I’ve just been diagnosed with type 1 diabetes. Question?

[alexeddude]

Hi there,
My name is Alex and just been diagnosed with type 1 diabetes. I’m age 21 and worried about going to bed because I may have a hypo during the night. I wouldn’t sleep if my reading shows between 0-6. My short term is Noverapid(average of 14 units) and tresiba (40 units)
What’s the best thing to do before bed so my levels don’t drop over night?

 

[Ljc]

Hello @alexeddude, welcome to the forum and the club no one wants to join.

I am very concerned about that 0-6 figure and hope it is a misprint ?
Your team should have given you a safe figure to go to sleep on, if they haven’t or you have forgotten then please cont@ct them ASAP, as you are newly diagnosed they will be expecting you to h@ve lots of questions as with T1 their is an awful lot to take in plus they really do need you to keep in close contact with them , so they can monitor your progress and adjust your insulin doses accordingly.

I have T2 rather than T1 but like you I am on multiple daily injections, so I do understand how scary it can be at first.
As you are newly diagnosed it is very likely you will have extremely good hypo awareness and will wake up very suddenly feeling dreadful.
I trust they have explained how to treat hypo’s?

Others here who have T1 so have more knowledge than me will be along soon.

 

[Kaylz]

Hi and welcome to the forum 🙂

Everyone has different targets for what they should be when they go to bed which is decided by working with your team, at the beginning they tend to set a wider target which will be narrowed as you get control and learn to adjust

How long have you been diagnosed? I don't mean any offence when I ask this but are you overweight at all? They generally base a starting dose of basal (your Tresiba) by your weight and to me 40 units is a lot to be started on, I'm also on Tresiba

What are your levels like during the day? and also what do they tend to be when you go to bed?
xx

 

[everydayupsanddowns]

Hello @alexeddude

Welcome to the forum, but sorry to hear about your diagnosis.

It’s not really for any of us random strangers on the internet to recommend changes to your doses, but all I can do is tell you what I have done over my 28-odd years with diabetes (also diagnosed at 21!).

My insulin needs change over the year, so when I notice that I am having hypos, I recognise that the insulin I’ve taken hasn’t balanced with the food I’ve eaten (plus my level of activity, hormones, either effect of alcohol, ambient temperature and a hundred other factors!). If you are repeatedly having hypos overnight with no obvious cause then it seems likely that your basal insulin may need adjusting.

This is easiest to see if your evening meal is taken around 6pm because that way your meal dose will have mostly finished acting by bedtime. Have you been told how to carb count yet? (matching the carbs you eat to your meal doses).

Your basal insulin is supposed to be keeping your BG level when no other insulin is acting. There’s a systematic way of checking if it’s doing this once you start adjusting things yourself which is described here: https://www.diabetes-support.org.uk/info/?page_id=120

Do you have contact details for your DSN to discuss your concerns?

Ultimately your clinic will be equipping you to adjust your own doses on an ongoing basis, my approach would be to adjust doses and carbohydrate ratios by approx 10% once I have identified what needs changing.

Good luck with getting things sorted 🙂

 

[everydayupsanddowns]

Oh... meant to add... the ideal (tiny!!) target range for pre-breakfast BGs in T1 is between 5.0 and 7.0.

Waking at less than 5.0 is associated with overnight hypos (which some people sleep through, particularly after more years lived with T1) and 7 gives just a little ‘wiggle room’ for a small breakfast rise.

It’s not something to get too hung up about (Especially where you are waking a little higher), but that’s the perfect sweet spot.

If you are waking below 5 (and especially below 4) with any regularity, usually your basal needs tweaking.

 

[Carlos]

Hi @alexeddude

Welcome to the forum. Not much to add to what has been said above.

Above all, don't panic, it gets easier. I was diagnosed at 22 years old, just over 25 years ago, and in all this time I have lived a fairly normal life, like the rest of the forum members. The most important thing is that you take control, which you seem to be doing, and any questions, specially at the beginning, be sure to go back to your diabetes team, that's what they are there for.

 

[KARNAK]

Hello @alexeddude welcome to the forum,🙂 as everyone else has said stick with your Diabetes team. I was using 56 units of Basel during the day and 34 units overnight, now I am on 14 units daily and 4 overnight and NovoRapid for meals, depends on the amount of carbs involved. Also stick with the forum and ask any question you like and as often as you like, there is always someone around. Make sure you always carry hypo treatment with you and ask for an Insulin passport if you don`t already have one, your DSN can supply it. Obviously we can`t advise you how to adjust your Insulin that's up to your DSN/Dr to advise you as @everydayupsanddowns has already stated, glad to have you onboard take care it does get better.

 

[Amity Island]

Hi there,
My name is Alex and just been diagnosed with type 1 diabetes. I’m age 21 and worried about going to bed because I may have a hypo during the night. I wouldn’t sleep if my reading shows between 0-6. My short term is Noverapid(average of 14 units) and tresiba (40 units)
What’s the best thing to do before bed so my levels don’t drop over night?

Hi,

To ensure I have a worry free good night sleep, I do 2 things (diabetes wise).

1. Ensure my basal (which is 20units Tresiba every morning) is doing the job and keeping background (without taking into account meals) blood sugar steady all day and night. This should be done with your consultants advice based on your weight/needs etc. getting basal dose correct is a must to start with.

2. I try to avoid eating after 6pm (6 hours before going to bed to let fast acting insulin run it's full course) and then check blood sugar before going to bed, if between 7 and 10 (my background usually drops by 2 units over night) I go straight to sleep, if above or below, make a correction (insulin Humalog or glucose). This only work if basal dose is correct.

Also, are you using a freestyle libre? flash continuous glucose monitor?

 

[DaveB]

Hi. As others have said your Basal dose is key here. I was also told to aim for a morning BS of between 5 and 7. If you are above or below that then your Basal dose may need tweaking up or down. Until you learn more about your own body you need to keep your Bolus down a bit and avoid injecting Bolus just before you go to bed. Just allow your last meal and Bolus to settle then test so you sleep in a reasonably stable state