Confusing night…

[Jimmy2202]

Hi guys.
wondering if some of you professionals can shed some light into proceedings during the night? 🙂

so, we had a late tea last night (gammon roast) around 8pm. Injected 4 units novarapid.
Went to bed 10pm with bloods at 9.0
Perfect.
Woke up around 3.30am so decided (as it’s new to me) to scan my arm and I had a reading of 19.4!
this morning 7.30am I’m glad to see my levels down at 10.0
Now - as I would never normally finger prick at 3.30am if I woke I never have known if this has happened in the past?! But given I now have the libre I’m naturally going to test in the night should I wake.

thanks in advance

 

[Ivostas66]

Do you have the Libre 1 or Libre 2? The 2 has alarms, which can warn you (loudly and somewhat annoyingly!) of high and low readings. When you checked at 10pm which direction was the arrow next to the 9? This gives an indication of the direction of travel - if I had an upwards arrow, I would have been tempted to have a glass of water, wait a while and then check again before potentially having a correction dose of insulin. For me a 9 prior to bed is a bit on the high side, but that is because 9 is the top of my personal 'range'.

What did the gammon roast consist of by the way? A meal that has carbs and fat can have a much slower release of glucose than carbs on their own. For example pizza - if I eat it, which is rare, I tend to become excited a few hours afterwards as my BG remains fairly constant (e.g. test and it says 6ish, carb count and inject, check my BG for the next few hours and it remains fairly constant below 8). But I am then woken by my Libre in the night telling me that I have spiked, often around 15 or 16.

One final thing is timings of meals. My DSN told me very early on that consistency at mealtimes can work wonders. Changes to mealtimes can cause issues. I know that if I eat after 7pm it can cause difficulties managing my BG. I try not to beat myself up if we are out for a meal and it is 8pm or later, and I see spikes in BG. And... don't forget the clocks went back yesterday - it always takes a few days for my body to adjust to that.

 

[Jimmy2202]

Do you have the Libre 1 or Libre 2? The 2 has alarms, which can warn you (loudly and somewhat annoyingly!) of high and low readings. When you checked at 10pm which direction was the arrow next to the 9? This gives an indication of the direction of travel - if I had an upwards arrow, I would have been tempted to have a glass of water, wait a while and then check again before potentially having a correction dose of insulin. For me a 9 prior to bed is a bit on the high side, but that is because 9 is the top of my personal 'range'.

What did the gammon roast consist of by the way? A meal that has carbs and fat can have a much slower release of glucose than carbs on their own. For example pizza - if I eat it, which is rare, I tend to become excited a few hours afterwards as my BG remains fairly constant (e.g. test and it says 6ish, carb count and inject, check my BG for the next few hours and it remains fairly constant below 8). But I am then woken by my Libre in the night telling me that I have spiked, often around 15 or 16.

One final thing is timings of meals. My DSN told me very early on that consistency at mealtimes can work wonders. Changes to mealtimes can cause issues. I know that if I eat after 7pm it can cause difficulties managing my BG. I try not to beat myself up if we are out for a meal and it is 8pm or later, and I see spikes in BG. And... don't forget the clocks went back yesterday - it always takes a few days for my body to adjust to that.

Thanks for reply.
I use a Libre 1
standard roast for us - I’d say about a carb content of 100g
It’s as if my novarapid didn’t work, and the roast kicked during the night when I was asleep ‍♂️

 

[Inka]

Two things occur to me @Jimmy2202 : the later meal and the clock change. I find eating late can often cause unusual spikes as said above. On pens (I have a pump now), I always found some weirdness the day after the clock changed. For me, that was usually unexpected lows, but it could go the other way too.

Added to all that, if you’re in your honeymoon period, then your own insulin will work erratically so the same meal can sometimes give different results.

I don’t have a Libre but always test if I wake up. It only takes seconds. If this is a one-off, I wouldn’t worry about it. Just try to eat earlier normally and keep this in your mind in case you get a repeat, but don’t concern yourself too much for now.

 

[Ivostas66]

As you are early in your diabetes journey, I would suggest keeping in touch with your DSN/ consultant and running things by them if you are uncertain. What is your carb counting ratio @Jimmy2202? Mine is 1:11 for most meals, and has been since diagnosis, but I have adjusted to 1:8 for breakfast over the past couple of years due to spikes. A dose of 4 for around 100g of carbs suggests yours is 1:25. Is this what you have agreed with your DSN?

As you are in the dreaded honeymoon period, as Inka suggests above, things can be a bit hit and miss when it comes to doses of insulin and how your body reacts. As my DSN said after one of my first big (unexplainable) hypos, "imagine that your pancreas woke up from a deep sleep and suddenly realised it had a job to do and kicked out some insulin before promptly falling back to sleep, that's what the honeymoon period can be like".

 

[Thebearcametoo]

Your Libre will be good for getting the data of what’s going on overnight and it may be that your basal needs to go up a bit but I wouldn’t take 19 on face value as we always found Libre to be less accurate the more out of target it was. As others have said it may be a late spike from your meal rather than anything too concerning. If there’s a pattern over the next week or two of being higher than target in the morning then that suggests your basal needs tweaking but your team can help you advise if you send them the data.

 

[Jimmy2202]

As you are early in your diabetes journey, I would suggest keeping in touch with your DSN/ consultant and running things by them if you are uncertain. What is your carb counting ratio @Jimmy2202? Mine is 1:11 for most meals, and has been since diagnosis, but I have adjusted to 1:8 for breakfast over the past couple of years due to spikes. A dose of 4 for around 100g of carbs suggests yours is 1:25. Is this what you have agreed with your DSN?

As you are in the dreaded honeymoon period, as Inka suggests above, things can be a bit hit and miss when it comes to doses of insulin and how your body reacts. As my DSN said after one of my first big (unexplainable) hypos, "imagine that your pancreas woke up from a deep sleep and suddenly realised it had a job to do and kicked out some insulin before promptly falling back to sleep, that's what the honeymoon period can be like".

Yes I’ve worked out my ratio is about 1:25
Thanks for your reply