Basal insulin and night hypos

[Northerner]

Northerner,

The results that a CGMS will give you are very useful indeed. I had one ove three days last October. Despite it being up and running over the weekend of my eighteenth birthday the results were a little unusual but it was well worth it.
However, I did find having that thing plugged into me a rather uncomfortable experience. Despite this the results that I got were worth the couple of days pain.

Tom H

Thanks Tom - where/how is it connected?

 

[Freddie99]

Hi Northerner,

It's connected by inserting a small plastic/metal sensor under the skin of your abdomen. This is done using a cannular. It's not painful the insertion and is not too dissimilar from the pump. It's also taped down into place using a large clear plaster.
Despite the discomfort it gave me the results were worth it.

Tom H

 

[sofaraway]

Hi Northerner,

It's connected by inserting a small plastic/metal sensor under the skin of your abdomen. This is done using a cannular. It's not painful the insertion and is not too dissimilar from the pump. It's also taped down into place using a large clear plaster.
Despite the discomfort it gave me the results were worth it.

Tom H

When i had mine I didn't find it uncomfortable to wear. the only thing was on the 3rd day I wanted to take it off as it was itching and starting to feel sore under the dressing holding the cannula in place. I think it was because i had played football and sweated alot making it itchy

 

[Freddie99]

When i had mine I didn't find it uncomfortable to wear. the only thing was on the 3rd day I wanted to take it off as it was itching and starting to feel sore under the dressing holding the cannula in place. I think it was because i had played football and sweated alot making it itchy

I reckon that it was just the location of the cannular, just a little too close to the rib cage for comfort. Apart from that the itchiness whenever I started to sweat was nigh on unbearable. Other wise no real discomfort apart from a little trouble walkin just after it was put in and a bad night's sleep. Stupidly I slept on my front which was where the damn thing was connected to.

Tom H

 

[Northerner]

I've had similar problems with Lantus. The options I tried were splitting my dose, which unfortunately didn't work for me, and changing the time of my dose. I now take my Lantus at lunchtime, which apparently makes me a bit odd, but it works for me. I still drop a little bit during the night, but I only have to snack if it's below six, and even then only something that's about five carbs.

The other thing is, is that there is a pen which goes up in one unit increments. Maybe you could ask about that, and try 19 units? 🙂

With my lovely new green pen, I tried a reduction of 1 unit last night. I was surprised at the effect that such a small reduction made, and also surprised - although logically I should have expected it! - that it was half the effect that a 2 unit drop had on me!

Thus, 1 unit causes an increase in fasting levels (in me) of around 2 mmol/l.
2 units causes an increase of around 4 mmol/l.

This means that my fasting levels are around 6 - 6.5 mmol/l, which is still within my desired range, but I think I might try changing the timing of the lantus next. I'll give this a couple of days though, just to check that it's consistently raising me.

 

[mikep1979]

i know my pct is now trying to swap everyone over to pumps as they are finding it is giving most type1's better control. however the only problem as most have found is funding. my pct thinks it may have found the answer to this problem tho. id advise you to ask about a pump northerner and just see what the response is as they can only tell you off what you say and as i always say i know more about my diabetes than my consultant as i have to live with it day to day.

 

[randomange]

With my lovely new green pen, I tried a reduction of 1 unit last night. I was surprised at the effect that such a small reduction made, and also surprised - although logically I should have expected it! - that it was half the effect that a 2 unit drop had on me!

Thus, 1 unit causes an increase in fasting levels (in me) of around 2 mmol/l.
2 units causes an increase of around 4 mmol/l.

This means that my fasting levels are around 6 - 6.5 mmol/l, which is still within my desired range, but I think I might try changing the timing of the lantus next. I'll give this a couple of days though, just to check that it's consistently raising me.

I discovered the same thing when I was trying to find the right dose - it's amazing the effect one unit can have! I'm glad to see it seems to be working better for you. 🙂

 

[mikep1979]

grrrr last night before bed bg was 6.8 woke at 2:49am to find i had a bg of 1.8!!!!! had a couple of detrose tabs and waited to check bg again at 4am and it was 6.2 fine and off to bed again. woke this morning to find it was 11.7!!!!! aaarrrrrrgggggggghhhhhhhhh!!!!!!!!!!!! i want a pump now!!!!!!!😡

 

[emma1972]

Mike, You probably corrected your hypo just before your liver stepped in with a good old sugar dump to save you.
happy days!

 

[mikep1979]

lol probably emma but its so annoying!!!!

 

[Northerner]

Update

Well, after several weeks of 'toying' around I've come to the following conclusions:

I do have nighttime hypos, but very rarely. Or, at least, I'm not having them very often at 3 am!

The hypos seem to be related to levels of activity during the day, or even the day before. If I go for a long run then I have found I need to reduce bolus and basal insulin for up to 36-48 hours afterwards. Having a lantus pen that lets me adjust in single units is very helpful in this respect, as a 2 unit adjustment is too much.

If I'm relatively low at bedtime (e.g. below 6.0), I have to have a snack. Peanut butter on seeded/granary bread works best.

After 8 months I'm gradually getting used to all the little factors that you have to take into consideration - and many thanks to all here who have offered advice and pointed me in the right directions🙂

 

[Lizzie]

Wow, have you really only been diabetic for 8 months, Northerner? I thought it must have been much longer, you give such good and detailed advice.

 

[bev]

Yes Northerner i thought you were an old hand at it all!

Just wanted to add that Alexs pen does half units - although it is a junior pen - but it has helped us sort out his night time levermere to 8.5. Its amazing what a difference half a unit makes! Bev