What do people consider a safe reading to go to bed with?

[rebrascora]

Hi
When I first started using insulin I used to be worried about having a hypo through the night. It has not happened so far to the best of my knowledge and a few months down the line I am now more confident and don't worry about it. I generally eat late in the evening anyway, which probably helps in this respect. I was under the impression that I should not go to bed with it less than 5.5 for some reason but my sister recently told me that her friend's partner will not go to bed with a reading below 10 which seems very high. I am pretty sure he eats a normal diet and injects insulin accordingly whereas I usually eat a very low carb diet with minimal bolus insulin. That said, I eat the majority of my daily carb allowance with my evening meal, so usually have 4 units of N/R on a night and all my basal insulin (12 units of Levemir.... consultant doesn't want me to split the dose yet for some reason)
Just wondering if I have picked things up wrong and 5.5 is a bit low for the threshold although it is in reality usually higher than that.... especially recently when I have been having a spate of high readings... but that is another matter.

 

[silentsquirrel]

Hi
When I first started using insulin I used to be worried about having a hypo through the night. It has not happened so far to the best of my knowledge and a few months down the line I am now more confident and don't worry about it. I generally eat late in the evening anyway, which probably helps in this respect. I was under the impression that I should not go to bed with it less than 5.5 for some reason but my sister recently told me that her partner will not go to bed with a reading below 10 which seems very high. I am pretty sure he eats a normal diet and injects insulin accordingly whereas I usually eat a very low carb diet with minimal bolus insulin. That said, I eat the majority of my daily carb allowance with my evening meal, so usually have 4 units of N/R on a night and all my basal insulin (12 units of Levemir.... consultant doesn't want me to split the dose yet for some reason)
Just wondering if I have picked things up wrong and 5.5 is a bit low for the threshold although it is in reality usually higher than that.... especially recently when I have been having a spate of high readings... but that is another matter.

I was told 8 by DN at GP surgery, I have adjusted this to 6.5 - if I am lower than this I will have a small snack, usually an Oatie biscuit (Lidl cheaper Hob Nob) plus cheese. If only just below, just 1/2 the biscuit plus cheese. No bolus, of course.

 

[Robin]

I was told 7-8, so I normally aim for 7.5. (If I was 10, I'd consider a correction dose!) I know my overnight blood glucose takes a dive, and then rises again, so 7.5 normally takes me down to the 5s by 4am, then I have sometimes risen to just above 7 by the time I wake up, or I’m still in the 5s, depending on whether the dawn effect has happened by the time I test.
I am fairly predictable overnight, though. When I’m using a Libre, it’s always the narrowest band on the graph, and always follows the same pattern. If I wasn’t so predictable, I might feel I needed a bigger safety margin.

 

[nonethewiser]

Once over wouldn't go to bed on less than 7, since on pump can safely go to bed on a 5.5 knowing there's no bolus floating around.

Libre helps to see what bg is doing, unless you lay on it and it gives a compression low on graph, been there a few times.

 

[rosy_nic]

I normal try to stay between 8-10 for me as I'm to scared of night time hypo's. Also I have poor Hypo awareness to and tend to fall straight asleep! But anything less that 7 it's snacks for me to keep me going to the next day.

 

[khskel]

Depends on when I ate and how much rapid acting I still have on board but about 6 would be fine.

 

[TheClockworkDodo]

I was told to aim for 8, and if I'm under that I snack before bed - if I'm much over that I have a correction dose, wait a bit, and then snack!

 

[everydayupsanddowns]

I think this is a HCP hang-up from older basal insulins with a more pronounced peak in action that were still taken before bed.

When first diagnosed I was told to always have a snack before bed without bolusing for it (approx 10g of carbs) which would put you around 9.0 if you were mid-range at bedtime.

People generally have a dip in cortisol output at around 3am which can cause lower BG at that time of day.

My current opinion is to keep an eye on what happens to BG overnight, and if wearing sensors, to aim for a slight rise rather than a slight drop. If my basal is set right, and if I’ve eaten early enough that there’s little if any bolus still working, most nights there is no need for me to artificially boost BG overnight.

Of course a number of other factors (exercise during the day, bolus still running, consumption of alcohol) might make a bedtime snack worth having for me. YDMV etc.

 

[SB2015]

On MDI I found it difficult to keep things level overnight so was a lot more cautious, especially at the start. I gradually reduced the bedtime target as things settled more. I tend to eat early, and prefer to leave 4 hours before I go to bed after eating, in the principle that my quick acting insulin will have done its job and food will have also done its work on my glucose (unless I had curry or pizza, ....). I then look at the trajectory of my BG and if it is behaving and level I will happily go to bed on a lower reading. If it is dropping it is a good excuse for a biscuit with my cuppa. This is certainly made a lot easier r me using the lIbre sensor.

 

[SB2015]

Ps
... on a more flippant note my OH advice when he saw the title was, “ A good book”!!

 

[Adehem]

If I am below 7 I have a small drink of milk. Not much is needed to raise it a bit. Milk is easy to take and easy to monitor how much to take. If I am around 7 I usually wake up at 6ish.