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Bedtime Test

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mum2westiesGill

mum2westiesGill

Well-Known Member
Relationship to Diabetes
Type 1
Bearing in mind you might have to eat something to put BS levels up a bit, how long before going to bed would you do your bedtime test?
 
For me it's usually about 15 mins or so, although my situation is different to most as I don't have any basal insulin to worry about. So, if I'm 4.5 when I test, I can just have a jelly baby or Belvita biscuit to raise my levels a little and be fairly sure that will be sufficient. Of course, it would depend how low I was - If I was below 4 then I'd probably have some thing then put off going to bed a bit so I could retest to make sure my levels had come up 🙂
 
we usually do it about 10 mins or so before bed -if H has a reading under 7 and has been playing football during the day then 2 rich tea biscuits. mind you he went to bed on 11.7 the other week and found himself at 2.8 at midnight{ a footy day} so far only 2 night time hypos in a year .
 
These days I am usually in bed before actually sleeping, so I would normally do it before I plan to shut my eyes........
 
Why would you need to eat something to raise your levels? If you need to eat to keep your BG steady in the night, you're taking too much insulin.
 
DeusXM said:
Why would you need to eat something to raise your levels? If you need to eat to keep your BG steady in the night, you're taking too much insulin.
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Perhaps if your evening mealtime bolus had sent you a bit low? There are more factors involved than just insulin, can anyone accurately adjust for exercise earlier in the day for example? Easier to have a little extra carb than to try adjusting a basal dose which may or may not have an effect anyway.
 
I dont eat anything before bed either, but my dose is right........🙂

There are a lot of folk out there who have something out of habit when its not really needed.....
 
DeusXM said:
Why would you need to eat something to raise your levels? If you need to eat to keep your BG steady in the night, you're taking too much insulin.
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so would you go to bed on 5.7 without doing anything ? having played football all afternoon {H does take a unit off -ratio 1-12 lunch so has 9-1 lucozade sport during footy etc after 1/2 hour? so 2 rich tea before bed -next morning 6.9.
 
DeusXM said:
Why would you need to eat something to raise your levels? If you need to eat to keep your BG steady in the night, you're taking too much insulin.
Click to expand...


Like Northerner says there can be more factors involved than just insulin. We're all different. In my case it's too much basal so at the moment I'm reducing this until I get some ok levels.
 
Hmm depends who we are talking about really doesn't it? I'd happily go to bed at 5.7 knowing my basal is great all night and of course as adults we plan stuff a bit more than little kids do so fine, if this always happens on a Thursday cos it's footer you could disturb his sleep by doing a night time basal test then set a different basal pattern for Thursday nights, but is your child going to automatically swap his basal pattern back to 'normal' day if he gets to school and Mr Bloggs the games teacher is off sick?

Or even tell you that when he gets home ....
 
trophywench said:
Hmm depends who we are talking about really doesn't it? I'd happily go to bed at 5.7 knowing my basal is great all night and of course as adults we plan stuff a bit more than little kids do so fine, if this always happens on a Thursday cos it's footer you could disturb his sleep by doing a night time basal test then set a different basal pattern for Thursday nights, but is your child going to automatically swap his basal pattern back to 'normal' day if he gets to school and Mr Bloggs the games teacher is off sick?

Or even tell you that when he gets home ....
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Plus, on a pump you're not stuck with one basal for 24 hours!
 
delb t said:
so would you go to bed on 5.7 without doing anything ?
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Depends. A reading like that is what I strive for at all times so if I was confident in my ability to match my basal to my liver output, then yes, I would do nothing. If I'd been playing football all afternoon, I would reduce my basal dose rather than eat. It is much better to prevent hypos by taking less insulin rather than by eating more. Eating more when technically you don't need to increases insulin resistance and causes weight gain. This is the main reason why many T1s end up overweight after a few years of treatment, as we're always told to stuff ourselves with excess food to provide fuel for a hormone which purposefully promotes fat storage.
 
DeusXM said:
Depends. A reading like that is what I strive for at all times so if I was confident in my ability to match my basal to my liver output, then yes, I would do nothing. If I'd been playing football all afternoon, I would reduce my basal dose rather than eat. It is much better to prevent hypos by taking less insulin rather than by eating more. Eating more when technically you don't need to increases insulin resistance and causes weight gain. This is the main reason why many T1s end up overweight after a few years of treatment, as we're always told to stuff ourselves with excess food to provide fuel for a hormone which purposefully promotes fat storage.
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But a reduction in basal dose if you're on one injection a day could have repercussions the following day when the effects of the exercise are fading, leading to higher pre-meal levels that then require extra bolus to correct. It would also depend on how much basal you injected as well - for me it would have been impossible to make a fine reduction in dose when I was on 5 units or less, far easier to top up with a little extra carb.

Going back to the OP, she is currently reducing basal to combat hypos, but is not sure how far the reduction should go and is still prone to hypos, so her situation is not stable and it is better for her to feel secure in her overnight levels.
 
With the OP on mind then, the logical course of action would be to not eat before bed, test and then eat if required, while making a careful note of the carb content and then monitoring in the night to see how things change.
 
I've just checked my DAFNE book and the recommended BG before bed is 6.5 to 8 - lower than this risks a hypo which you might want to risk if you have very good hypo awareness but it is a risk. Surely better to keep your BGs at the DAFNE recommended levels before bed than risk having a hypo that you don't notice. There are also a lot of people on MDI who cannot keep their BG stable during the night whatever they do. Personally unless my BG is too low I never eat before bed BUT if it was that or risk a hypo that I didn't know about then I would have a snack. If you are always able to keep your BGs stable at 5.7 you are incredibly fortunate, but for very many Type 1 diabetics this just isn't possible on injections, however hard they try which is why we are here to offer help and support.
 
AJLang said:
I've just checked my DAFNE book and the recommended BG before bed is 6.5 to 8 - lower than this risks a hypo which you might want to risk if you have very good hypo awareness but it is a risk. Surely better to keep your BGs at the DAFNE recommended levels before bed than risk having a hypo that you don't notice. There are also a lot of people on MDI who cannot keep their BG stable during the night whatever they do. Personally unless my BG is too low I never eat before bed BUT if it was that or risk a hypo that I didn't know about then I would have a snack. If you are always able to keep your BGs stable at 5.7 you are incredibly fortunate, but for very many Type 1 diabetics this just isn't possible on injections, however hard they try which is why we are here to offer help and support.
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i think it's all very individual. many years experience and frequent tweaking and testing of my basal rates and i correct if my bg is above 5.0 when i go to bed; i also set my alarm and test at 1am. for me the idea of going to bed with bg @ 6.5-8.0 is ludicrous, and very poor advice considering the average humans beings tendency to require more insulin overnight. but then dafne courses are about teaching things that i would define common sense and the introduction to books like "think like a pancreas" or "pumping insulin" wouldnt even be covered in dafne. on mdi its perfectly possible to have excellent control if you work hard, i kept my hba1c @ around 6% for years. its not about fortune its about working hard understanding your body and acting accordingly.
 
I would agree with the comment that a drop in nighttime basal could have repurcussions for control - in terms of high levels, the following day- unless basal requirements were also similarly reduced for the duration of that dose
One of the reasons why I am more a fan of split basal dose and my regimen of choice after the pump would be mdi with split levemir- and if this was not availabe- lots of experimentation with lantus or consider split isophane
 
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