No background insulin, nighttime hypos

[Veggietimes]

Hi all, I’ve been diagnosed with slow-onset type 1 a few months ago. Currently I need mealtime insulin, but not background. I’m using a Dexcom G6 as I’m pregnant (4 months). The things is, I’m getting hypo alarms at the moment, even when the novorapid is long gone from my system. Like half four last night - 3.3mmol/l apparently… I think it was real as I wasn’t lying on my Dexcom arm, and was having a weird dream, which I’ve noticed is often the case if I’m woken by a hypo alarm. Hypo again this morning (3.8), aaages after my dinner insulin. The thing is, I don’t know what to make of it - it’s my own body’s insulin doing this. My doctor said it was ok to turn the alarm settings down a bit at night once my dinner insulin has worn off, but there’s a limit to how low I’m confident turning them down. But then maybe loads of pregnant women without diabetes are getting this low at night and it’s perfectly normal?!

 

[BlueBerry11]

Hi there, congratulations on your pregnancy!

I didn’t want to read and run, but dont have any answers either. I was wondering if you’ve been given a blood glucose monitor and are able to do a finger stick? I use the freestyle Libre and my alarm sometimes goes off and it’s correct but sometimes it goes off and I’m not having a hypo. I think the general advice with the flash monitors are to test with a finger stick whenever you feel weird or when you get a hypo alert as finger sticks are more reliable. I don’t know if that’s different with a CGM but might be worth trying?

 

[EllieM]

Non diabetics can go into the 3s but it's not a problem because they don't go significantly lower. (Dr Bernstein claims that a bg of 65mg/dL is normal for non diabetic women, and that is 3.6mmol/L )

Are you able to do a blood test next time your alarms go off to see how accurate your dexcom is at night?

A 10% error could make a big difference....

 

[Sicko]

Hi, the dexcom can sometimes give false readings, this is true, especially if you are pregnant an laying on the side of the sensor, i think it can block the signal reaching the reader? I am over weight an it sometimes happens to me. Also, when pregnant i believe insulin production will fluctuate a lot, especially as your baby produces insulin too which can result in bg going up an down anyway. My advice. Talking from someone who suffered from nightly 4-6am hypos every night, until i was put on cgm and pump. Is, before bed, eat something that is very slow releasing, like nuts, do not eat necessarily eat that many, do not take insulin for them, because they are slow release carbs, it might just bump your night time levels up enough to prevent hypos during the night. Your cgm will give you the results the following day. Before my pump an cgm, i always had to have crisps, or biscuits, or nuts before bed, or i would hypo. Of course i ended up high in the mornings but there was nothing i could do about that until i was up. An strange dreams, definetly hypos, had violent dreams all my life until the pump, its the adrenerline release your body makes trying to higher bg levels.

 

[agwagw]

I wonder if the time of action of the Novorapid is playing a part? I was on Novorapid for many years. Once I started monitoring BG with the Libre sensor (over four years ago) I began to realise that Novorapid is very slow acting for me - sometimes reaching a peak over six hours after injection. This could lead to hypos in the night. A very helpful person on this forum pointed me in the direction of Fiasp insulin. This is the same insulin (Aspart) as in Novorapid, but formulated to act more rapidly. I requested to change insulin, medics happy with this. After two months on Fiasp I can see that it is indeed much faster acting - within an hour not the four to six hours as was the case before. It is now much easier to keep control.

It sounds like you may be Lada, as you still have some insulin production. One suggestion would be to reduce your carbohydrates, which would allow you to reduce the amount of insulin you inject - which would reduce the risk of hypos. Unfortunately, there are still dietitians who recommend keeping a significant amount of carbohydrates and 'just up the insulin'. This is a route to a roller coaster of highs and lows as happened to me when I first went onto insulin.

 

[hboyt]

When you are type 1 first of all you have a honeymoon period where there is still some insulin working is maybe why you aren't on any background insulin and getting hypos.

Also when I was pregnant I wasn't considered hypo until 3.5 and didn't treat until 3.5 and only tested with 15g carbs. Being pregnant can make blood sugar's swing quite drastically in a small space of time! .

Another thing if you not sure about the CGM reading I would always back it up with a finger stick blood test.

Maybe you could try asking for a pump as well. Mine collaborates with my CGM and turns insulin off or increases in automatically depending on the CGM glucose readings.

Aww hope you can get all the help u need. Having diabetes diagnosis is a big enough learning curve let alone with being pregnant on top of it!
Xx

 

[FR]

Hi, the dexcom can sometimes give false readings, this is true, especially if you are pregnant a laying on the side of the sensor, i think it can block the signal reaching the reader? I am over weight an it sometimes happens to me. Also, when pregnant i believe insulin production will fluctuate a lot, especially as your baby produces insulin too which can result in bg going up a down anyway. My advice. Talking from someone who suffered from nightly 4-6am hypos every night, until i was put on cgm and pump. Is, before bed, eat something that is very slow releasing, like nuts, do not eat necessarily eat that many, do not take insulin for them, because they are slow release carbs, it might just bump your night time levels up enough to prevent hypos during the night. Your cgm will give you the results the following day. Before my pump an cgm, i always had to have crisps, or biscuits, or nuts before bed, or i would hypo. Of course i ended up high in the mornings but there was nothing i could do about that until i was up. An strange dreams, definetly hypos, had violent dreams all my life until the pump, its the adrenerline release your body makes trying to higher bg levels.

My freestyle also alarms at night and I fingerprick to check it - sometimes it’s inaccurate but sometimes I’m low too.

If I’m low just before bed in the 4’s I have a Planet paleo brand grass fed cacao chocolate collagen hot drink at night with no milk just boiling water added - the collagen protein -takes longer to digest and the protein is much slower overnight which helps reduce the nightly lows and alarms on my freestyle libre 2 overnight - collagen is also great for gut healing - and cacao is high in Polyphenols which are great for gut healing and anti inflammatory

A small handful of pistachios are also great ( reference Dr Gundry “yes no food list” for gut healing ) pistachios are low in lectins ( unlike almonds) to help gut healing as we all know diabetes and high sugar levels are inflammatory and healing your gut and lowering inflammation is a great place to start - Dr Gundry - Chris Kresser - Dr Hyman - Dr Sarah Ballantyne - are all great online references you can use for science based gut health / anti inflammatory and paleo “food is medicine” approaches to later onset type 1 to try to lengthen your honeymoon period as much as possible! I have a lower carb food approach with background insulin and no mealtime insulin with type 1 LADA slow onset - being pregnant will be different - hope you’re ok - Dr Sarah Ballantyne ( Paleo Mum) and Chris Kresser are both great resources online for nutrient dense foods for you and the baby!