Nighttime hypos with bfast Levemir

[Ken21]

Hi

Diabetic 14 years, T2 but now LADA?
Hba1c was 62, now estimated 55 from Libre.

Taking one lot of 9u of Levemir at 7:30 a.m ( I don’t really understand why, if only taking one shot, that evening would be a more sensible time …..hence my bfast insulin strategy)

This largely keeps me in target range ( about 75 per cent of time), with occasional spikes up to 12 after daytime carbs. Would like to increase bfast dose, but…….,

Tend to go to bed slightly high ( between 10 and 12) but usually nice figures overnight.,…except…..I occasionally ( once or twice a week) trigger my low 4.2 setting on Libre in middle of night).

Thinking of having slice of apple and peanut butter as I go to bed to avoid this.

Any thought on any of this welcome
Thanks
K

 

[helli]

Basal (such as Levemir) is supposed to keep our levels stable in the absence of food, exercise, bolus insulin, etc.
If you are falling from 11 to 4 overnight, your dose is likely to be too high.
Our insulin needs can vary. For example, when we have an active day, we may need less overnight. The advantage of Levemir is that it is relatively short acting so, if you see a correlation between overnight lows and exercise during the day, you could drop your Levemir on active days.

However, are you certain the night time lows are real lows or could they be compression lows (when pressure is applied to sensor such as lying on them in our sleep and they record false lows)?
If you have an alarm when you get low on your Libre you should double check with a finger prick test.

 

[khskel]

Might be worth considering a basal test https://forum.diabetes.org.uk/boards/threads/basal-testing-made-easy.19060/

It's in the thread for people using pumps but applies just as much to us needle stickers.

NB are you just on levemir or are you using fast acting as well for meals?

Just a thought.

 

[Inka]

If you’re not on fast/meal/bolus insulin, then I’d ask about that. If you’re dropping overnight, your Levemir is probably too high. If you’re not having a fast/meal/bolus insulin, your Levemir is probably set too high because it’s trying to compensate for that.

 

[gillrogers]

I'm on a split dose Levemir that I can give at 12 hour intervals as my night time need is much lower than my day time. Perhaps an option but you'd need to speak to your DN first?