Nocturnal hypos

[Depressed_Boy_Skelly]

Last night I had a hypo (3.1 at 1:54am-2:00am) after waking up from a dream about me having a hypo (weird). I seem to have a hypo every time my mum gives me insulin before bed (she was suppose to stop doing this, but here we are). I don’t give myself insulin due to sight impairment, I can’t see the numbers (I know you can hear it but I forget to count the clicks).

I don’t know why this is? I don’t do anything different before bed, I take my medication, then go to sleep. I don’t eat a lot during the day due to a bowel condition, and I don’t want to have a snack before bed because my bowel condition is caused by eating and then I will end up having an accident while I’m asleep, and as a 24 year old that is very embarrassing.

Why does this happen all the time? Do I need to change anything?

 

[Robin]

Is it your basal (long acting) insulin that you are taking just before bed? If so, what brand is it, and do you take it once a day or twice? What time do you have your last meal of the day and inject short acting insulin?
If you can tell us, it will give us more to go on, to work out what’s happening.

 

[rebrascora]

Hi

Sorry to hear you are having nocturnal hypos. That's not good but sometimes they can be difficult to avoid particularly if they are intermittent and there is no obvious pattern. Knowing more about which insulins you use and when will give us more idea of what might be going on but if it is any consolation, I have just come through a week of nocturnal hypos followed by a week of high levels and now things are behaving perfectly again. Sometimes they just happen. I too have had hypo dreams wake me up to a hypo. It is clever how the brain works!

I inject my insulin in the dark in bed quite often and I don't bother to put the light on. I often think about people with diabetes and sight loss when I do it and it isn't actually that difficult once you have a system. I just count the clicks as I am dialing it up and I always keep my basal pen nearest the outside of my pencase and the bolus insulin near the centre, so I know which one is which from the position in the case. I find it amazing how I can wake up and inject my basal insulin on a morning in the dark without even being fully awake. So that might be something you want to think about taking control of yourself. Obviously you would get your Mum to double check the first few times until you became confident, but it is certainly doable.

As regards your digestive problems, have you sought medical help with that and have you looked at adjusting your diet as that can make a big difference to lots of gut related problems.

Do you have the Freestyle Libre system to help you with managing your levels or are you relying on finger pricks. Must say, I can't figure out how to do a finger prick test in the dark, so Libre is brilliant for just being able to scan and get a result.

 

[Depressed_Boy_Skelly]

Is it your basal (long acting) insulin that you are taking just before bed? If so, what brand is it, and do you take it once a day or twice? What time do you have your last meal of the day and inject short acting insulin?
If you can tell us, it will give us more to go on, to work out what’s happening.

It’s not. It’s my novorapid. I take 23 units of Tresiba every morning because that was causing the hypos at night, so we switched it to morning instead. My last meal is normally around 4:30-5pm in the week and later (7pm) on weekends.

 

[Depressed_Boy_Skelly]

Hi

Sorry to hear you are having nocturnal hypos. That's not good but sometimes they can be difficult to avoid particularly if they are intermittent and there is no obvious pattern. Knowing more about which insulins you use and when will give us more idea of what might be going on but if it is any consolation, I have just come through a week of nocturnal hypos followed by a week of high levels and now things are behaving perfectly again. Sometimes they just happen. I too have had hypo dreams wake me up to a hypo. It is clever how the brain works!

I inject my insulin in the dark in bed quite often and I don't bother to put the light on. I often think about people with diabetes and sight loss when I do it and it isn't actually that difficult once you have a system. I just count the clicks as I am dialing it up and I always keep my basal pen nearest the outside of my pencase and the bolus insulin near the centre, so I know which one is which from the position in the case. I find it amazing how I can wake up and inject my basal insulin on a morning in the dark without even being fully awake. So that might be something you want to think about taking control of yourself. Obviously you would get your Mum to double check the first few times until you became confident, but it is certainly doable.

