Hi, Claire,
Has your Dr ever suggested testing a different regular insulin? Perhaps the Humalog and Tresiba aren't getting along so well? Also, are you counting your carbs? And what kind of diet are you on?
Humalog is quick acting and short living, but has a peak of 1-2 hours. I would really like to know how many carbs you're having with the amount of insulin you're taking. Insulin/carb ratio, again, very important. Humalog can live as short as 2 hours in your system, so if you're still processing or releasing sugar from your meal after 2 hours, naturally, you will need more of that insulin. If you're eating a high carb, high fat, high protein meal, you are absolutely going to struggle with balancing those glucose levels. Remember, simple carbs act fast, but complex carbs act slow and over time. So, if you're combing them in excessive amounts, you are going to have multiple spikes spread out.
Not to mention, once you get above 200 mg/dl (11.1 mmol/L), it is increasingly difficult for the body to properly process the insulin and thus requires even larger amounts of insulin to correct the issue. Unfortunately, once the insulin finally starts working, it can hit all at once and cause glucose to crash. So, steady monitoring is also essential here. Do you have a CGM? Constant glucose monitoring device. These are highly beneficial.
Our bodies do interesting things during the evening/sleep time. One of those is releasing stored glucose. My husband and my son are both type 1 diabetics. My husband does better on an insulin pump that can actively pump small doses of regular insulin into his body throughout the night, so he isn't waking up with high glucose levels and having to inject himself at 2 or 3 or 4 in the morning. My son had to switch his long acting insulin dose from night time, to morning, because his glucose would drop dramatically at night after taking it.
There are multiple things to consider and discuss with your Dr. Hopefully they listen to your concerns? Based solely on the information you've given us, I'd personally suggest being more strict about the meal you have at night - keep it lean and low carb, count the carbs and adjust your quick acting insulin dose based on that. Eat earlier in the evening. Consider going for a walk or implementing some other workout routine in the evening - exercise does wonders for diabetics. Wonders. Oh, and don't forget to calculate your protein. A lot of diabetics don't know that protein must also be accounted for, just like carbs. For every 20g of protein, consider counting 10g as it were carbs.
Diabetes is tricky. There is never going to be a set standard for what needs to be taken. You have to literally consider every detail of your routine and try to decide what is going to work the best for you, personally, because no diabetic experiences the same routine or the same reaction as another. This is hormones in a nutshell. Best of luck!
