corrections at bedtime?

[lauraw1983]

Tell me something.....why do my corrections at bedtime if I take them not work like they would at other times?🙄

It is just because once we go to bed we are obviously not active at all? 🙂p)

We were out for a (rare) meal last night and while I knew my carb count wouldn't be quite right I didn't think it was far off. We went to the cinema after and I had checked my levels a couple of times, think they were around 8 or so but still some active insulin on board and didn't want to risk a hypo anyway, would sort it when home if still a bit high.

By the time I got home 14.7! RARGH. My meter calculated a correction of 2.5u which I did along with my basal and went to bed.

This morning still 13.1. 😡

This has happened quite a few times lately hence asking here - a once off would be ok.

I ate chicken breast with olive, caper & tomato sauce with rice (small bowlful and I left about 1/2 of it). And we shared some foccacia bread which I carb counted like pizza as it was just like a thin pizza base with basil and cherry tomatoes. 6.5u taken. Level was 8.0 before eating.

At the cinema 2 (small!) scoops of Ben and Jerrys (naughty!) Level was 8.2 and took 4u. This might have been well off I guess - not something I usually ever eat!? I tried to look it up online but in the cinema proved a bit difficult lol.

21:10 - 9.5 (figured I'd sort a correction when home)

23:00 - 14.7 😡 2.5u correction

7.20 - 13.1. 4u correction taken and not had breakfast yet, but will check it again shortly.

I realise it's not a "typical" evening but it's more my question about these (late?) night corrections - why do they seem to do nothing!?

Even if I have a snack later at night....and bolus accordingly for it....my levels will not do what they would in the daytime with the same insulin?!

 

[Northerner]

I have hardly ever corrected before bed, so just speculating. I wonder if the fact that you are not moving around and your heart rate will be reduced as you sleep means that the insulin is not being absorbed as quickly as it is during the day?

 

[DeusXM]

Your ratios and correction factor will change throughout the day as a result of your metabolism. At night, your metabolic processes will alter, which means your insulin requirements will alter.

 

[everydayupsanddowns]

Lots of variables involved. For me the biggest 'unknown' is usually how much *food* is still going. Insulin seems relatively predictable, but absorption profile of food seems to vary wildly in different combinations for me. Next time you do an ovenight/late night correction I'd be tempted to set a 3am alarm to see what the state of play is then (correction bolus will be pretty much spent at that point for the scenarios you've suggested)

 

[lauraw1983]

Your ratios and correction factor will change throughout the day as a result of your metabolism. At night, your metabolic processes will alter, which means your insulin requirements will alter.

Well yes. My ratios are different for breakfast to lunch and dinner. How do I work out what correction factor might be needed at bedtime....I take split Levemir (soon as I get up and about 10.30/11 at night) and obviously worry about night hypos if I took too much fast acting it'd peak in the early hours!

What are your ratios?

 

[lauraw1983]

Lots of variables involved. For me the biggest 'unknown' is usually how much *food* is still going. Insulin seems relatively predictable, but absorption profile of food seems to vary wildly in different combinations for me. Next time you do an ovenight/late night correction I'd be tempted to set a 3am alarm to see what the state of play is then (correction bolus will be pretty much spent at that point for the scenarios you've suggested)

Blah 3am alarms 😉 Thought someone might say that....😛

 

[lauraw1983]

Also....7.4 now.

Injected 4.5u for 30g carbs about 10 mins ago, going to eat in next 10-15 mins.

 

[Pumper_Sue]

Hi Laura,
2 things spring to mind.
Being over 13 would give you insulin resistance, thus more of a correction needed in that dept.
Also the meal plus the ice cream would probably take quite a time to go through your system. Hence insulin spent before food absorbed.
Some of the foods eaten would cause what is known as the pizza effect, end result high bs at a later date 😱

 

[lauraw1983]

Hi Laura,
2 things spring to mind.
Being over 13 would give you insulin resistance, thus more of a correction needed in that dept.
Also the meal plus the ice cream would probably take quite a time to go through your system. Hence insulin spent before food absorbed.
Some of the foods eaten would cause what is known as the pizza effect, end result high bs at a later date 😱

Hmm yeah - why don't these clever meters take the insulin resistance thing into account....that would be handy! Though I guess the point is it should NOT be that high...ever. 🙄

Yeah I figured the foccacia might do that....I don't often eat pizza these days as I hate trying to work it out but thought that was more related to the cheese being loaded on top too and the fat delaying it! The rest of the meal had little saturated fat (except the ice cream later obviously!)

 

[bennyg70]

Hi Laura,
2 things spring to mind.
Being over 13 would give you insulin resistance, thus more of a correction needed in that dept.
Also the meal plus the ice cream would probably take quite a time to go through your system. Hence insulin spent before food absorbed.
Some of the foods eaten would cause what is known as the pizza effect, end result high bs at a later date 😱

Im with this one... Catches me out a lot, and the bain of my life.

 

[Pumper_Sue]

Hmm yeah - why don't these clever meters take the insulin resistance thing into account....that would be handy! Though I guess the point is it should NOT be that high...ever. 🙄

Yeah I figured the foccacia might do that....I don't often eat pizza these days as I hate trying to work it out but thought that was more related to the cheese being loaded on top too and the fat delaying it! The rest of the meal had little saturated fat (except the ice cream later obviously!)

Do you think the rice also played a very big part? I know it would do with me.

