Hi everyone,
After 3 years of very tight control (and feeling very grateful at how lucky I have been with the ease of control) in the past few weeks I have been really struggling.
I currently take 10 units of Tresiba before bed at around 10pm and my I:C ratio is now about 1 unit per 10g (used to be more like 1:20)
A typical day goes like this:
- I wake up @ 6-8mmol / inject 3 units for breakfast / have a small spike to 9mmol or so and then remain nice and steady at 5-7mmol until lunch
- Take 3 units for a low carb lunch / stay steady at 4-7mmol all afternoon
- Units for dinner vary, but even if I have a low carb meal and bolus with very high accuracy this is what happens:
* Inject 30-45 mins before eating to restrict spike;
* Assuming I carb counted and bolused correctly, I'll stay steady in the 5-8mmol range from eating dinner at c. 8pm until going to bed at 11pm (occasionally I will split-bolus or add an additional bolus depending on what I am eating and if my Dexcom shows me creeping up)
* I'll go to bed at 11pm-ish with my Dexcom showing me nice and steady at 5-6mmol
* My Dexcom alarm will then go off between 12am to 3am and I'm suddenly at 11-14mmol???!??!
* I'll bolus but still end up spending the whole night higher than I would like (e.g. 8-11mmol); sometimes my alarm will sound again at 4/5am because I'm still high despite the middle of the night bolus, so I'll take yet another bolus but still be in the 6-8+mmol range on waking.
Previously, I've had perfectly stable overnight sugars and would almost always wake up in the 4-5mmol range. The only time I'd have highs in the middle of the night is if I had a high fat/high carb meal (e.g. pizza/pasta) and the delayed digestion, understandably, spiked me. But now it's happening regardless of what I have dinner, even if it's a salad or low carb option.
Any ideas what's going on here or tips for things I can try?
I always thought our bodies needed LESS insulin at night but I seem to need more.
I'm reticent to increase my Tresiba given my daytime levels seem okay but maybe that's the first thing to try?