Spiking BG

[SkylineFrontier]

Hi Forum,

Typically I have excellent control of my type one diabetes, with my HbA1c's consistently at 5.3 and 5.2. However over the last few days have been experiencing uncomfortable high peaks in my BG, during the late evening and throughout the night of and at around 11.8. It is also disrupting my sleep. Can anyone please offer advice?

 

[dancer]

We all have to make changes to our insulin regime, from time to time. This is probably your turn.

If you have a sharp rise 2 hours after your evening meal, increase your evening bolus. If your bolus is OK then it will be your basal that is the problem. Do you by any chance take a small snack (without bolus) before bed? If so, it could be time to leave out the snack. (I asked this because I was told to take a snack when I was on Lantus).

 

[Nuck]

How long have you been T1?

 

[tim2000s]

Hi @SkylineFrontier love the fifth element avatar! Welcome to the forum. The other question is how long have you been diagnosed? As @dancer says, we all have to adjust insulin amounts from time to time, whether that's simply body changes or whether that's down to illness, which this could be a precursor too, although for illness it tends to be constant. There's often no rhyme nor reason to it.

 

[SkylineFrontier]

Thanks for the advice, @dancer, @Nuck and @tim2000s it's appreciatedCheers for complimenting the avatar!@tim2000s!

I've been diagnosed 2yrs 5 months. The bolus dose appears to take effect following dinner resulting in a BG of 6.5. The rise occurs post 10pm without any snacks. I only snack before bed if my BG is below 6.4. I usually take my basal just before sleep. Should I be taking it earlier?

I've been on the same insulin regime since diagnosis and I find lantus to be quite aggressive.

 

[dancer]

Looks like the Lantus isn't lasting 24 hours. You should contact your DSN who might suggest splitting the dose. She might suggest changing to Levemir as I think this works better than Lantus, if splitting the dose is necessary.

 

[SkylineFrontier]

Thanks! It certainly looks that way. I'll change the time of dose, so I can monitor my BG response better, and attempt to talk to my DSN....

 

[himtoo]

Thanks! It certainly looks that way. I'll change the time of dose, so I can monitor my BG response better, and attempt to talk to my DSN....

Hi there @SkylineFrontier
welcome to the forum

with lantus just be aware that as a long acting insulin it can take a couple days for any changes in dose amount or timing to come through in readings , so tread carefully with your changes and make sure your DSN is up to speed with what you are doing.

all the best !

 

[SkylineFrontier]

Hi himtoo, thanks,

Will do

 

[noblehead]

Should I be taking it earlier?

You could try that, but you might just be shifting the problem if your basal dose is running out and not lasting 24 hours.

Certainly split-dosing may help or ask about switching to the new basal insulin called Tresiba, it's more expensive than lantus & levemir but it lasts up to 42 hours after injecting, I'll tag @robert72 as he uses this insulin and has had great success on it.

 

[SkylineFrontier]

You could try that, but you might just be shifting the problem if your basal dose is running out and not lasting 24 hours.

Certainly split-dosing may help or ask about switching to the new basal insulin called Tresiba, it's more expensive than lantus & levemir but it lasts up to 42 hours after injecting, I'll tag @robert72 as he uses this insulin and has had great success on it.

Hi noblehead,

Thanks for posting. I did try splitting the lantus does,once before over a different issue once,and it didn't work. Switching basal insulin sounds great.How do I go about asking to switch? I ask this because my medical team have always been abrasive and(I'm not kidding) bluntly authoritarian.

 

[noblehead]

Hi noblehead,

Thanks for posting. I did try splitting the lantus does,once before over a different issue once,and it didn't work. Switching basal insulin sounds great.How do I go about asking to switch? I ask this because my medical team have always been abrasive and(I'm not kidding) bluntly authoritarian.

I'm afraid you could only change after getting authorisation from your diabetes team, still worth asking just the same as nothing ventured nothing gained..................

 

[SkylineFrontier]

Yep, I agree there. I'll ask and seem what happens....

Thanks

 

[robert72]

Hi noblehead,

Thanks for posting. I did try splitting the lantus does,once before over a different issue once,and it didn't work. Switching basal insulin sounds great.How do I go about asking to switch? I ask this because my medical team have always been abrasive and(I'm not kidding) bluntly authoritarian.

hi @SkylineFrontier

I had trouble with Lantus not lasting 24 hours. I did try splitting the dose but I found it to be generally erratic. I had tried Levemir but had an allergic reaction to it at my injection sites, so I asked my consultant about Tesiba and he was happy for me to try it. My GP wasn't so thrilled as it's quite expensive, but I've been on it for almost 2 years now and find it works very well for me.

 

[SkylineFrontier]

hi @SkylineFrontier

I had trouble with Lantus not lasting 24 hours. I did try splitting the dose but I found it to be generally erratic. I had tried Levemir but had an allergic reaction to it at my injection sites, so I asked my consultant about Tesiba and he was happy for me to try it. My GP wasn't so thrilled as it's quite expensive, but I've been on it for almost 2 years now and find it works very well for me.

Hi robert72,

Thanks, good to know. I too found lantus to be erratic when splitting the dose. I will certainly start with my consultant, it's really worth a try as lantus is so aggressive, it puts me into hypo between 4-6am everyday. I have got use to this,but if there is alternative, it would be great to try. Cheers

 

[himtoo]

Hi robert72,

Thanks, good to know. I too found lantus to be erratic when splitting the dose. I will certainly start with my consultant, it's really worth a try as lantus is so aggressive, it puts me into hypo between 4-6am everyday. I have got use to this,but if there is alternative, it would be great to try. Cheers

the 3am slot was my problem area with lantus but deffo you should speak to the consultant-- one imagines you know the drill -- go in prepared with all readings and hypos and patterns clearly logged -- you won't leave him a leg to stand on

 

[SkylineFrontier]

Good idea! I'll be prepared this time, with printed CGM readings. He's only ever looked at my metre readings once. However, if I take a 30 day reading it's pretty undeniable

 

[B583]

Looks like the Lantus isn't lasting 24 hours. You should contact your DSN who might suggest splitting the dose. She might suggest changing to Levemir as I think this works better than Lantus, if splitting the dose is necessary.

I have found increasing the dosage of Lantus a unit or two at a time, see if that stretches the length & decreases the BG somewhat. Though having split my Lantus for nearly a year now, that I change accordingly, depemdingo nthe time of day required.
Having a similar problem myself at the moment, I searched on here for help too!! I have high's in the night & mornings from beingl ow in the evenings before dinner & sometimes bed. Any further suggestions would be grasteful.

 

[Sarahkylie88]

Hello,
I had exactly the same as you, I was on levemir and I would have a spike a couple ofhours before my long lasting insulin was due and it came on fairly suddenly. I was change to tresiba too and it was fab and much more flexible, when I went on holiday to America I didn't have to worry about the time difference because tresiba can last longer than 24 hours. As others have mentioned it is more expensive and some places don't want to prescribe it, but definitely worth asking X X X