That's probably why I end up high in the morning...Thanks will keep trying
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Goodbye Lyumjev
- Thread starter Charl
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Hi @Charl
I have never used Tresiba, so can't really offer technical advice, but as @rebrascora asked what are these types and quantities of snacks that you have in evening or during night?
Lucyr
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Sorry I don’t understand this point. If you already put whatever is needed by your bed but are waking up high then you’re overtreating, use less of whatever you put there.
Lucyr
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If they’re not either to prevent a hypo or to keep you up after a hypo, but rather just because you’re hungry, then you should be taking insulin for them
If you are having to eat these every night to prevent or treat hypos then you need to fix your insulin doses to stop needing the snacks
rebrascora
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So, do I understand correctly that you are going to bed quite early around 9pm? If so then you probably need to try to eat earlier than 7pm because ideally you want to be going to bed about 4 hours after injecting your insulin, so that most of it has been utilized and there is very little active insulin left.
Can you also tell us exactly what you had as a snack yesterday or how many carbs when you were 8.2 and dropping and was it because you were hungry or because you were worried about your levels dropping? Did you have any other snacks after that through the night? Just trying to understand why your levels went up to mid teens which seems to be a bit of a trend from the posts I have read.
I just have portions of Jelly Babies by the bed for if my low alarm goes off and I will usually only have one (5g carbs) or two (10g carbs) depending upon what my levels are and if the arrow is horizontal or sloping downward or if the graph shows they have dropped significantly from going to bed. The general advice is that 10g carbs will raise your levels by about 3mmols so one jelly baby will raise my levels 1.5 mmols. If my alarm goes off at 4.5 then 1 jelly baby should take me up to about 6mmols and 2 should take me up to 7.5.
You do have to check any night time low alarms with a finger prick though, as lying on the sensor can cause a false low often referred to as a compression low, so unless you wake up with obvious hypo symptoms then it is wise to double check before you treat. I keep all my testing kit by the bed.
The info and graphs you have supplied this afternoon suggest that this is not a basal insulin issue, but that you are either over treating lows (or impending lows) or eating snacks at bedtime unbolused because you are hungry. It is probably better to have a more filling meal earlier and not need to snack at bedtime and then just have however many carbs you need to push your BG up a bit if you are a little low, like just 5g carbs or whatever you need to get your levels up to about 8. If your basal dose is right, then provided you don't eat any more through the night, you should then wake up about on about 8mmols in the morning and then you will find your morning levels don't need much of a correction and your NovoRapid will be more effective.
It would appear to be the snacks which are the issue. Not that it is wrong to snack, but if your levels are not low, then you will need to inject insulin for the snack, especially if you still have food from your evening meal digesting as you will if it is only 2 hours later.
Can you also tell us exactly what you had as a snack yesterday or how many carbs when you were 8.2 and dropping and was it because you were hungry or because you were worried about your levels dropping? Did you have any other snacks after that through the night? Just trying to understand why your levels went up to mid teens which seems to be a bit of a trend from the posts I have read.
I just have portions of Jelly Babies by the bed for if my low alarm goes off and I will usually only have one (5g carbs) or two (10g carbs) depending upon what my levels are and if the arrow is horizontal or sloping downward or if the graph shows they have dropped significantly from going to bed. The general advice is that 10g carbs will raise your levels by about 3mmols so one jelly baby will raise my levels 1.5 mmols. If my alarm goes off at 4.5 then 1 jelly baby should take me up to about 6mmols and 2 should take me up to 7.5.
You do have to check any night time low alarms with a finger prick though, as lying on the sensor can cause a false low often referred to as a compression low, so unless you wake up with obvious hypo symptoms then it is wise to double check before you treat. I keep all my testing kit by the bed.
