Nightly hypos

[Val58]

Hi,
My partner has nightly hypos, luckily she wakes up each time but it’s obviously frustrating and concerning having them. She takes long acting Lantus in the morning and evening. Her blood glucose levels have been very up and down for at least 2 years.
Has anyone had a similar experience?
Many thanks,

 

[eggyg]

Hi @Val58 and welcome to the forum. It is very concerning that your partner is having nightly hypos. What sort of numbers are we talking about? Has she been diabetic for a long time or is she new to it? I firstly would speak ASAP to her diabetes team/ GP/ nurse, it looks like she needs a reduction of her basal insulin. Having regular hypos can be very dangerous and needs addressed now. I am assuming she tests before bed and treats anything under a 7, ie a 10gr carb snack, chocolate digestive, a slice of Burgen bread. Please speak to someone TODAY as it’s very important that this is sorted. In the meantime search for basal testing on the forum, top right on this page you will see a search facility. Good luck and please let us know how she gets on. Elaine.

 

[everydayupsanddowns]

It sounds like your partner needs to adjust insulin doses downwards. Repeated nocturnal hypos are no fun, and can really put a dent in your hypo awareness (I speak from experience!).

When do you generally eat your evening meal? Ideally I try to eat the evening meal around 6pm, which means that by bedtime its dose has more or less finished working. This makes overnight levels easier to assess as it is only(!) activity level in previous 24 hours, illness, alcohol intake and basal insulin.

Basal needs go up and down during the year (in my experience it is rare for me to need the same amount of basal from one month to the next) so regular tweaks are not uncommon.

Had your partner ever systematically checked their basal insulin needs? Once it is more or less set right small tweaks can work well, but an occasional set of basal checks are helpful.

There’s a good write up of basal insulin and how to check it here: https://www.diabetes-support.org.uk/info/?page_id=120

Let us know how you both get on 🙂

 

[trophywench]

I was using Lantus for over 5 years and it didn't keep me level overnight whether once or twice a day so I asked to be changed to Levemir instead - again twice a day. 14u am (7.30 ish) and 4u at night but still went hypo around 5 am which was a right PITA. By changing the bedtime dose to 9.30 ish at night - sorted.

The good thing about Levemir as opposed to Lantus is that when tweaking amounts and timings you can normally see the effect of any change within the first 12 hours of making the change whereas if you change anything with Lantus it's always 3 whole days before you know if it was right or wrong. Just so tedious!

But anyway - don't do anything until your partner has done a full 24 hours of basal testing, which will take most of one week anyway.

 

[Bloden]

Hi there. 🙂 I had the same problem with Lantus - overnight hypos at 3am or 6am. So my endo changed me to Tresiba. No more night-time hypos. 😛 Lantus was a peaky devil and only lasted about 18 hours, so I was glad to see the back of it!

 

[Val58]

Thank you all for your replies. My partner has spoken to her diabetes dietitian and is trialling reducing Lantus by 2u in am and 2u in evening. Lots of food for thought from your messages though and interesting points to consider so thank you so much. She has had type 1 since 1979 so not new although ups and downs are more of a recent thing (last couple of years) with daily and nightly hypos as low as 1.9 at times-frequently in the 2s or 3s certainly. She has done basal testing before but would do it again. She is also epileptic and has been through menopause recently. I honestly think anyone who deals with diabetes is amazing and thank you for taking the time to advise. 🙂

 

[rebrascora]

It is likely that the change in hormone levels due to the menopause may be causing her problems. I have recently started HRT and found that I needed to increase my basal insulin as a result.
Lows of 1.9 and even in the 2s through the night are not good at all and need to be prevented. It is good that she is reducing her basal insulin and I too think that she will see an overall improvement as a result.
If she has been diagnosed that long, it may have been drilled into her from a young age that high BG readings are to be avoided, but because she has been having so many regular hypo events recently it would be a good idea to run her levels deliberately higher for a while so that hopefully her body will get used to the higher levels and learn to detect hypos before she drops into those dangerous 2s or 1s.

 

[Bruce Stephens]

She has had type 1 since 1979 so not new although ups and downs are more of a recent thing (last couple of years) with daily and nightly hypos as low as 1.9 at times-frequently in the 2s or 3s certainly.

With any luck, the ups and downs are largely because of the lows so reducing those will make everything easier to deal with.