High at night

last night i was up till 2am at home. before going to sleep, i took my blood sugar and it was 207. omg. i felt fine. i didnt correct because one stupid unit can lower me 100 points, sometimes even more. (a couple of weeks ago i tested at 248, corrected with 1 unit and woke up at 4am with a bs of 60-no other fast acting insulin on board, zero).

i woke up this morning with a bs of 113, which is an acceptable number. i dont have a chance in hell of getting a cgm where i am. could this mean im that high EVERY night?!? and how can i fix this without going low if this is the case??

No, I definitely wouldn't assume this means you are that high every night, though it couldn't hurt to do some more late night testing. Did you eat a high fat food for dinner (perhaps high fat and also relatively high carb?). If so the highs can indeed come much later, and I believe you've said that living in Spain you eat later.

You might want to do some testing and record keeping to lock in that ISF. If it really is 1:100 you would be a great candidate for a pump, which I would assume is an option in Spain.

thanks for the reply zoe. i am still really sensitive to insulin, going on about 2.5 years in, caught it really early and low carbed and exercised like crazy from the beginning.

i may have had a bit more carbs than usual, but not by much. in the next couple of months, novonordisk will be making 1/2 unit pens for spain again-they stopped in 2002 or something-and i cant wait to be able to safely correct at night! and during the day without having to sit on the sofa for four hours after putting in a unit!

the only way to get a pump here is if ihave uncontrolled diabetes, so i guess ill have to do irreparable damage to my internal organs by letting myself run ridiculously high very often, or make friends with local ambulance drivers by getting myself so low that i require urgent care, neither of which are very appealing! i will talk to my endo again about a pump when i see her in may. i love socialised medicine. kind of.

Ah, I didn't think of that. I just assumed that anything the U.S. had, Western European countries had as well.

I wouldn't start thinking about solutions for a potential problem.
Test a few nights in a row and see if that's really the case!

Are you sure that in Spain they don't have half unit pens? How do they handle the pediatric situation? In any case you can order it online from another country in Europe with 0 problems (besides the price). Alternatively, did you give a thought to syringes? (you can dose 1/4 there).

What insulin do you use for bolus and corrections?

Could you look into diluting insulin? I don't know much about it (have never done it myself), but I know it's possible.

Ditto on diluting. I think some insulins can be diluted with medical grade saline.

yeah, ive begged for syringes and have been told that the units are too small, asked about diluting, told no, that 1/2 unit pens will be here in a couple of months. honestly, i dont know how they handle the peds situation! novo nordisk stopped marketing the 1/2 unit pens in spain because it was not economically viable. nice.

i use novorapid for my corrections. i hardly ever bolus because i am on a low carb (ish) type diet. if i eat lots of carbs, i do physical activity afterwards. i may be running the basal a bit hot, though i dont think so...

right, so ill have to test in the middle of the night, but if im on mdi, can i expect to be flat all night? i mean, bg is bound to go up early morning?

There are 1/2 unit marked syringes with whom you can eyeball 1/4. Also, I think there are medium to dilute Novorapid. (never done that)

Bernstein once said that he uses a regular insulin for correction (intramuscolar) cause of the analogs are too strong for him.

If you have no problem in funding your own stuff just buy 1/2 pens and you are done. The cheapest made by Novo is the novopen junior.

Do a night basal test. Be sure you don't have anything in your stomach and check once or twice. As regards dawn phenomenon, everyone is different. In my case, I just inject 1u of regular waking up and I'm done.

Maybe you can find another doctor to work with you on the diluting. Perhaps you could call the insulin manufacturers and find out what can be used to dilute and possibly buy online. There are some that can. I can't eyeball the 1/2 unit syringes to 1/4 (I can barely do 1/2u, but maybe it's a coordination/vision issue. I found the disposable pens kind of leaky, and didn't have faith in them, but maybe non disposable ones don't have that issue. But still at 100 points per unit, I'd want to dilute. I'm at about 20 and would like to be able to.