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Low readings

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Charlotte.xo

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Type 1
Hey! I’m Charlotte, I’m 28 and been living with type 1 diabetes for 12 years. New to the forum but not new to diabetes.

Recently been having low readings of a night (every night for the last 5 nights) lowered all my insulin during the day and my long acting of a night but still waking up in the night having hypos at around 2am.

Any tips on what I could be doing wrong? (after 12 years of being pretty well controlled I have no idea why it’s started now)
Does anyone else have low readings before bed/during the night and how do you treat them. (Waking up sweating and shakey and shoving jam in my mouth isn’t ideal)

Thanks guys,
Charlotte xo
 
Hi @Charlotte.xo What insulins do you take and what times? Could you be ill? I find both tummy bugs and migraines cause lows. Colds often do as well. Usually just before they start. Hormones can also cause lows.

I also find hotter weather can too. Perhaps the sudden hotter nights are affecting you?
 
What are your levels like when you are testing before you go to bed? I take carbs on if I'm below a certain level and how much I have depends on the level I'm sitting at when I test xx
 
Inka said:
Hi @Charlotte.xo What insulins do you take and what times? Could you be ill? I find both tummy bugs and migraines cause lows. Colds often do as well. Usually just before they start. Hormones can also cause lows.

I also find hotter weather can too. Perhaps the sudden hotter nights are affecting you?
Click to expand...

I take novorapid during the day with each meal and lantus at 10pm every night. I don’t feel unwell at all. I’m doing hardly any exercise compared to my normal, given the current circumstances. It seems so bizarre.
 
Kaylz said:
What are your levels like when you are testing before you go to bed? I take carbs on if I'm below a certain level and how much I have depends on the level I'm sitting at when I test xx
Click to expand...

For example last night my blood was 8 before bed and before my long acting and then by 1.30am it had dropped down to 2.3!
Maybe I need to be having a snack before bed now.. though this has never happened before x
 
Charlotte.xo said:
I take novorapid during the day with each meal and lantus at 10pm every night. I don’t feel unwell at all. I’m doing hardly any exercise compared to my normal, given the current circumstances. It seems so bizarre.
Click to expand...

I’ve never used Lantus but I know it can very occasionally cause hypos. Have you considered moving your Lantus to earlier in the evening? That way you’d have any drop in sugars while you were awake. I also know people who take their Lantus in the morning.
 
Ok, so you dropped around 3 and 1/2 hours after your Lantus. Just to check, are you eating your evening meal later (and thus having Novorapid active later)?

I think 8 is a perfectly reasonable sugar to go to bed on. If it was me, I’d carefully and gradually move the time of the Lantus (check with your team if at all unsure).

If the Lantus continued to cause problems, I’d look at moving to split doses of basal, ie morning and evening. Some people do do this with Lantus, but Levemir is more common. You can then have slightly less basal in your evening basal to avoid drops overnight. I have a pump and my lowest insulin needs are in the early hours of the night (roughly 11pm to 3pm).
 
Inka said:
Ok, so you dropped around 3 and 1/2 hours after your Lantus. Just to check, are you eating your evening meal later (and thus having Novorapid active later)?

I think 8 is a perfectly reasonable sugar to go to bed on. If it was me, I’d carefully and gradually move the time of the Lantus (check with your team if at all unsure).

If the Lantus continued to cause problems, I’d look at moving to split doses of basal, ie morning and evening. Some people do do this with Lantus, but Levemir is more common. You can then have slightly less basal in your evening basal to avoid drops overnight. I have a pump and my lowest insulin needs are in the early hours of the night (roughly 11pm to 3pm).
Click to expand...
I usually have my evening meal and do my last novorapid by 7pm and it’s been fine until now. Last night I lowered the lantus dose by almost half and still had low sugars. I’m waiting for a call back from my diabetic nurse and I’ll ask/suggest changing the time of my lantus.

thanks so much!! x
 
I need a lot less between 11pm ish and 3am ish that at any other time of day, even though it's comparatively high all evening. I too was on Lantus and couldn't get any sensible and enduring proper control until I swapped to twice daily Levemir.
 
Hello @Charlotte.xo
Just to say, welcome to the forum and as you can see from the replies you are getting, there is a large amount of knowledge and support here.
I hope that the answers help you find a good solution.
 
Hi and welcome, agree with trophywench, lantus is notoriously difficult to tinker with. Also, if I remember you have to wait a couple of days for any changes to take effect. I would try changing Lantus to the morning. But better still, change to Levemir and split your dose.
 
Welcome to the forum @Charlotte.xo

I had similar problems with Lantus and night time hypos, and the thing that fixed it for me was taking it at breakfast time.

It has a slight ‘peak’ of activity about 4-5 hours after injection, and the body, co-incidentally generally has its lowest cortisol output around 3am - when those overlap it only takes a small change in insulin needs to dip you into a regular hypo.

And my insulin needs are likely to start dropping now the weather is warming - they aren’t fixed through the year and need regular tweaking.
 
Slight, Mike? Nope! It has a definite and marked spike at approx. 5 hours, if you happen to be one of the many people Lantus does it to! simply because as with everything where diabetes is concerned, we are all different.

Yeah that's the other thing with Lantus, it hangs around for about 3 days hence change a dose tonight, and it won't be until Monday you'll see if it seems to be working if not Tuesday. Levemir - though when you first swap you need to wait for 3 days ish till you get rid of the Lantus out of your body, thereafter you can see the results pretty much immediately which is a huge relief. I've usually tried to leave it a couple of days to make absolutely certain before changing it again or changing anything else - except where it's been utterly disastrous!
 
Thank you so much guys this has been super super helpful! I lowered my dosage and actually after 3/4 days my readings were better, still low but no hypos during the night (they are the ones I hate most) waking up with readings between 3 and 5 are so much easier to manage as I can just have breakfast as normal and bring levels to where they should be!
Also slight change in my diet/eating habits and exercise the last week so having less insulin during the day and generally feeling much better! I’d say this isolation/lockdown has given me a kick up the butt too! xo
 
Great news @Charlotte.xo 🙂 You might be able to fine tune things a little more so that you wake up closer to 5 rather than 3. Again, allow 3 days to see how any changes work.

It must be a relief to have stopped the nighttime hypos -they’re the worst.
 
So good to hear that things are getting better for you.
Although there are many down sizes to isolation, I think many of us are finding it gives an opportunity to re-think what is important, and addressing some things that we can, that help ourselves.
 
Hi @Charlotte.xo so glad you are getting your figures under control with the help of our very knowledgeable members. Night time hypo`s a bit of a nightmare pun not intended, as @Inka says a bit more adjustment and that 5 is doable well done.
 
This, @Charlotte.xo is merely part of diabetes rich pattern! The gift that simply keeps on giving - she typed through gritted teeth LOL

Just because you've had excellent control since Day 1 never means you'll retain it 'for ever'. We learn over the years that you only retain whatever it is for 'a while' - but nobody can predict how long or short that 'while' will be.

Hopefully this has done the trick 'for now' anyway, but it's so easy to get used to, isn't it. I'm the world's worst for spotting unwanted trends quickly but luckily, it hasn't caused me serious harm so far AFAIK.
 
Great to hear @Charlotte.xo

Hope the better BGs hang around for a good long while for you.
 
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