Type 1 Struggling with my pre-bed target of 8.5

[JBlaza]

Hi all
I was diagnosed with Type 1 on 1st June so this is still all very new and I am looking for input on how other people manage their pre-bed levels. I have been told my my consultant that I should be at least 8.5 before I go to bed.

I currently eat my dinner at about 7:30pm and go to bed at 10pm. I am currently matching my insulin to my carbs with my evening meal, so when I test at around 9:30pm I tend to be in the 5-8 range. If I was over 6.8, an arbitrarily picked number on my part, I have just gone to bed as is and kept my background insulin on 5 (I am on Levemir). I am waking up at 6am feeling fine with levels around 6. If I was below 6.8 I would have a snack such as fruit with a blob of greek yoghurt, or a hot chocolate made the old fashioned way with chocolate and hot milk. I haven't bothered testing again and again feel ok in the morning, or maybe a bit groggy as I know I don't sleep as well with this snack.

However, when I saw the consultant I got in trouble for this as I should be recording over 8.5 before I go to bed! I am currently doing this by eating a more substantial snack by adding biscuits, but my quality of sleep is taking a big hit. My pre-bed readings have not gone over 10 so I don't think it is really my sugar levels that are the problem, rather that I am trying to digest while asleep.

What do you all suggest? I see my options as:
- taking less insulin (Novorapid) with my evening meal so I stay higher after that.
- finding high-sugar snacks that are lighter. Clearly I could eat some sugar or sweets to make myself spike but I am guessing the whole point is to avoid hypos overnight and I don't see how really high GI would help.
- ignoring my consultant - but would I know if I was having hypos overnight unless I test?

I also find the concept of wanting to be 8.5 before bed conflicting with trying to keep my HbA1c down.

Thanks!

 

[himtoo]

Hi JBlaza
welcome to the forum

this fits in with the classic "you can live how you like" stories the medical people trot out at us yet in "real" life things aren't always that easy and straight forward.

the main thing i would say is for the time being as you are very newly diagnosed -- just take some time to learn how you feel when you stay in a routine -- it is only 7 weeks so far -- i would be just taking it 1 day at a time right now - there is plenty of time in the future to figure out when to ignore your consultant

I would myself be looking at possibly eating a bit earlier if possible as you are going to bed only 2 1/2 hours after taking fast acting insulin ( 5 hour duration ) , I always try to eat at about 6:30 and I go to bed about 11pm so I am confident that my before bed blood glucose reading is going to stay fairly level throughout the night

another thing to mention is that in these early days your body may still be producing some of it's own insulin ( honeymoon period )
which is why you might not be seeing any levels over 10.

at the risk of sounding boring and repetitive --- just take things slowly and don't worry too much about the overall levels in these early days -- plenty of time to get your control tightened up to HbA1c's of below around 6.5% ( 45-48 )

all the best

 

[urbanracer]

Hi all
I was diagnosed with Type 1 on 1st June so this is still all very new and I am looking for input on how other people manage their pre-bed levels. I have been told my my consultant that I should be at least 8.5 before I go to bed.

I currently eat my dinner at about 7:30pm and go to bed at 10pm. I am currently matching my insulin to my carbs with my evening meal, so when I test at around 9:30pm I tend to be in the 5-8 range. If I was over 6.8, an arbitrarily picked number on my part, I have just gone to bed as is and kept my background insulin on 5 (I am on Levemir). I am waking up at 6am feeling fine with levels around 6. If I was below 6.8 I would have a snack such as fruit with a blob of greek yoghurt, or a hot chocolate made the old fashioned way with chocolate and hot milk. I haven't bothered testing again and again feel ok in the morning, or maybe a bit groggy as I know I don't sleep as well with this snack.

However, when I saw the consultant I got in trouble for this as I should be recording over 8.5 before I go to bed! I am currently doing this by eating a more substantial snack by adding biscuits, but my quality of sleep is taking a big hit. My pre-bed readings have not gone over 10 so I don't think it is really my sugar levels that are the problem, rather that I am trying to digest while asleep.

What do you all suggest? I see my options as:
- taking less insulin (Novorapid) with my evening meal so I stay higher after that.
- finding high-sugar snacks that are lighter. Clearly I could eat some sugar or sweets to make myself spike but I am guessing the whole point is to avoid hypos overnight and I don't see how really high GI would help.
- ignoring my consultant - but would I know if I was having hypos overnight unless I test?

I also find the concept of wanting to be 8.5 before bed conflicting with trying to keep my HbA1c down.

Thanks!

You will very likely know about night time hypo's, we tend to wake up quickly in a hot sweat when it happens. I keep Lucozade beside the bed these days, but since I started doing that I haven't actually needed it!!

If you're lucky, you will find that your overnight BS drops are consistent. Mine were very consistent for a while but seem to vary wildly at the moment. Sometimes I drop 2mmol, sometimes 4mmol, haven't noticed any pattern yet.

 

[endocrinegremlin]

Your dinner is not out of your system, nor is your insulin, when you are going to bed. Novorapid will take at least 4 hours to go through your system. If you are going to bed feeling ok and waking up with a good level and carry on as normal. These are fantastic numbers for so early in your D life! Explain to your Dr that it isn't out your system. They might be thinking you are falling later but you have just as good a chance of rising or staying the same. Given you are waking up on 6 there is nothing to suggest anything is going wrong during the night at the moment.

also, your dr is only saying that now. They sure won't want you over 8.5 later. Seems you are just ahead of the progress curve at the moment.

 

[JBlaza]

Thanks all. I can't move my evening meal any earlier as I don't get home from work until 7, and I don't want to go to bed later as I need my sleep and get up at 6. It is just frustrating being set guidelines that don't seem to work for me. I have no problem changing things again in the future if I need to but I am a strong believer that if it isn't broken don't fix it