Night time seems to not be the right time...

[Peely66]

Bedtime and over night appears to be my most problematic period of the day for staying in range I've noticed.
I can go to bed in range sometimes and it rises whilst I'm asleep and can stay level out of range so that takes a correction in the morning. Occasionally if I manage to catch it rising before sleep and correct than it falls too low and I wake up low. Lots of things spring to mind like the type of foods I eat in the evening maybe have more of a tendency to raise BG later as sometimes I dip and react also.

Any one else have this issue and have any strategies for getting that beautiful straight line in range over night.

I think if I can discover how to get this right I would be able to hit 70% TIR more often. I seem to hover in the 60 to 65 % a bit too much.

 

[JonathanGi]

Most people's BG will go up at about the 03.00/04.00 time - the dawn phenomenon, and when we first get out of bed.

 

[Tdm]

Could you share a cgm graph? What basal insulin are you on and when do you take it?

Generally, its the basal that will we operating overnight, so if you are on a steady decline/rise, it will normally be the basal that needs adjusting.

what bolus insulin do you take? When do you take it?

Its good if you can take your evening meal early enough that is finished working before you go to sleep

 

[everydayupsanddowns]

Yes nighttime was my nemesis too!

Mind you 60 to 65% is nothing to be sniffed at you should feel very proud of that.

Part of the problem for me was the inconsistency - just as I’d tweaked things to be vaguely level I’d have a random night or two, which behaved very differently. Basal checks helped though they are a bit of a faff of course!

But the thing that helped most of all was unsurprisingly a hybrid closed loop particularly for the 10% of nights where I suddenly with no warning seem to need almost no background insulin. Having a system that could sense that happening and shut off my background profile was basically the only thing that helped. Now on the tSlim I’ve also got the brains of my Pump adding a little insulin if levels are drifting higher, my overnight levels have never been better.

 

[rebrascora]

Yes, my nighttime levels are very variable/tricky, partly I think because I need so little basal insulin at night compared to during the day (22u in the morning but only 0-5u at night) and exercise/activity has a much greater impact on my nighttime levels when I am asleep, than it does when I am actually exercising. Having Levemir as my basal insulin helps because I can adjust my night time dose separate of my daytime needs and reduce it the night after exercise and reduce it again the next night if necessary but it is a fine balance and very easy to get it wrong. It doesn't help that I sleep best in the 4s and 5s, so I don't like to go to bed too high. I end up with rather too many nocturnal hypos although most are very mild ones and don't concern me too much at all, but I am aware that they can erode my hypo awareness, so I do need to be mindful of balancing the advantages of good sleep with the risks of losing my hypo awareness.