you mentioned Levemir?
 
heronbrook said:
Thanks Ruth plenty to think about there, whilst I know snacking is always a possibility I am as confident as I can be it isn't that. The fat and protein is really interesting and could well be a cause, her snacks do often include proteins and fat e.g chicken skewers/ Low carb etc. she hates the idea of a pump but 2 injections of Basel would be better is that what you were referring to when you mentioned Levemir?
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Yes, some people take one shot of Levemir in the morning, and another before bed. That way you can deal with different requirements for basal over the two periods. Tim does that. If you look at some of hsi posts, he explains it.
 
RuthW said:
Yes, some people take one shot of Levemir in the morning, and another before bed. That way you can deal with different requirements for basal over the two periods. Tim does that. If you look at some of hsi posts, he explains it.
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I only joined this forum today after coping with T1 as a single dad for last 4 years glad I did now, such a weight off hearing from people like I have today. Thanks Ruth you've been a big help.
 
Get her to join too. There's a really good teens section. I wish I had known some other diabetics when I was young. It can really help with adjustment, i think.

Anyway, welcome!
 
RuthW said:
Get her to join too. There's a really good teens section. I wish I had known some other diabetics when I was young. It can really help with adjustment, i think.

Anyway, welcome!
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thanks again and I will ask her x
 
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