Nighttime Rebound Hypos

mckencf

Newbie
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Hi, hoping someone can help me.
For the past few months, I have been waking up soaked in sweat, but with BS in the 10 - 12mmol range. Initially, I figured I was starting menopause (I am 44) as both my Mum and sister started early. However, I have since read about Simogyi Syndrome, and am more inclined to think could be this - also have seen my GP who has ruled out early menopause.

I have been testing through the night now for about 7 weeks, and I can't catch where I am dropping and am now very frustrated...and tired with very sore fingers! :dead:

When I test hourly, my bg is fine and relatively stable, but when I switch to 2 hourly - I can wake up several times through the night and need to change my pjs because they are soaked through - bed also looks like a crime scene, with a damp outline of my entire body on my sheets!

I have 2 cgm sensors left from an earlier purchase, albeit they are out of date, although I found an article from Medtronic stating that sensors should be unaffected up to 18 months out of date. However, I did give up on the sensors originally because I found them inaccurate, but given my desperation, might be willing to try again.

Is there anything, anyone else would recommend or suggest? Eg. Last night before bed (11pm), I was a bit higher than usual at 11.6, as also struggling with a bit of a cold just now, and took a modest correction dose, as recommended by my pump. At 4am, I was 17.0 and drenched in sweat.

When testing evey 2 hours, I can go from 8.0 to 15.0 between checks.
Thanks
 

tim2000s

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Hi @mckencf I suspect that you aren't getting hit with Somogyi at all. As you have tested on an hourly basis through the night and seen no sign of any drop, the likelihood is much more that you are (as you have seen) simply seeing an escalation in bg level overnight. Your jump from 8-15 in two hours is reminiscent of a cannula blockage or site problem earlier in the evening. This does seem like an ideal time to use the CGM to see the trends, regardless of the values they produce.

Unless you are doing something totally different before bed on the nights when you are testing at two hourly intervals, it seems highly unlikely that you are hypoing and recovering. I'd also ask how long you have had diabetes, as once it's more than ten years, it decreases the likelihood of somogyi occurring.
 

mckencf

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Thanks tim2000s,
I have been diabetic over 25 years, and was offered the pump because I had a lot of issues with night-time hypos on mdi. I am very active, so have tested after runs and training as well as on rest days to check for comparisons. When I hit the 'highs' in the early hours, I always do corrections, which bring me down, so I figured it couldn't be a site problem or blockage, and never have more than 0.1 ketones. Also, not prone to 'sweats' except when hypo-ing - my husband calls me the ice queen as I am usually freezing cold!
Planning a short run tonight, as still have the cold, but will attach a sensor and see what results I get - I have never made any adjustments based on the cgm data in the past, out of curiosity, if I get 2 or 3 days of similar trends, what changes would you suggest as a rule of thumb to start with?
 

CarbsRok

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It just sounds to me as if you need to reset your basals as obviously well out.
 

tim2000s

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I'd agree with @CarbsRok. Once you've seen how your bg levels trend overnight you'll have a better idea of what to do next.

One thing that's sometimes helpful is to graph your bg, insulin, exercise and food using excel or a piece of paper to see what you are doing when. You often see patterns that way that are not immediately obvious when looking at lists of numbers.
 

noblehead

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When I test hourly, my bg is fine and relatively stable, but when I switch to 2 hourly - I can wake up several times through the night and need to change my pjs because they are soaked through - bed also looks like a crime scene, with a damp outline of my entire body on my sheets!

That is odd, can't for the life of me think why going from hourly to two hourly would make a difference if your bg are fine when testing hourly, probably best that you mention this to your pump DSN/Consultant and see if they can throw some light on things.
 

mckencf

Newbie
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Type of diabetes
Type 1
Thanks all. I managed to fit the enlite sensor last night, and it is more accurate than last time I tried them. So will track for the next 5 days or so to spot where I am going wrong and make the necessary corrections.
 
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CarbsRok

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Thanks all. I managed to fit the enlite sensor last night, and it is more accurate than last time I tried them. So will track for the next 5 days or so to spot where I am going wrong and make the necessary corrections.
Don't forget to allow another 20 mins on your calculations for a basal change. IE., high at 2AM according to your sensor then the high is actually 20 mins before that reading so changed your basal 2hours 30 mins beforehand.