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Type 1: Any advice welcome

scarfmad

Member
Messages
20
Location
worcestershire
Type of diabetes
Type 1
Treatment type
Insulin
Hello,
I know a lot of people on this forum are very knowledgeable, so I wondered if anyone could help with any suggestions. Diagnosed type 2 in May 16, then in June 16 rushed to A&E with ketoacidosis and stayed in hospital for a week and was discharged now being type 1. I take Lantus in the morning only but was taking it morning and night which has been constantly changed by nurse, and Novo rapid with food. Started the LCHF over a week ago blood sugars good.
Finally I get to my question I always had quite high bg before bed ranging from 12 to 23 mmol/l, but always wake up with good bg 5.1-6.3, even with bg 23 I wake with 5.6. So doing the LCHF before bed bg is now about 6.5 or in the 7 something, so I am being woken about 3 am with a hypo bg 2.1 and this has been for the last 4 nights.
I know I maybe still honeymooning, but could anyone suggest a snack before bed that will work with the LCHF. Every morning I wake up with what feels like a very bad hangover and just feel like I need a new battery just so exhausted, even though I haven't had any alcohol since April this year.
Sorry for rambling on and many thanks in advance.
 
Love the ***** cat! What medication are you on?
 
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@scarfmad Hi :)

Have you been shown how to carb count and match your insulin to your food? With Type 1 you have to 'be your own pancreas'. The book Think Like A Pancreas is really good with lots of info.

Most Type 1s here eat moderate amounts of carbs. You shouldn't need to LC to control your sugars (although, of course, you can choose to eat what you like). If you were having high sugars, then that would mean your insulin needed adjusting.

Now they're going low, then that might require an adjustment to your insulin too.

Have you spoken to your DSN? Have you been able to do any basal testing? Ideally, your basal insulin should keep your blood sugar steady overnight.

In the meantime, you could experiment with a small snack before bed eg a digestive biscuit and cheese. A digestive is approx 10g carbs so if that's too much or not enough, it's easy to increase or decrease the carb amount by adding halves of biscuit, etc. You could also try oatcakes.
 
@scarfmad Hi :)

Have you been shown how to carb count and match your insulin to your food? With Type 1 you have to 'be your own pancreas'. The book Think Like A Pancreas is really good with lots of info.

Most Type 1s here eat moderate amounts of carbs. You shouldn't need to LC to control your sugars (although, of course, you can choose to eat what you like). If you were having high sugars, then that would mean your insulin needed adjusting.

Now they're going low, then that might an adjustment to your insulin too.

Have you spoken to your DSN? Have you been able to do any basal testing?
Hello,

Thanks for your reply, yes I carb count and match my insulin to my food, and I am half way through the book.

Before starting LCHF I ate a very healthy diet chicken or fish and lots of vegetables, also too many almonds and brazil nuts I know they are low carb but not if you eat excess like I was. I didn't eat ready meals and hardly any sugar if any.

My nurse said I am still on my honeymoon, I saw my consultant last Friday and he said the same.

Thanks again
Julie
 
I've added some snack ideas to my post above :) It will be a case of experimenting to find what works for you.

I would let your DSN know though as it may be that a slight change to,your basal will help.
 
Heya @scarfmad - what time do you have your evening meal ? also are you doing a correction dose based on the reading you get before bed ?
 
Having the confidence for adjusting your basal is going to be your key to stop the hypos at 3am.
Yes, perhaps you will need a snack (or want to) at bedtime. However, you shouldn't have to......

It maybe that you are only needing one basal insulin (if you are taking two) or if you are taking one basal that you may want to split it in to two doses.. and the evening dose can be lower to try and stop the 3am.

To stop my 3am lows I've had to change my basal insulin and take it at 4pm. Its effects have largely worn off by 3am. However, this has left me with rises from 4am onward..

There are different ways to stop 3am hypos. It will be experimenting but you need to do this with reading good books like "think like a pancreas" and with the backing of hospital people.
 
