32 years and still need help!!

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thompson4984

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Type 1
Hey guys and gals,

Been type 1 for over 30 years but recently I've been having some issues at night, well more early morning!
So over the past week or so I have been woken up around 4/5am by my dexcom alarm going off for a hypo alert. The only way I've been able to stop this is to bump up my sugar levels to about 18 but then by the morning I'm down to about 7 or 8.
Nothing new in my routine and most evenings are spent chilling on the sofa so no obvious reasons for it to me!
 
thompson4984 said:
Hey guys and gals,

Been type 1 for over 30 years but recently I've been having some issues at night, well more early morning!
So over the past week or so I have been woken up around 4/5am by my dexcom alarm going off for a hypo alert. The only way I've been able to stop this is to bump up my sugar levels to about 18 but then by the morning I'm down to about 7 or 8.
Nothing new in my routine and most evenings are spent chilling on the sofa so no obvious reasons for it to me!
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Any reason why you can't cut your basal? 🙂 Do you actually check with a finger poke? I ask because it's not unknown for a compression low if you have been sleeping on your sensor.
 
Pumper_Sue said:
Any reason why you can't cut your basal? 🙂 Do you actually check with a finger poke? I ask because it's not unknown for a compression low if you have been sleeping on your sensor.
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I have dropped it. Yes do check not everyone but they seem accurate lows
 
thompson4984 said:
Injections, tresiba 200 and yes, not every one but they seem accurate
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Then I’d reduce your Tresiba more if you’re dropping that much overnight. What time do you have your evening meal?(just checking your bolus will have gone).

Have you had hypos during the day as well as the very early morning?
 
Inka said:
Then I’d reduce your Tresiba more if you’re dropping that much overnight. What time do you have your evening meal?(just checking your bolus will have gone).

Have you had hypos during the day as well as the very early morning?
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What could be causing the sudden change? Usually about 5:30 the whole family sits down for dinner.

No no hypos during the day. Daytime running a little high at the moment
 
thompson4984 said:
What could be causing the sudden change? Usually about 5:30 the whole family sits down for dinner.

No no hypos during the day. Daytime running a little high at the moment
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I don’t know @thompson4984 Has coeliac been ruled out and other conditions that can cause hypos? If you’re tending to go high during the day and low overnight, you could switch to a twice daily basal and that would allow you to have more insulin during the day and less at night.
 
Inka said:
I don’t know @thompson4984 Has coeliac been ruled out and other conditions that can cause hypos? If you’re tending to go high during the day and low overnight, you could switch to a twice daily basal and that would allow you to have more insulin during the day and less at night.
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My wife and daughter are coeliac so most of our dinners are gluten free, have a review in couple of weeks so will speak to medical team about insulin change maybe
 
My basal need wobbles up and down through the course of the year. And one of the telltale signs is generally that meal doses or corrections aren’t behaving normally, or that levels overnight aren’t stable.

Have you ever come across the idea of basal testing? It was probably 20 years before I came across the idea, but it made a huge difference to how ‘random’ my diabetes felt. It’s a method of checking that your basal is only doing its job of holding you roughly level through the 24hrs when no bolus insulin is acting. If your basal is set high it’s quite possible to have artificially reduced meal ratios and correction factors (because your BG is generally trending downwards). Or the reverse can be true. Rapid doses can be higher to combat rising BG to make up for basal shortfall - which then means they don’t scale well, and you are fighting a losing battle!

If you think it might help, there’s a write-up of how to check your basal dose here:
https://www.mysugr.com/en/blog/basal-rate-testing/

Tresiba works over a very long timeframe, so if you end up tweaking your dose, make sure you leave it a few days between adjustments for it to settle.

Hope you manage to get it sorted without too much faff. 🙂
 
I'm curious - firstly your basal insulin is which? then I'm interested to know which basals you've used this century (ie comparatively recently) and why they were discarded in favour of such a long lasting and hence not quickly adaptable brand, and how long you've now been using it? Finally - which Dexcom do you use.
 
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