Night time hypos

[Boot]

Hi, I keep having a hypo within an hour of going to sleep at night. We eat dinner an hour or two before bedtime and I think my carb counting is pretty good. It seems that no matter what I do even after a meal with significant carbs my blood sugar crashes. I treat the hypo then sometimes I am quite high (13+) for the rest of the night. My hypo treatment is juice and half a slice of wholemeal bread. I suspect my bolus rate needs adjusting but I have no idea how to do this. Any advice would be gratefully accepted. Thank you

 

[helli]

Do you check these hypos with finger pricks?
I ask because they could be compression lows where you lie on your sensor in your sleep causing it to report a false low
This could explain why you go high for the rest of the night if you are eating carbs when not needed

 

[Inka]

Hi, I keep having a hypo within an hour of going to sleep at night. We eat dinner an hour or two before bedtime and I think my carb counting is pretty good. It seems that no matter what I do even after a meal with significant carbs my blood sugar crashes. I treat the hypo then sometimes I am quite high (13+) for the rest of the night. My hypo treatment is juice and half a slice of wholemeal bread. I suspect my bolus rate needs adjusting but I have no idea how to do this. Any advice would be gratefully accepted. Thank you

First follow @helli ‘s advice and confirm you’re actually hypo. If so, try eating your evening meal earlier. That way your bolus will be pretty much out of your system. You can then judge if you need to adjust your bolus ratio or not.

What bolus insulin do you take? Some have a little kick around the 3hr mark.

 

[SimonP]

Might need to split bolus, take some when you eat/before as per usual, then some after the meal. Especially if the meal is potentially slow absorbing (an hour or two isn't long for a full meal to be digested, but it depends what and how many carbs). This is a bit of a pain at bed time as you need to go to bed with active insulin (and undigested carbs) and trust that you got the numbers right. Much nicer now though with alarms on CGMs.

Let us know how you get on.

 

[Boot]

Do you check these hypos with finger pricks?
I ask because they could be compression lows where you lie on your sensor in your sleep causing it to report a false low
This could explain why you go high for the rest of the night if you are eating carbs when not needed

Thank you, don't tend to do this as half asleep but really good advice. Will do this from now on!

 

[Boot]

First follow @helli ‘s advice and confirm you’re actually hypo. If so, try eating your evening meal earlier. That way your bolus will be pretty much out of your system. You can then judge if you need to adjust your bolus ratio or not.

What bolus insulin do you take? Some have a little kick around the 3hr mark.

Thank you really useful advice. I take fiasp for bolus insulin.

 

[Boot]

Might need to split bolus, take some when you eat/before as per usual, then some after the meal. Especially if the meal is potentially slow absorbing (an hour or two isn't long for a full meal to be digested, but it depends what and how many carbs). This is a bit of a pain at bed time as you need to go to bed with active insulin (and undigested carbs) and trust that you got the numbers right. Much nicer now though with alarms on CGMs.

Let us know how you get on.

Thank you so much for your help. Much appreciated and hopefully will put an end to the late night hypos. You are all very kind.