Before I sleep

As I write this its 3am, and I’m STILL waiting for my blood sugar to reach 140 so I could safely sleep (it was 108 2 hours ago, now 98, after taking 2 “points”(24gm) of carbs in the form of rice). This has been a long term issue with me. Whenever its lower than 140 or 130 before I sleep, I take something depending on how low it is, and find that it somehow only makes a difference over 2 hours later! This isnt the best when it comes to sleep. I dont want to sleep until it gets higher, so I can take my night insulin (lantus) cause I’m then deemed to oversleep. What should I do then? Also, often times when its 140, and I take my lantus like a nice diabetic before I sleep, its around 80 or 90 20min later! to me, when I sleep its the most complicated point in the day.

Does this have anything to do with my dinner? I often times dine around 4-5hours before I sleep. Maybe I require less dinner insulin? for meals I take actrapid.

I’m not sure I understand why you are wanting to be 140 before sleeping. 80 or 90 or 108 are perfect numbers. Is it that you are afraid if you are 108 you will drop to 50 or 60 during the night? If this is the case then you are taking too much Lantus. I know it’s easier to control your basal levels with a pump, but even with long-acting basal, the right dose should keep you from dropping more than 30 points overnight.

I am with you on this one! If I am below a certain figure (I measure in mmols) I am almost guaranteed to get a hypo during the night. I take a sugary snack before bed as I am rarely high enough.

Perhaps a lower dose of insulin at the last big meal of the day would help. Only way to do it is to experiment. Good luck.

I have the opposite issue. It’s 1:30am, and I’m at 160 which is WAY high for me, for no reason I’ve figured out yet. I’m waiting for mine to get down to at least 120 before I sleep. We are all so different :wink:

Sounds like you’re taking too much Lantus to be dropping that rapidly. Lantus typically takes several hours to start working. I’ve not heard of basal taking effect this quickly unless it was accidentally injected into muscle. Best to adjust insulin to what you eat & need rather than eating to cover the insulin.

My goal for sleep is 90-100.

I’m not sure why you feel you need to be at 140 to go to sleep? Do you often go low at night? I would have been perfectly happy going to bed at 98 or 108.

Lantus is a long-acting insulin and should not have any immediate impact on your blood sugar. Ideally, your bedtime blood sugar and your waking blood sugar should be about the same. Your waking blood sugar should not be 20 points below your bedtime blood sugar. If you are having huge drops overnight, then that might be a sign that you are taking too much Lantus. Reduce it by 5% and see what happens. Keep testing and make small adjustments.

I don’t think it has anything to do with your dinner because insulin should be out of your system in 5 hours. If you are not sure, note down what time you took your dinner insulin, then test your blood sugar 5 hours later. Even if that means setting an alarm clock to get up to test.

Finally, if the goal is to get blood sugar up quickly, you need to take quick-acting carbs. Like orange juice, Haribo, glucose tablets. Those will act immediately; you should not be sitting around waiting for your blood sugar to rise.

I know what you’re going through. I used to be on Lantus for long acting. I dreaded bedtime so bad for the wretched year of my life that I was on it.

I had episodes where I would take my Lantus shot, and 15 minutes later I would drop 4 mmol/L (72 mmol/mg)…and keep dropping, despite eating. I experimented with this; I would make sure I had no fast-acting (Humalog) in my system for 4 hours. It happened often enough to really scare me about hypo’s. I later learned that this drop usually happens if you hit a vein with Lantus, then the special acid coating that makes it act slowly, dissolves way too rapidly. A fix I tried was taking 1/2 does at bedtime and 1/2 dose in morning. I was taking 18 units/day, so I split it into 9 at night and 9 at day. Easier to compensate for if I kept dropping. Nevertheless, these episodes scared me a lot and made me feel unsafe going to bed with normal readings for the longest time. In contrast, I was happy with regular readings during the day, because Humalog never caused problems like that…but I found them very hard to attain with such bad nighttimes.

In addition, Lantus is NOT a 24-hour insulin for all people. For me, it hit like a tow truck for the first 4-5 hours, then did very little to help with naturally rising glucose (released by the liver) throughout the day. I had to go to bed with a reading of 14 (252) if I wanted to wake up no lower than 4 (72). I could NOT go to bed with a lower reading. Thanks to that and the rapid drops, there was a time where I only felt safe if my reading was around 20 (360) when I took the Lantus.

My advice: If this is happening to you…switch insulin, fast! Don’t let Lantus do that to you. I had asked my doctor for help but received none. I am now on an insulin pump running only Humalog insulin, and while my numbers aren’t perfect yet (some hormone issues that I am working hard on with new meds and a low carb diet), they are so much better than I got on Lantus. If the pump isn’t an option for you, there are always other long acting insulins. Just my advice! I hope you can figure something out =)

Hey thanks a lot for your advice! I will be experimenting with less lantus tonight.

