Going low in the small hours

[Tdm]

Wondered if anyone can help?
Over the last couple of week i've been woken up by my dexcom at around 3am.
I take novorapid for tea, no later than 7pm, so that should run out about midnight.
I take 2 units of abasaglar/glagarin basal insulin which is 24 hrs. I take it with my evening meal. As my dose is so low its not really practical to change it, but it tends to keep me level overnight. Apart from the above mentioned 3pm.
I have tried taking by basal later, at 11pm, but that has no effect on the 3am alarm. I have tried eating a snack before bed, but that doesn't help - my blood sugars still manage to go low at 3pm. They are then ok for rest of the night.
Any thoughts?

 

[Inka]

Could you try 1 and1/2 units to see how that works @Tdm ? It’s strange that this has just been happening over the last couple of weeks. Perhaps your basal needs have dropped a little?

 

[Pumper_Sue]

Have you checked with your meter to see if you are actually low? If you are low and you feel it's impractical to lower your basal, could you have a small snack before bed?

 

[trophywench]

My goodness @Tdm - it's just what normal bodies do! It's that time of the night when anyone without diabetes has their lowest BG too. The sort of thing that makes me say to OH, Oh buggrit, according to this (meter or Libre) it looks like I am human, after all! (Blimey, never? when did that happen then? is a typical response)

I think you've got to give Inka's suggestion a go really but if you only have a 1u pen, might have to do that and then fathom out what to do about the aftermath of that. Any such fixes can never be regarded as permanent anyway.

 

[SB2015]

Has it been a lot hotter where you are, especially over night? That does have a big impact.

Well worth getting a half unit pen. When you are on low doses it makes a lot of difference

 

[Tdm]

My goodness @Tdm - it's just what normal bodies do! It's that time of the night when anyone without diabetes has their lowest BG too. The sort of thing that makes me say to OH, Oh buggrit, according to this (meter or Libre) it looks like I am human, after all! (Blimey, never? when did that happen then? is a typical response)

I think you've got to give Inka's suggestion a go really but if you only have a 1u pen, might have to do that and then fathom out what to do about the aftermath of that. Any such fixes can never be regarded as permanent anyway.

I kinda though that may be the case. My consultant also suggested it may be linked to hot weather. I have changed by duvet to the lightest tog ( i know i should have done that before now) which may help. I will report back.
I don't think abasaglar comes in half unit pens. Levemir does, but don't you take half as much twice a day? So it wouldn't help either. I did ask my consultant but he didn't think it was a goer. I assume my badal needs will increase when i am out of the honeymoon period.
I have half unit pen for novorapid and 2 spare. Not entirly sure how that happened, but at least i have a back up to my backup.

 

[Inka]

You could swap to Lantus (the original glargine insulin) as there’s a half unit pen for that. It’s Junior Star or something similar.

 

[SB2015]

I have changed by duvet to the lightest tog ( i know i should have done that before now) which may help. I will report back.

Finally switching duvets is almost a guarantee that the weather will change!!!

I hope that you get things settled. The half unit pens seem a good plan.

 

[Tdm]

Well, i did go low, but it was later, about - i had a late correction dose of insulin and the low would seem to correspond to that running out (i often go lowish as a kick in the tail of novorapid running out)
Will try again tonight, but its looking promising

 

[trophywench]

That in itself is exceptionally weird to me. I know - because Patti and others all said so - that Humalog absolutely has 'a sting in it's tail' - but I've used Novorapid for well over 20 years by now - and have never, ever, found it doing that. Plus I don't recall anyone else having an issue with it - cos I'm sure I'd have noticed since it is 'me' and yes afraid we all do take more notice of things that could affect us personally however open minded we are.

Not suggesting that you don't have this prob @Tdm - we are absolutely all different - but from DI - the forerunner of DSF onwards - it's the same length of time I've been using forums and engaging with queries etc from so many different people, I would have thought someone might have mentioned it being an issue before, really.

Wonder if it's more to do with your own production of (late?) Phase 2 insulin?

Such things are sent to try us. And they do.

 

[Tdm]

Yup, still in honeymoon so could be that. It never used to do it, but its been doing it for a month or so. Probably just one of those things

 

[SB2015]

Yup, still in honeymoon so could be that. It never used to do it, but its been doing it for a month or so. Probably just one of those things

When I was in the Honeymoon Period my pancreas used to go on strike for ages, have a bit of rest and then decide to start playing again with no warning, so your blip could very well be that sort of issue.
I remember my consultant’s advice: ‘You need what you need’ so I had to make changes to my doses to deal with these blips.

 

[everydayupsanddowns]

Yup, still in honeymoon so could be that. It never used to do it, but its been doing it for a month or so. Probably just one of those things

A month of regular nightly lows is pretty grim @Tdm

Have you seen what happens if you suspend your basal for a few days?

At 2u for 24 hours (tbh at low doses it may not be lasting all 24?) you’d be on something like 0.08u per hour - so it seems likely you have some home-grown insulin filling the gaps.

Have you discussed that possibility with your Dr? I’d guess they are keen to knock those nightly lows on the head?

 

[Tdm]

Well, got a undisturbed nights sleep, so going to a thinner duvet seems to haveworked

 

[trophywench]

How low did your BG go last night at that time then?

 

[Tdm]

About 6.5 at 3am, it went lower later. Its amazing the difference the tog on your duvet can make

 

[Robin]

Levemir does, but don't you take half as much twice a day? So it wouldn't help either

I switched to Levemir to help with my 3am lows. You take it twice a day, but you can split the doses unevenly. I currently take 5 units in a morning, and 3 at bedtime. Also, because it’s flexible, in that it doesn’t hang around in the system, you can alter the dose to suit what you’ve been doing. If I've had a couple of glasses of red wine with my evening meal, I lower my overnight dose to 2.5 or even 2, because red wine always sends me lower. As does exercise, I have been known to skip my nighttime dose altogether if I've had a particularly strenuous day.