Woken by hypo

[Northerner]

Right, I'm 5.8 before bed, so that 10.7 must have been a timing issue with the food/injection. Now, do I lower my lantus again? Last night I had 7 units and was 6.0 before bed AND I had a slice of toast and jam. I think I will lower to 6 units and have a slice of bread and peanut butter and see what happens by morning - hopefully without any need for jelly babies at 3 am!

 

[everydayupsanddowns]

Now, do I lower my lantus again? Last night I had 7 units and was 6.0 before bed AND I had a slice of toast and jam. I think I will lower to 6 units and have a slice of bread and peanut butter and see what happens by morning - hopefully without any need for jelly babies at 3 am!

Hope you survived the night OK Northener... basal tweaking is notoriously tricky on Lantus, especially if you are victim of the 3-day 'Lantus Lag' before new doses settle down.

Do you inject at 11ish? If I remember rightly there's a sort-of mini peak in Lantus activity around the 3-5 hour mark which probably isn't helping things for you

 

[Northerner]

Hope you survived the night OK Northener... basal tweaking is notoriously tricky on Lantus, especially if you are victim of the 3-day 'Lantus Lag' before new doses settle down.

Do you inject at 11ish? If I remember rightly there's a sort-of mini peak in Lantus activity around the 3-5 hour mark which probably isn't helping things for you

I decided to go ahead and lower the lantus to 6 and have the peanut butter sandwich (although that went against instinct!). Good idea as it turned out - I woke at 3:30 am and tested: 4.4 mmol/l. So if I hadn't had the PB I would probably have hypoed again. Woke this morning to 5.3 so all's good! 🙂

 

[everydayupsanddowns]

I decided to go ahead and lower the lantus to 6 and have the peanut butter sandwich (although that went against instinct!). Good idea as it turned out - I woke at 3:30 am and tested: 4.4 mmol/l. So if I hadn't had the PB I would probably have hypoed again. Woke this morning to 5.3 so all's good! 🙂

Good news that it worked well Guess you'll be keeping an eye on it for a few days more to see how it settles...

I always used to have a little suppertime something, but these days it more feels like needing to eat something to stop me going hypo overnight is an indication that my basal's not quite right. Have you done much in the way of looking at your before/after bgs when not eating/bolusing for various meals in the day? Can be a useful way to check what your basal is up to, without bolus distractions.

 

[Northerner]

Good news that it worked well Guess you'll be keeping an eye on it for a few days more to see how it settles...

I always used to have a little suppertime something, but these days it more feels like needing to eat something to stop me going hypo overnight is an indication that my basal's not quite right. Have you done much in the way of looking at your before/after bgs when not eating/bolusing for various meals in the day? Can be a useful way to check what your basal is up to, without bolus distractions.

My sensitivity changes through the day (or should that be resistance?). If I don't eat breakfast my leves creep up - thank you Mr Liver - but I can skip lunch or even evening meal and stay steady. I've been very happy with my lantus dose for well over a year, it's just stepping up the training that is changing it. When I was injured earlier this year I needed 9 lantus to stay below 7 fasting. I'd say my novorapid has reduced by around 30% too recently, just playing catch up! 🙂

 

[Carina1962]

Am just taking a few mins break before i finish work and wondered, Northerner, how did you get on last night? hopefully not woken up in the small hours by a hypo again?

 

[Northerner]

Am just taking a few mins break before i finish work and wondered, Northerner, how did you get on last night? hopefully not woken up in the small hours by a hypo again?

I did wake up, as I often do anyway, but tested at 4.4 so had a jelly baby and woke in the morning to 5.3 - hurrah! 🙂

 

[Northerner]

Unbelievable! I tested about an hour ago and I was 4.7 (4.5 hours after tea). Clearly too low to go to bed on, given my recent history so I had a slice of jam on toast. Got distracted and now it's an hour later so thought I would just test again before injecting my lantus - three point flipping nine!!! I've just eaten jam on toast! Where did it go?

So, I think I'm going to have to have a slice of peanut butter on bread now. I don't really want to reduce my lantus again as it would send me high tomorrow morning, and I certainly don't want to contemplate splitting my lantus when I'm only on 6 units anyway, plus all this change going on.

I may be back on at 3 am! 😱

 

[Northerner]

I had my peanut butter and 6 lantus. Woke at 4 am and tested at 5.8 - woke up this morning to 5.0. So it looks like I cracked it last night, but I'm still very surprised that I needed two slices of bread plus jam and peanut butter to keep my levels up. I'd expected to go much higher!

 

[everydayupsanddowns]

Unbelievable! I tested about an hour ago and I was 4.7 (4.5 hours after tea). Clearly too low to go to bed on, given my recent history so I had a slice of jam on toast. Got distracted and now it's an hour later so thought I would just test again before injecting my lantus - three point flipping nine!!!