As regards your digestive problems, have you sought medical help with that and have you looked at adjusting your diet as that can make a big difference to lots of gut related problems.

Do you have the Freestyle Libre system to help you with managing your levels or are you relying on finger pricks. Must say, I can't figure out how to do a finger prick test in the dark, so Libre is brilliant for just being able to scan and get a result.

I take novorapid and Tresiba. But I switched to Tresiba in the morning instead of at night due to this reason. I’m trying to get a hang of it and will be hopefully getting some visual aids at some point to help me.

My digestive problems have been investigated and I’m waiting to hear from them. I have an appointment from my gastroenterologist next Monday, as I had a colonoscopy last month. They were thinking it could be celiac disease, and every time I eat gluten free products I have no symptoms so honestly I think it’s that aswell either that or a gluten sensitivity or intolerance. If not I’ll be getting these things tested like gluten and dairy products as it happens with milk also.

I have the freestyle libre 2 and that’s what the alarm was last night when I woke up. I had to scream really loud for my mum as I was confused, couldn’t get up because I was weak and felt like a plate of jelly, hope my neighbours weren’t too scared. Honestly sounded like I was getting murdered, but she had her headphones in and I just panicked when she didn’t come straight away as I was close to falling back to sleep, and panicked that I would die or go into a coma. I told my cat to go get my mum (to my surprise she actually helped) who says cats can’t sense anything or understand. I’d prefer an alert dog but cats will have to do. They are quite smart

 

[Inka]

It’s not. It’s my novorapid. I take 23 units of Tresiba every morning because that was causing the hypos at night, so we switched it to morning instead. My last meal is normally around 4:30-5pm in the week and later (7pm) on weekends.

Perhaps your Tresiba needs reducing? Or if it’s not working for you, maybe a twice-daily basal like Levemir would work better? This is because you could take less of it at night and so reduce your risk of hypos.

 

[rebrascora]

The Tresiba could still be dropping you low overnight even though you take it in the morning. It would almost certainly do that to me because I need much less basal insulin at night than I do during the day and the Tresiba releases a very uniform amount day and night. Thankfully I use Levemir as my basal and I can adjust the daytime and night time doses separately.

You should keep some hypo remedy by the bed or even under your pillow so that you have it ready to take in case you can't get your Mum's attention. Again, I keep mine on the bedside table and have perfected the technique of reaching for them and taking them without putting the light on. Of course it is always best to double check a hypo before treating but certainly in an emergency, it is far safer to take some emergency fast acting carbs and risk going too high, as risk losing consciousness to a hypo.
Are you relatively newly diagnosed?

 

[PattiEvans]

It’s not. It’s my novorapid. I take 23 units of Tresiba every morning because that was causing the hypos at night, so we switched it to morning instead. My last meal is normally around 4:30-5pm in the week and later (7pm) on weekends.

Hi @WreckTangle If it is indeed the Novorapid that your mother is injecting you with before bed then she must stop. Novorapid should only be taken when you eat... unless of course your BG was high and she is injecting as a correction to bring your BG down, in which case I would think she is injecting too much.

 

[Sally71]

Why is your mum injecting novorapid before bed? It should only be injected when you eat or to correct a high blood sugar. If neither of those applies when you go to bed, then you don’t need the novorapid and it will make you go low. Is this why your mum was told to stop injecting you with it at bed time? Has she perhaps misunderstood something?

 

[DaveB]

I agree that Novorapid should normally only be taken just before each meal. The injection amount should be related to the amount of the carbs at that meal using your carb-ratio. A rough ratio is 1 unit of Bolus to each 10 grams of carb but if in doubt keep the insulin a bit below that to avoid risk of a hypo. Occasionally you might use the Bolus as a correction. Do you think your Mum understands how each insulin works?

 

[Robin]

Does your Mum understand that Tresiba goes on working for the full 24 hours after it has been injected, (longer, in fact, because the doses are designed to overlap) so the morning dose will still be drip feeding insulin to your system all night? I wonder if she thinks it runs out.