Both of my past endos would tell me to only take my lantus with a BG of 160, rather than 140 or 120, which is what confuses me now… I thought lantus decreases the BG slowly, hence the need of a slightly higher BG before you sleep?

Also, quick acting carbs have the risky of shooting high then LOW right away, which is why I only tale them when really low

Another thought is that Lantus doesn’t work for everyone. If you are still seeing rapid drops, you might want to think about splitting your dose. Same total dose, but take half every 12 hours. If that still doesn’t work, you might want to consider switching to Levemir which is the other 24 hour insulin.

A 24 hour insulin should NOT give you rapid drops. If it does, it isn’t right for you.

Wow thanks a lot for sharing your case! Thing is, with me the endos would tell me to sleep with 160 even, rather than 140. I guess u and I are under the same category but lantus was more evil with u :stuck_out_tongue: glad you found an alternative! I’ll try experimenting with lower lantus dosages first before I switch

Lantus has peaks, if you have the option of trying Levemir. I find Levemir much more level. Levemir is best used in two doses.

Basal works so slowly that ideally it should keep BG stable, not lower it significantly. With the right dose, you shouldn’t be raising BG to prevent lows.

Fast acting carbs don’t cause lows later for me.

My gut reaction is to say try less lantus and less actrapid at dinner. People are less insulin resistant in the evening. During the morning, my I:C is 1:8, but I can get away with a 1:20 ratio in the evening. That’s because you’re producing fewer hormones in the evening, thereby making you less insulin resistant. If you do this, you might find that you’re ok with going to bed at 120 or so. Just make sure to set an alarm and test in the middle of the night, maybe more than once initially.

I would fire any endo who is telling you that you need to be 160 (or 140) to sleep, and actually eating more food to raise you up to that level! Those numbers are highs to be avoided, not sought out. As everyone else is saying, I agree that if you are dropping too low (more than 30 points) overnight then you are taking too much Lantus. I also agree that either splitting the dose or switching to Levemir (in split doses) might work better.

If this repeats suggetions or information provided by others here I apologize. I am at work and they are gracious by giving me some time to post on here during work hours.

I take Lantus as well and I take mine in the mornings. I used to take other insulins and would have lows mainly at night. When I was switched to Lantus the doctor and I talked and decided to take it in the morning before breakfast. That might help aleviate that nervousness and allow you to sleep better.

I also suggest that you keep track of your food and beverage intake and I mean be exact with it. If you are outside and swallow a knat, put it down. You will start to learn how different foods affect you. We are all different and foods and medications affect us differently. Get to know how your diabetes reacts.

Knowing how your body responds will also help to keep the nerves in check.

Mmmm. What is the carb content of a gnat? Interesting thought! I swallowed (or inhaled) and was bitten by hundreds this time last year - and was mostly hypo for 3 weeks - but that was the exceptional heat, methinks!

I actually asked a doctor once what the calorie intake was for a knat versus how many calories you lose when one bites you. I wanted to know whether I was ahead or behind.

Brokenpole, what was the answer? I am curious!

I don’t think it has to do so much with the amount of Lantus being distributed; it is the method of distribution that is the problem for some of us. On Lantus, I had to take minimum 18 units or else my BG would be on the rise all day, with no chance of good readings at all. On Humalog (basal with the pump), I need about 19-20 units a day. The difference is Lantus was working for the first 4 or so hours way too hard, then tapering off and doing very little for the rest of the day; while my pump basal setting works guaranteed even amounts–as much as required–every hour of the day. Splitting up the Lantus shots helped a little but not much in my case.

TaupeLime, by all means…try out split shots first. But if that doesn’t work…I suggest not waiting to switch. Problems like this can make you feel crappy and over time will cause damage.

As Zoe said, you shouldn’t need to go to bed with a high reading, the idea of basal insulin (long acting like Lantus) is it counteracts the glucose your liver releases naturally. So you should be able to go to bed with, say, a reading of 100, and wake up with 100.

And remember…if this problem keeps occurring with different types of long acting insulin…there’s always the pump :o) just like types of insulin, it works for some, and not for others…not for everyone. But seeing as we have similar cases with nighttime long-acting complications, I can guarantee you that that problem–in my experience–goes away as a pumper.

LMAO “If you are outside and swallow a knat, put it down!” win <3

Oh, I never got an answer, other than him be a smart… . He would always come back asking me how I was going to count them.