Basal issues...

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Freddie99

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Relationship to Diabetes
Type 1
Ok folks this is the issue. I now take my levemir at about eight in the evening. Now as a student I'm normally up into the small hours and awake rather late. The thing I have noticed over the past few nights is that without any fast acting in my system (despite having to correct and deal with ketones on a few evenings this week) my bloods have dropped. I can wake up at seven ish in the morning to get a glass of water and test my blood which comes out to be in range (four to ten millimoles per litre) but if I then go back to sleep until say ten I've shot up to about fifteen millimoles per litre.
My theory is that my basal makes me hypo and then I bounce back. This is quite possible as my hypo awarness is on the way out and I sleep like a dead man.
When the nurse last saw my blood spreadsheets she told me to increase my levemir gradually. However, this seemingly had no effect. Prior to going to uni I had my basal just so. This was because I'd reduced it from split dose to a single dose of twenty four units in the evening. You see, my last DSN (coincidentally the one who has looked after me since diagnosis) thought that I was getting too much basal. I think she was spot on. Trouble is that my current DSN doesn't see it that way.

I suppose I must come to the conclusion of my dissertation and ask the burgeoning question does anybody have a flaming clue? My levemir at the moment is at twenty six units.

Tom
 
I find that if I wake up normal time I'm in range but a lie in makes me rise. Also have the same if I get up but don't eat for a while. I'd put it down to dawn phenomenon/ the effects of not eating for so long.
Interestingly , I'm on lantus and also on 26 units a day and my dsn has said several times that she thinks I'm on too much. Pretty sure I'm not hypoing in the night though, I have pretty good awareness and wake up fom night hypos (usually caused by panic correcting before bed)
 
Ah my DSN said that I should raise my insulin in the evening because I wasn't showing typical symptoms of night hypos. I know what you mean about lying. I think I will just have to start getting out of bed earlier!
 
I'm the same if I get up and then return to bed without eating - I show a rise (although not a big one, maybe 2 mmol/l). Funnily enough, if I am having troubled/little sleep but don't get up and return to bed it doesn't happen! I'm guessing that if your body 'wakes up' a bit too much, that's when your liver kicks in with a glucose dump thinking (as though it's independent of your brain!) that it needs to give you the boost to start the day. This boost, as we know, normally stops if we eat something - hence why it rises if you get up but don't eat for a long time. Just my thoughts!

Regarding basal doses, I am currently on 7 lantus reduced from 20 and it is nigh on perfect. As I wasn't sleeping well last night I tested a couple of times when I woke. I had gone to bed at 4.7 (plus toast and marmalade), was 5.7 at 3 am, 6.0 at 4:45 am and 4.0 on rising at 8 am. I think I am incredibly lucky that it is working so well for me - long may it continue!
 
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