High Night Time Readings

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Barnsley1978

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Hi all,

Still a newbie so may be another silly question.

I didn't eat after evening meal at 7 last night.

Went to bed with a reading of 9 and woke up to a reading of 18.

I had 16 Tojueu half an hour before bed.

Is this strange?
 
What was your evening meal? That is quite a dramatic rise but just wondering if it is at least partly down to "pizza effect" where a fatty meal like pizza or a creamy pasta dish or sometimes a rich lentil dish will release it's carbs much later than you would expect causing a significant rise overnight.

Other things to consider.... if this is a regular trend with your levels rising overnight, then your honeymoon period may be coming to an end and you perhaps need to increase your basal insulin dose, or perhaps you are coming down with a bug/virus. Sometimes increased BG levels are the first sign of impending illness as your body gears up to fight whatever infection it is, or possibly your Toujeo has been left somewhere warm and degraded. Of these options, your honeymoon period coming to an end or starting to come to an end, is the likely cause, I had 3 distinct steps when my basal needs increased over a period of a couple of months and then stabilized for a few months and then started to increase again as my remaining insulin producing beta cells were killed off. Overall it took 2 years from diagnosis for this to happen and then I have been pretty stable for the last 3 years, so if you are relatively newly diagnosed, that would be my best guess.
 
Evening meal was trying to be low carb, four sausages and sauerkraut. Had about 150g of full fat Greek yoghurt too.
 
There are a number of reasons why this is happening. It is useful to know what is happening to your BG whilst you are asleep which is what makes a Libre or other CGM really useful.
Assuming you use a basal (slow acting, once or twice a day) and bolus (fast acting with meals) insulin regime
- if your BG continued to rise throughout the night, it is likely your basal insulin dose is too low
- if your BG rose after eating and then plateaued (or went up slowly), it is likely you did not take enough insulin with your evening meal.
- if your BG went very low and then rose, this could be "somogi effect"- you had a hypo and your body realised so dumped a whole lotta glucose. You could have a "hypo head"(like a bad hangover without the fun of the night before) if this was the cause.
- if your BG was stable(ish) throughout the night until the early hours, this could be Dawn Phenomenon - a helpful glucose dump from your liver to give you energy to start your day.

In other words, "it depends".

Plus, there is the fun of increased insulin resistance with higher BG - and that insulin resistance applies to both bolus and basal insulins. So, if you did not have enough bolus with your evening meal your BG would get high which would make you insulin resistant and a normal basal dose may not be enough.

Do you carb count and adjust your bolus according to what you eat? Or are you on fixed doses?
 
Hi Helli,

Thanks for the reply.

I am on fixed at the moment.

My BG started rising about midnight then was 18 when I woke. I did some medium intensity exercise with no food and it peaked higher.

Attached my graph
 

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Barnsley1978 said:
I am on fixed at the moment.
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Were you given any indication how many carbs are assumed for your fixed dose? The reason I ask is that our body uses different amounts of insulin according to how many carbs we eat. You mentioned you tried to eat a low carb meal. This is not necessary with Type 1 and doing so whilst your DSN is trying to work out your dose (or insulin to carb ratio) will confuse things because low carb can make us insulin resistant. The usual advice is to eat as you intend to going forward.

Barnsley1978 said:
My BG started rising about midnight then was 18 when I woke.
Click to expand...
Actually, the graph looks as if it was stable (but higher than ideal) at midnight but the spike started at 3 or 4 am. It is hard to tell from a single day but this could be a combination of Dawn Phenomenon and a high BG leading to insulin resistance.
I would keep an eye on this tonight and contact your DSN if you experience the same.
Barnsley1978 said:
I did some medium intensity exercise with no food and it peaked higher.
Click to expand...
Again there are few things which may be happening.
- Foot on the Floor/starvation mode - if we do not eat when we get up, our helpful bodies assume we are starving so will continue to dump glucose until we eat. Some people are more susceptible to this than others.
- Exercise putting stress on the body - some exercise (typically resistance training) will push our BG up. But also, our bodies can feel stressed if we try to exercise when our BG is too high. For me, exercise with a BG in double figures is hard work, it's as if I can't get energy to my muscles, and raises my BG further. The frequent comment about exercising to reduce BG does not work for me.
 
