Question about high bg at bedtime

[Shari68]

Hi,
The last couple of days my bloods have been running high between 11 - 13, I think it's due to a cold that's starting on me. I was taking a bit more fiasp insulin to try and bring it down. Last night just before bedtime my bg was 16. I took 4 units of fiasp and tested my bg 30 mins later, they had gone down to 11 so I went to bed.
At 1am I woke up taking a hypo, my bg was 4.2. I was full sweating, feeling disoriented and very light headed, staggering all over the place. It was a huge scare.

This is the first time I have had a proper hypo. I've had false ones after 1 was first diagnosed with LADA a couple of months ago, but not feeling half as bad as I did last night.

Anyway, my question is what should I have done to bring my bg down from 16 to 8 (which is the number my DSN said to be around, no lower)?

Thanks in advance.
Sharon

 

[searley]

Without knowing timescales it’s difficult but

There are many things to remember here.. fiasp is still working for up to 5 hours the peak of the action is 55 minutes after taking it... so depending on how long before you had you meal time insulin then the additional 4 stacking on top of it may have been just too much 30 minutes is not enough for the insulin to have even started working properly so bearing this in mind and the amount you had dropped in the last 30 minutes then it’s a bit dangerous to just goto bed as you have not even reached the peak of its action

For many T1. 1 unit of insulin will drop bg by upto 3 mmmol so in theory you took enough to potentially drop you to 4 more time and experience will tell you what’s right but for now you need to test more often to see the effects of the insulin

Secondly it could be your long acting insulin is too much but this is less likely in this instance


True clinical hypoglycaemia isn’t until you reach 3.9. So the effects you had is probably where your body is used to being high so it is warning you early I know I used to feel hypo at 5 in the beginning

 

[Shari68]

Thanks Searley. The both points you make, the 55 mins peak and 1 unit = 3mmols I did not know, so that's very informative

 

[searley]

Thanks Searley. The both points you make, the 55 mins peak and 1 unit = 3mmols I did not know, so that's very informative

It’s different for everyone and may change over time but a good starting point

Also remember how long before you had insulin because that may still be having an effect

You in the short term are better playing safe and taking slightly less until you get used to how it affects you..

Also keep a good record of bg’s what you eat and inject and at what time. This way you can discuss with your care team

 

[ert]

Insulin corrections should be with meals. DAFNE recommends waiting for breakfast and dosing for that with extra correction units added to your normal ratio. Remember 1 unit of FA is likely to drop you 3 mmol/l. So if you were at 16 mmol/l you may only need a correction of 2.5 units (not 4 which could drop your blood sugars 12 mmol/l).