Heya @scarfmad - what time do you have your evening meal ? also are you doing a correction dose based on the reading you get before bed ?
Hello,
Thanks for your reply, evening meal about 7/7.30 pm, don't do a correction before bed as I have tried that and I ended up dropping like I am now and having hypos, I am very fortunate as in the night I don't have the sweating just shaking with hunger so to speak and it does wake me. Trouble is I am not experienced enough and so you sort of go into panic mode and raid cupboards (not quite that bad) I have learned now not to over eat with a hypo, because I then have to deal with the high bg later.
 
Having the confidence for adjusting your basal is going to be your key to stop the hypos at 3am.
Yes, perhaps you will need a snack (or want to) at bedtime. However, you shouldn't have to......

It maybe that you are only needing one basal insulin (if you are taking two) or if you are taking one basal that you may want to split it in to two doses.. and the evening dose can be lower to try and stop the 3am.

To stop my 3am lows I've had to change my basal insulin and take it at 4pm. Its effects have largely worn off by 3am. However, this has left me with rises from 4am onward..

There are different ways to stop 3am hypos. It will be experimenting but you need to do this with reading good books like "think like a pancreas" and with the backing of hospital people.
Hello,
Thanks for your reply, I take my Lantus at 9 am now but I have taken it at 6 am and then I went on morning and night doses 6 am and 11 pm, then 6 am and 6 pm, now as I said one injection now 9 am. All the above have had the same effects that is why I had to come off night time. My last injection is my novorapid with my dinner about 7/7.30 pm.
The nurse says it is honeymoon and it will sort it self out.

The one thing which does bug me, I try really hard to eat healthy all day then at night time I have to try to get my bg high so I don't wake with hypo, which seems waste in one respect of my time and energy put into to my diet and bit of exercise I make myself do (only some walking and not very far, but several times a day)
 
Having the confidence for adjusting your basal is going to be your key to stop the hypos at 3am.
Yes, perhaps you will need a snack (or want to) at bedtime. However, you shouldn't have to......

It maybe that you are only needing one basal insulin (if you are taking two) or if you are taking one basal that you may want to split it in to two doses.. and the evening dose can be lower to try and stop the 3am.

To stop my 3am lows I've had to change my basal insulin and take it at 4pm. Its effects have largely worn off by 3am. However, this has left me with rises from 4am onward..

There are different ways to stop 3am hypos. It will be experimenting but you need to do this with reading good books like "think like a pancreas" and with the backing of hospital people.
I am halfway through the book.
 
Hello,
Thanks for your reply, I take my Lantus at 9 am now but I have taken it at 6 am and then I went on morning and night doses 6 am and 11 pm, then 6 am and 6 pm, now as I said one injection now 9 am. All the above have had the same effects that is why I had to come off night time. My last injection is my novorapid with my dinner about 7/7.30 pm.
The nurse says it is honeymoon and it will sort it self out.

The one thing which does bug me, I try really hard to eat healthy all day then at night time I have to try to get my bg high so I don't wake with hypo, which seems waste in one respect of my time and energy put into to my diet and bit of exercise I make myself do (only some walking and not very far, but several times a day)

Totally understand thoughts around the frustration eating extra to stave off hypo's.

Have you only tried lantus? I didn't find lantus good for splitting in to doses but levemir was better and insulatard for me is quite good.

However, are you happy with your day time levels and have you done any basal testing to see wheter there is room to lower the lantus more? Have you got 1/2 unit pens?

There is another newer insulin (degludec) tresiba that health professionals could consider you for..
 
Hi. There is a hint in your readings that the Basal may be slightly too high as the big BG reduction during the night when the Lantus is running out may be showing that the Basal is too high. I assume you are at present using the standard Bolus ratio of 1 unit to 10gm of carb? I use Levemir which is marginally more predictable but I don't split it but many do. Lantus lasts 18-24 hours whereas Levemir is only 12-18 hours. I would stick with the Lantus unless you and the nurse find you can't get it right together with the Bolus. Although you may well be in the honeymoon, as I was a few years back, it should really only affect the size of the shots and these would gradually need to be increased over time as mine have.
 
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