 

[DeusXM]

My ratios are different for breakfast to lunch and dinner. How do I work out what correction factor might be needed at bedtime....I take split Levemir (soon as I get up and about 10.30/11 at night) and obviously worry about night hypos if I took too much fast acting it'd peak in the early hours!

What are your ratios?

Mine vary dramatically throughout the day. For the mornings I've had to give up eating carbs full stop - they run somewhere worse than 1:5. Lunch tends to be around the 1:10 mark and dinner is around 1:12. But again, this also varies dramatically depending on what I eat. My correction factors get even more complicated. Generally it's about 1u to 3mmol/l but in the evenings this can drop to as much as 1u to 1mmol/l. Then, to make things worse, there are days when for various reasons. I just don't eat very much at all, maybe less than 1200 cal. The next day, I'll find my correction factor is more like 3u to 1mmol/l as my liver starts to get panicky.

 

[trophywench]

Oh it's just one of diabetes' little myseteries, ain't it?

I had a very small amount of popcorn (yep sweetened) at the flicks last week, landed up with stratospheric BG at bedtime.

Last night we went again, I ate shedloads and jabbed 2u as no idea of the carbs - and was hypo at the end of the film. Only like 3.2 not flat out, but tedious. Came home went to bed - 12.0 this morning .....

I think your body just kicks up when you feed it anything different LOL

Correction rates - well if your carb ratio is different then yes presumably your correction rate would be different too.

So can I ask a Q of pumpers? if your carb ratio is different at X o'clock, is your basal rate different at that time too? - baecause your body doesn't differentiate between what's bolus and what's basal so presumably if it's insulin resistant at X o'clock, it's resistant to both? I dunno cos my carb ratio and correction rates are the same all day.

You can't judge this on MDI because you have no way of telling how much basal your bod is using at any partic time, can you?

 

[Pumper_Sue]

So can I ask a Q of pumpers? if your carb ratio is different at X o'clock, is your basal rate different at that time too?

Do you mean correction ratio? If so yes corrects differs through out the day.
Basal is obviously different day and night and by the hour in some places.

 

[Dory]

TW - my basal, bolus and correction ratios are all independentfrom each other and are all different during the day.

Laura - I'm having this exact same problem, in fact it happened last night - went to bed at 11pm with it being 10.1, meter gave a correction dose of 6.4 (well it was slightly under that; I'd had 5 grapes as well so the 6.4 includes a 0.7 bolus dose), but this morning i still woke up with it reading 12.0 at 7am. had the same breakfast as other days, gave myself the same bolus as usual, and the relevant correction dose....yet at 11am it's still 10.9.

I've come to the conclusion that was posted previously - ie eating late/just before bed leaves a lot of food (and thus carbs) 'floating' in your body - is right. I know I need to change something, somewhere, to sort that but that's a question I can't seem to work out myself (and a lot of attempts at basal testing are proving useless at the moment).

 

[everydayupsanddowns]

So can I ask a Q of pumpers? if your carb ratio is different at X o'clock, is your basal rate different at that time too? - baecause your body doesn't differentiate between what's bolus and what's basal so presumably if it's insulin resistant at X o'clock, it's resistant to both? I dunno cos my carb ratio and correction rates are the same all day.

I think mine tend to go in pairs... If bolus rate is more insulin, then correction rate is more insulin, vice versa - having said that there's not a great deal of variation tbh. My 'worst' time is breakfast where I typically just pretend to Artoo that I'm having 10-15g more CHO than I actually am. Except on the weekends when if I add the extra I end up in hypo-city

Tch! Diabetes eh!

 

[Hanmillmum]

Carb ratios, correction doses and basals change throughout the 24 hours with my dtr. Breakfast is most resistive which reduces as the day procedes, then she is incredibly sensitive over night to any insulin - this is reflected in her lowest basal rates and correction rates ( have to be esp careful with this).

 

[lauraw1983]

TW - my basal, bolus and correction ratios are all independentfrom each other and are all different during the day.

Laura - I'm having this exact same problem, in fact it happened last night - went to bed at 11pm with it being 10.1, meter gave a correction dose of 6.4 (well it was slightly under that; I'd had 5 grapes as well so the 6.4 includes a 0.7 bolus dose), but this morning i still woke up with it reading 12.0 at 7am. had the same breakfast as other days, gave myself the same bolus as usual, and the relevant correction dose....yet at 11am it's still 10.9.

I've come to the conclusion that was posted previously - ie eating late/just before bed leaves a lot of food (and thus carbs) 'floating' in your body - is right. I know I need to change something, somewhere, to sort that but that's a question I can't seem to work out myself (and a lot of attempts at basal testing are proving useless at the moment).

What meter do you use?

It is sooooo frustrating!!

 

[lauraw1983]

Do you think the rice also played a very big part? I know it would do with me.

Well my other tests with rice at home have never shown it to be a big problem for me - but I often sub rice for cauliflower rice anyway.

however at home I only eat basmati rice and the rice last night was much shorter fatter grains (more like risotto type stuff?? it was an italian restaurant) so I suppose that might...but I wouldn't imagine a great deal?

 

[lauraw1983]

On the correction ratio thing.....

I might need to refer to my book at home but I'm sure DAFNE just had a blanket rule for corrections, that 1u would bring most people down by 2-3mmol (obviously this needs worked out) but not that it changed at different times of the day?

I had my meter set at 1u for 2mmol but was having hypos so switched it back up to 1u for 3mmol. I wonder if for morning and evening I need to have it on 1u for 2mmol drop and leave the daytime as 3mmol....hmmmm.