Fluctuating BS at night

Does your blood sugar stay relative stabile at night? My blood sugars have been going up around 200 and then dip back down. It does this a few times a night sometimes. Leaky liver to blame?? Also, often, as soon as I drop off to sleep, my blood sugar jumps about 30 points. Sometimes it will stay stabile and in good range during the night. I take ozempic 0.5 and once a day. That’s my only med for diabetes. I exercise for 30 minutes around 4 pm in the evening. Any thoughts for why this is happening.

For me it depends on what I ate for dinner, if I had a good amount of fat, I will be up and down all night. Also I don’t eat anything past 7 pm. I have also reduced fat esp oils in my diet.

I also have a looped pump and it keeps me steady all night most of the time.
There are also hormonal shifts that happen while we sleep.
I have a predawn spike that happens at 4 am or so. But my pump flattens that out.

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I didn’t think about the fat content of supper being a factor… Thanks for that tip, I’ll try to watch and see how that affects me.

It’s a new realization, at least 6 months ago. I started to experiment with carbs and carbs with fat.
I find that fat caused temporary insulin resistance and also makes the carbs last longer and are more unpredictable.

I then. Read the book Mastering Diabetes because some members here suggested it.

I don’t follow it strictly, but it really helps me stay in range

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I think it’s common for some people’s BG level to go up at night. But I don’t think it goes up a lot. But yea, if you eat later it could be that your insulin has run out or was not enough to cover what you ate. That would be particularly pertinent to high fat since it delays carb absorption, but also with some people high protein ,as that can actually hit later too.

Mine does too! Every single night. I’ve never read anyone else mention this. It doesn’t make any difference how much earlier I ate or what I ate or what time I go to bed, it always happens.

If I remember, I have a small bolus (1/2 or 1 unit) an hour to half an hour before going to bed. But I usually don’t remember.

Thanks for your reply beacher. Sorry you have this dilemma too. I tried taking some rapid acting insulin before bed and it helped my blood sugar for a few hours but then it spiked when the insulin wore off. LOL…
I don’t exercise as long in the winter as I do in the summer. I think that helps my sugar to stay stabile. I bought a new piece of exercise equipment. I hope I like it and it’s kind to my joints… I miss swimming !!
I just don’t like my BS spiking up to 200 as that’s too high.

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Since you are managing your blood glucose with Ozempic alone, it appears you are T2D. There are many factors that can make overnight blood sugar unstable and my T1D experience may not mirror yours.

I use a low carb (<30 grams/day) high fat way of eating. I don’t find that the level of fat that I eat causes erratic blood sugar movement, at all. I believe that mixing high fat with high carb slows carb metabolism and can lead to an overall mismatch between insulin and food.

I eat my last meal of the day around 5:00 pm and usually go to sleep at 9:00 pm. My meal last evening was a 10-ounce steak with a small fermented cabbage side dish. My overnight blood sugar, as measured by my CGM, ranged from a low of 79 (4.4) to a high of 104 (5.8) with most of time spent in the 80s (4.4-5.0).

Since I’m a T1D and not a T2D, I do not share your metabolic profile. Yet I think the influence of fat on carbohydrate metabolism may be similar. I believe the combination of high fat with high carbs is difficult for the body to metabolize, especially for those of us with impaired glucose metabolisms.

I suggest that you run personal experiments to help identify what might be happening with you. You could experiment with meal quality as well as timing, including not eating dinner at all, and see what BG effects you notice.

You could also add some exercise into the experiments to see its effect on you. Maybe you could also experiment with the timing of your med to see it that changes anything. In that case you may want to consult with your doctor. Good luck!

For sure a high fat and high carb meal doesn’t work well for most of us with diabetes.
When I had pre diabetes, at first, I couldn’t figure out why my A1c was 6.0 until I woke up in the middle of the night to check my blood sugar and bingo, there were my high blood sugars. It’s always been a problem for me. The CGM is a lifesaver and pinpointing when things are good or going awry. Thank you for the insight, Terry.

Many nights I am in a good range when I go to sleep, and at the same time, I know based on how much insulin I’ve needed over the course of the evening (which is something that I can do more flexibly with Afrezza), I still have “carbs on board” essentially. I’ve gotten comfortable with taking sometimes even substantial doses of Humalog (whatever seems needed to cover the leftovers) in those situations which most of the time works out great, occasionally results in a low. I had a gastric emptying scan that came out normal, but it was done in the morning, and I still wonder if I get some degree of delayed emptying in the evening only… it seems to take much longer for anything, fat intake factored in, to hit my blood stream then.

Very cool that you Afrezza, not many people are on that. With ozempic, gastric emptying is longer. Thanks for mentioning that… Something to think about.
Last night, I had a pretty big piece of sirloin steak and a baked potato. I took my long acting insulin the the evening before dinner and also some Novolog to cover the baked potato. My blood sugar was good during the night and also in the am! I took something to help me sleep and some magnesium. I am wondering if the sleep meds helped my blood sugar by helping me to sleep better??? I haven’t been the best sleeper in the last few years. Gonna take it again tonight and see how it goes.

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This for me has been the best consequence of Dexcom/Tandemx2: it almost doesn’t matter WHAT my glucose is when I go to bed, it settles down and I wake up with blood sugar of ver close to 6 mmol/L. If glucose is dropping toward 5 when I go to bed, I’ll have a small snack and if it’s climbing and threatening to go out of range either I’ll give a unit or two (by telling it I’ve just eaten 10 g of carbs even if I haven’t) or I’ll do some low level exercise like treadmill for 10-15 minutes.
But the control IQ has completely fixed my overnight variability.
My problems are the daytime!

My issues were solved with control iq as well
You can bolus units of insulin without pretending you ate something.

If you hit the bolus button it will suggest a correction. If you don’t like that number just touch the number of units it suggests even if it’s 0.0 and you can enter any number.

I do this for corrections all the time because I don’t want my data skewed when it comes to carbs consumed.
Also the suggested bolus is nearly always spot on.


Ha! I learned something!!
I guess if I treat a low, I can enter the 20g of carbs I take or whatever, and then tell the pump NOT to infuse any insulin. Might help with tracking . .

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One caveat you can’t enter zero. You need to bolus 0.05 at least. The 0.0 I was talking about was the suggested bolus the pump gives you. You can just cancel that or bolus 0.05.