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HELP- Bedtime hypo

G

gkitty

New Member
Relationship to Diabetes
Type 1.5 LADA
Pronouns
She/Her
I was treated as a type 2 for 10 years before seeking private medical care. The doctor changed my diagnosis to type 1.5 lada and put me on insulin. I was taking 30 units basal and approx 20 short term. 4 week ago I was prescribed mounjaro and the results have been staggering. My levels dropped so much I have reduced and completely come off all insulin.
However I am suffering with a strange side affect and wondered if anyone else had experienced this.

My levels are steady all day around 6. They rise with dinner but are returning to a healthy read within 2 hours (No meds). As soon as I go to bed, around a reading of 9 and start to relax I plummet to a hypo almost immediately. This is happening every night so I'm having to treat with sweets and toast!

Any theories?
 
Welcome @gkitty 🙂 Do you use a CGM? If so, do you fingerprick to check the hypo (CGMs can have false lows overnight sometimes)? And finally, how low does your blood sugar go?
 
gkitty said:
I was treated as a type 2 for 10 years before seeking private medical care. The doctor changed my diagnosis to type 1.5 lada and put me on insulin. I was taking 30 units basal and approx 20 short term. 4 week ago I was prescribed mounjaro and the results have been staggering. My levels dropped so much I have reduced and completely come off all insulin.
However I am suffering with a strange side affect and wondered if anyone else had experienced this.

My levels are steady all day around 6. They rise with dinner but are returning to a healthy read within 2 hours (No meds). As soon as I go to bed, around a reading of 9 and start to relax I plummet to a hypo almost immediately. This is happening every night so I'm having to treat with sweets and toast!

Any theories?
Click to expand...
Are you checking the owls that you are having at night with a finger prick test? If you are using a sensor it is possible to get compression lows where you lie in the sensor and it changes the readings and shows a false hypo. This would often show with a steep descent and recover quickly once you move. Always worth checking these with a finger prick.

When you go low in the night how low are the readings? If we have a hypo it is important to treat this with about 15g of carbs and then wait. Sweets and toast could be an overload of glucose.

It is to hear that your levels have settled and that you are now managing without insulin. What tests tap did they use to determine that you are Type 1.5? It is unusual to be able to manage without any insulin as with this condition there is a gradual destruction of the beta cells so the only way of getting insulin is by injection. A person with T2 who then start using insulin does not become a T1 or T1.5 (LADA. These are totally different conditions, often confused in adults as some of the symptoms are similar. Worth getting clarification regarding your T1.5.
 
The drop is immediately as soon as I get into bed. The cgm reading will go 'arrow down' and drop very fast very rapidly to 3.5. As its happening regularly I start to treat before it drops below 4 with the 15/15 rule. It's literally as soon as I close my eyes.

I agree regarding getting a second opinion of my diagnosis of type 1.5.
 
gkitty said:
The drop is immediately as soon as I get into bed. The cgm reading will go 'arrow down' and drop very fast very rapidly to 3.5. As its happening regularly I start to treat before it drops below 4 with the 15/15 rule. It's literally as soon as I close my eyes.
Click to expand...
I agree with @Inka and @SB2015 that lows from a CGM need to be double checked with a finger prick.
It may be that you are lying on your sensor and causing a compression low - pressure on the sensor is stopping the flow of the interstitial fluid to the sensor so it is "making up" a false low. This is most common to happen when we are in bed.
It is rare for someone taking no insulin to regularly experience hypos so I woudl definitely be checking the CGM for confirmation.
 
On seeing your post, my thoughts were, are you relying on the CGM saying it thinks your going low or FP testing to confirm this is the case,
I usually shower in the evening and my libre readings go up then (depending how hot & long my shower is) then obviously on laying down we have to account for possibly of compression lows
 
Ok so as per usual my cgm has just gone off as I lay down to relax
Definitely not compression as laid on opposite side.
Cgm reading 3.6 finger prick test 8.6!!!

What the hell... so now I don't trust these sensors at all. It's not a faulty sensor as changed 2 days ago and both doing same thing.

Cant believe it's so far out...
 
You can get false lows without compression. Sometimes clothing ‘pulls’ it but sometimes it’s the angle/twist of the muscle or flesh as you lie down @gkitty Sometimes this can be avoided by careful placing of the sensor.
 
Tried sitting upright without any tension on my arm- from clothes/muscle or otherwise. Relaxed and guess what alarm went off again. 3.7. FP said 8 so I ignored alarm and it then did a sensor error for 10 mins. Cam back on and had jumped back up to 5.2 with no record on the graph of the hypo reading.

These sensors appear to be extremely temperamental and now wondering what the point of wearing it is if I'm ignoring the alarm!
 
I don’t know much about Mounjaro @gkitty but if you’re not taking insulin or other meds that put you at risk of hypos, you might be better off stopping using the CGM.
 
Yes thats what I'm thinking. It's a complete waste of time really.

Unless mounjaro can reduce sugar levels enough to cause hypos?
 
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