The info and graphs you have supplied this afternoon suggest that this is not a basal insulin issue, but that you are either over treating lows (or impending lows) or eating snacks at bedtime unbolused because you are hungry. It is probably better to have a more filling meal earlier and not need to snack at bedtime and then just have however many carbs you need to push your BG up a bit if you are a little low, like just 5g carbs or whatever you need to get your levels up to about 8. If your basal dose is right, then provided you don't eat any more through the night, you should then wake up about on about 8mmols in the morning and then you will find your morning levels don't need much of a correction and your NovoRapid will be more effective.
It would appear to be the snacks which are the issue. Not that it is wrong to snack, but if your levels are not low, then you will need to inject insulin for the snack, especially if you still have food from your evening meal digesting as you will if it is only 2 hours later.
Usually go to bed around 10, usually eat around 7 o'clock if possible.my snacks had been cream crackers ,crisps, milk ,was feeling hungry plus thought my readings were low considering it was only 9pm, should I have bolus for them, my evening insulin was under 3 hours. Thanks
Inka
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If you’re high, insulins like Novorapid can take more than 2hrs until you start to see a drop, and then it can be quite sudden, eg a small drop of a couple of mmols, then suddenly going down. I wouldn’t have doubled your correction like that.
With bedtime snacks without insulin, I found it best to stick to the same carbs at the same time. I usually ate the same thing too. If you keep it more casual, it’s easy to eat more than you need. If you’re hungry top up your bedtime carb snack with non/low carby items like nuts or a raw carrot, or meat, cottage cheese, hard boiled egg, etc.
Thanks...Obviously I'm going to have to change my evening snacks to something less carby.
Inka
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A few grams of carbs are usually ok. I have a bedtime carby snack when on injections, but I find I do need to stick to an amount rather than just graze on them because I try to avoid bolusing at bedtime. If you’re happy to bolus at bedtime, you can eat more carbs, but IMO it’s safer and less stress to not have that insulin on board.
W
Was going to do the night time basil test but a low reading has changed that, must have overestimated the carbs in my evening meal, now is probably the time when I would have a snack attack to get my readings up before bed, any suggestions for something to have to get my readings up before bed, last bolus insulin was around 2hrs ago. Thanks
Was going to do the night time basil test but a low reading has changed that, must have overestimated the carbs in my evening meal, now is probably the time when I would have a snack attack to get my readings up before bed, any suggestions for something to have to get my readings up before bed, last bolus insulin was around 2hrs ago. Thanks
Lucyr
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Personally with 5.4 I’d likely just leave it and keep an eye on it, unless I had something particularly fast acting for dinner but you know your body best.
Thanks for that advice, I did leave it and carried out my overnight basal test, i think, had nothing to eat or drink from 6.30pm , still woke up on 13.6 but hey ho could have been worse. Thanks
rebrascora
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That is a pretty useful basal test as it is a nice straight line and a very uniform slope indicating that you do appear to need a basal increase after all!
Proud to be erratic
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If that overnight
This is so that you aren't chasing something that isn't really representative because if you aren't confident it's repeating you'll struggle to get a basal you can depend upon and then any tinkering or tweaking of bolus will inevitably not quite work. A day or 2 now getting that confidence in your basal will prove to be time very well spent and once your basal is fixed you'll probably not need to alter it again until late spring when the real warmer weather comes. Whenever you change your basal do then wait at least 3 days to get your own peace of mind that the new dose is where you want it to be. Patience while waiting is really worthwhile.
If this graph is similar to previous overnight graphs, then great just nudge your Tresiba up by, I suggest, no more than 10%. But if you don't have a clear repeat then leave this for at least one more night.
This is so that you aren't chasing something that isn't really representative because if you aren't confident it's repeating you'll struggle to get a basal you can depend upon and then any tinkering or tweaking of bolus will inevitably not quite work. A day or 2 now getting that confidence in your basal will prove to be time very well spent and once your basal is fixed you'll probably not need to alter it again until late spring when the real warmer weather comes. Whenever you change your basal do then wait at least 3 days to get your own peace of mind that the new dose is where you want it to be. Patience while waiting is really worthwhile.
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