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Nighttime hypoglycaemia

C

cbooth5

Active Member
Messages
31
Type of diabetes
Type 1
Treatment type
Insulin
Hi all,
My DSN is on holiday at the moment so just wanted some generic advice and ideas even though I know may not be able to get specialist advice on doses etc. I'm still in my honeymoon period (diagnosed end of June 2023) and on these insulins:

Tresiba 1 unit morning
Novorapid 1-2 units with meals (judging best off carb content ~ 50g:1 currently)

I try have my sugars running at 8-10 before I go to bed. They will drop within 3 hours and I often get woken up at 3am, 6/7am or 9am but mostly just once per night by libre alarm, eat then go back to bed. Sometimes I snack before bed on purpose to 'feather' the number to 8 or 9 on purpose (e.g. alcohol free beer, nuts, crackers) but maybe this triggers my own insulin secretion? It's really exhausting me as trying to get back to work this week and desperately need rest. I was originally on 4 units tresiba but we tapered it down to 1 unit as it was much worse on a higher dose a month or two ago.

Now I'm second guessing myself, i.e. would nighttime control be better on 2 units, or do I need to get an echo pen from the GP to try deliver 0.5 units tresiba? Just wanting to draw on people's experiences and knowledge, thanks in advance
 
Antje77 said:
Do you double check those Libre lows with a finger prick?
Click to expand...

I've only just started doing this and most of the time they are reasonable, for example I've had 6.9, 7.9mmol/L which is really fustrating at the time the alarm goes off below 5.0 (it may read something like 4.3 or 4.5 when it actually recognises the level). Let me know if you have any advice, I would set my libre alarm lower but if I set it to 4.5 I find I wake up with a crashing headache and genuine hypoglycaemic symptoms which ruins the whole next day for me headache wise - because by the time I'll have registered maybe I am bordering on ~4.0 (ish) territory.
 
Not sure if this is suitable for you but I’m finding higher fat/protein I.e. meat plus oats or other carbs gave me a high value well into the next morning, however, I assume this encourages weight gain. However I think your proposal of changing to a pen that delivers 0.5 sounds a better idea.
Also have something low gi index plus sugar after your hypo, if you’re not. My DSN mentioned this to me when my basal was too high.
 
Mitchsi said:
Not sure if this is suitable for you but I’m finding higher fat/protein I.e. meat plus oats or other carbs gave me a high value well into the next morning, however, I assume this encourages weight gain. However I think your proposal of changing to a pen that delivers 0.5 sounds a better idea.
Also have something low gi index plus sugar after your hypo, if you’re not. My DSN mentioned this to me when my basal was too high.
Click to expand...

Thanks, will go shopping tomorrow and give this a try! I've not tried very high protein before bed e.g. meats. I can have something before bed lowish carb content, but the issue is it'll still spike into the 13-15 territory and I feel like this is worse than it going low! I can only have small amounts only
 
Hi C, I’m not on insulin but also have nighttime hypos - especially around 2-3am. I’ve found eating longer lasting carbs & protein later in the evening. I was eating a low sugar biscuit or snack before bed to get my BG above 7 but they just made me crash again later. I’ve found cheese & a couple of heavily seeded wholemeal crackers does the trick & not drinking any alcohol several hours before I go to bed. If my alarm does go off (set at 4.5) then offer just getting up & walking downstairs to get a drink of water does the trick -I guess my Liver starts pumping out the glucose. I wait 15 mins to make sure it’s still up & I don’t need a snack & if low again have a low sugar biscuit. It’s very annoying & exhausting so I hope you get it sorted!
 
cbooth5 said:
I've only just started doing this and most of the time they are reasonable, for example I've had 6.9, 7.9mmol/L which is really fustrating at the time the alarm goes off below 5.0 (it may read something like 4.3 or 4.5 when it actually recognises the level). Let me know if you have any advice, I would set my libre alarm lower but if I set it to 4.5 I find I wake up with a crashing headache and genuine hypoglycaemic symptoms which ruins the whole next day for me headache wise - because by the time I'll have registered maybe I am bordering on ~4.0 (ish) territory.
Click to expand...
Unfortunately the only solution here is to use something other than the libre app, which can apply fingerprick calibrations to correct the values that the libre is producing. Apparently some people get decent readings and can use the non-corrected libre app, I don't, I almost always have an offset, I therefore use the combination of Juggluco + XDrip+. There are other options, especially if you use an iPhone rather than an Android phone like me. Lots of threads about how to set things up if you decide to look at this.

However, stopping the overnight drop, even if it's not always actually to hypo level, would also remove the alarm issue. The question I'd try to answer is whether the early morning hypos are caused by your pancreas reacting to what you've eaten, or by the insulin you're injecting (i.e. too much).

How many carbs do you eat for supper and at what time? Can you post a graph showing your typical BG over this period through till you go low early morning?

I would certainly ask for a pen that can deliver 0.5U, I use one and it's very useful.

This won't last forever, eventually your pancreas will stop "helping" you, though from what I've read (as I don't remember it was so long ago), it can take quite a few months.
 
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