Thanks all for the info,

I have been trying to eat low carb and maximum twice a day but it doesn't seem to be working.

I'm just surprised how much by BG rises with exercise.

The starvation mode might be a thing as you say but I don't feel hungry especially when I wake up.

I feel fine with the exercise even though my BG is high.
 
WHY on earth are you trying to eat low carb? Just eat your NORMAL meals at your NORMAL mealtimes.
 
Barnsley1978 said:
To try and keep my BG low.
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With Type 1, the way to keep your BG low is through the correct use of insulin not diet.
However, this will not be possible while you are on fixed insulin dose.

It is worth talking to your DSN about this. Meanwhile, start practicing carb counting even if you don't use it to calculate your insulin dose, it is useful to note the carbs in your meals and the affect on your BG to highlight the differences to you and your DSN.
 
Don't I still have to try and keep my carbs low? I thought it would help.

I have a call with a dietician Friday.
 
Barnsley1978 said:
To try and keep my BG low.
Click to expand...

No @Barnsley1978 It’s not the food with Type 1 - it’s the insulin! If you eat a sandwich and your blood sugar goes too high, that’s not because sandwiches are ‘bad’, it’s simply because your insulin wasn’t quite right (wrong amount, wrong timing).

The recommended diet for Type 1s is the same healthy diet recommended for people without diabetes. There’s zero need to eat very low carbs and it actually makes control harder.
 
Barnsley1978 said:
Don't I still have to try and keep my carbs low? I thought it would help.

I have a call with a dietician Friday.
Click to expand...

What will help is eating normally and getting your insulin right (which takes a little time). That’s what Type 1 is all about - being our own pancreas.
 
Barnsley1978 said:
But if I need more insulin with higher carb foods lowering the insulin will help?
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How will that help? And more than that, if you eat too few carbs your body will develop a form of insulin resistance which can mean you need more insulin not less.
 
I don't know. New starter that's why I'm asking.
I've been told carbs raise my BG so I have tried to restrict them. That's why I thought having less carbs would mean less insulin and less of a spike.
Also I thought exercise would make my BG go down that's why I am worried it's not normal.

Sorry, newbie with fixed mentality I think.
 
Yes, carbs raise blood sugar but that’s normal and what they’re supposed to do. Usually our pancreas deals with the carbs by releasing the appropriate amount of insulin so our bodies can use them. With Type 1, our pancreas can no longer do that as our immune systems have attacked and damaged it, so we have to take over its job by calculating and injecting insulin 🙂

Type 1 is a very different condition from Type 2 diabetes.

In the absence of carbs, your body will make glucose from protein and this usually causes a late rise in blood sugar hours after your meal. Also, too few carbs and your body thinks it’s in a famine so it will increase insulin resistance, sometimes shockingly so.
 
Barnsley1978 said:
Also I thought exercise would make my BG go down that's why I am worried it's not normal.
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Exercise can improve your insulin sensitivity.
However, the idea that exercise immediately reduces BG is not always true. It is another one if those "it depends..."
Typically, longer cardio will cause BG to go down whereas stop/start exercise (e.g. HIIT) and resistance exercise (e.g. weights) will cause it to go up.
There are other variables too such as BG, weather and your fitness.
For example, cycling is one of my activities.
If I pootle along the flat canal tow path, chatting to my mates, my BG is unaffected.
If I go for a blast around local undulating country roads for 30 minutes or more, my BG will go down.
If I trudge up a steep hill against the wind in the rain, my BG will go up.
 
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