I've had those days too. So frustrating! It usually seems to coincide with more visits to the Gym (which given your current level of training seems similar). I've also never been able to establish any way of working out the actual duration of bolus for me, only the 4ish hours figure provided by the manufacturer. With all the other variations we all see in the way our own bodies I find it hard to believe it would be 4 hours for everyone.

Will you drop Lantus by another unit? Just to see if you can make it through a night without having to have hypo-busting jam sandwiches (unless you are enjoying them of course...)

 

[Northerner]

I've had those days too. So frustrating! It usually seems to coincide with more visits to the Gym (which given your current level of training seems similar). I've also never been able to establish any way of working out the actual duration of bolus for me, only the 4ish hours figure provided by the manufacturer. With all the other variations we all see in the way our own bodies I find it hard to believe it would be 4 hours for everyone.

Will you drop Lantus by another unit? Just to see if you can make it through a night without having to have hypo-busting jam sandwiches (unless you are enjoying them of course...)

I'm pretty sure novorapid lasts 5 hours in me, maybe longer depending on where I inject - another factor that undermines the 4 hour figure! I'm half-tempted to drop the lantus again, but sort of nervous about it, as5 units would be the lowest dose I've ever been on and 75% less than I was originally on! I did test the doctor's knowledge at my appointment this morning, by asking her about residual beta cell function, but she admitted that she couldn't really anser my question and better to ask the consultant. She didn't seem to be aware of the C-peptide test. All that is fair enough though - I like her honesty and it may actually be the first time she's ever been asked the question!

 

[everydayupsanddowns]

I'm half-tempted to drop the lantus again, but sort of nervous about it, as 5 units would be the lowest dose I've ever been on

I've given up trying to understand such things... I recently had a 35ish% drop in bolus requirement (during one of my periods of basal system experimentation and/or warm weather, I forget which!). In the end I've decided I can only go by the meter for whatever seems to be happening now, this week... this level of activity... this ambient temperature... If my fbg's weren't rising and I was battling overnight lows I'd be tempted to either a) drop another unit or b) shift Lantus to the morning (which is what I've ended up doing) so that Lantus's fading happens overnight.

The downside of this of course, is that breakfast spikes are trickier to manage...

Still... I very rarely wake up low these days. Which is nice.

 

[Northerner]

Morning lantus is a possibility I suppose, given that it is in the morning that I have the greatest resistance. I'm so used to my regime though, and it does work pretty well overall, so I'm reluctant to change injection times.

 

[Robster65]

If you work out how it all interacts (preferably with algorithms), can you drop me a PM please ?

Ta.

I suspect someone sneaks in during the night and injects some more humalog/novorapid but occasionally swaps it for glucose.

Rob

 

[everydayupsanddowns]

@Robster Ha Ha! Yup that's it exactly. The mystery is solved at last!

Morning lantus is a possibility I suppose, given that it is in the morning that I have the greatest resistance.

Conversely I'd say that indicates morning Lantus may not work so well - given that it takes a good few hours of onset to get going. If you tend towards a little DP anyway you need your Lantus well and truly up and running first thing I reckon.

 

[Northerner]

If you work out how it all interacts (preferably with algorithms), can you drop me a PM please ?...
Rob

http://www.diabetessupport.co.uk/boards/showthread.php?t=673 😉

...Conversely I'd say that indicates morning Lantus may not work so well - given that it takes a good few hours of onset to get going. If you tend towards a little DP anyway you need your Lantus well and truly up and running first thing I reckon.

Lantus gets going pretty quickly in me. I've never had a problem with my waking levels, but I do have a problem if I don't eat soon after rising.

 

[lucy123]

Hi Northerner,

I hope things get sorted for you.
Sorry to hear about your night time issues - its awful when you have broken sleep.
I should imagine it is quite scary being on your own too.

Fingers crossed for you and well done on the running.

 

[Northerner]

Hi Northerner,

I hope things get sorted for you.
Sorry to hear about your night time issues - its awful when you have broken sleep.
I should imagine it is quite scary being on your own too.

Fingers crossed for you and well done on the running.

Thanks Lucy 🙂 There always seems to be a transitional period when I step up the training, only to be expected really - what's really difficult though, is working out how to tackle it safely without your blood sugar levels going crazy! 😱

 

[Robster65]

http://www.diabetessupport.co.uk/boards/showthread.php?t=673 😉

Thanks for this. I programmed it in and the laptop melted.

I've largely given up on trying to find any set patterns. There's as many exceptions as there are scenarios. We have a notepad detailing the last few weeks intake, insulin and exercise and flick through to find a 'similar to'. It may eventually show patterns linked to sunspot activity or interglacials. I'm not really this cynical.

Rob

 

[Northerner]

Thanks for this. I programmed it in and the laptop melted.

I've largely given up on trying to find any set patterns. There's as many exceptions as there are scenarios. We have a notepad detailing the last few weeks intake, insulin and exercise and flick through to find a 'similar to'. It may eventually show patterns linked to sunspot activity or interglacials. I'm not really this cynical.

Rob

Haha! Love it! There might be a poem idea there! 🙂