High Sugars Overnite

T1 for 15 yrs.adult onset, age 60 Novalog and Levemire… from 8 am-10 pm, ave 100 levels. But come 10 pm? take My Levemire and test & it spikes to 175’s and No matter how my much NLog I take as a Correction? I still have to set my alarm for 2 hrs., test and take more…I tried splitting the levemire to just about everything else under the sun… but, Unless I get up 2 hrs after bed and test and take a correction on the ave of every other nite? I will get up in 200’s… and Unable to get a Pump…
Any other ideas? Thanks

What are you eating for dinner? If you have something with high fat content, perhaps the carbs are hitting your system later than you would expect.

Hi Dennis,
My digestive processes are a problem for me and I wonder if the same thing is going on for you. Are you taking the Levemir twice a day? I have to set times to eat and pretty much stick to those times. I eat dinner between 5:30 and 6 pm., absolutely no later than that. I eat nothing after dinner until bedtime. Then I have some yogurt mixed with two tablespoons of ground flax. And the time for this is fixed also. It has to be around 10 and i shoot my night time Lantus. If I need correcting I also shoot my Humalog as well. I always have meat and vegetables and maybe some fruit for dinner, but am having to watch how much meat it is. My doctor says that my own particular digestion has changed over time and that is his best guess as to why we have to set my eating and shooting times so particularly. We have also increrased the amounts of Lantus I take for both mornings and evenings. I sure hope this is a help for you. I know how miserable a night is when blood sugars run high

I agree with libby, fats can cause a spike 4+ hours after a meal, it might even be your lunch that’s causing the stir.

If I can be so bold - try not to eat so late and get a 1/2 hour walk in there before bedtime.

Best of luck!


Why take more NLog as correction here? You need more Levemir. If you go up about 100 mg/dl in the night, over about 8hrs, and you take two shots of Levemir per day, then for the Levemir shot a couple hours befor bedtime, add the number of units you would use of Novolog to drop you 150 mg/dl (probably about 6 units?)

You might also consider whether it is protein that you ate for dinner which might be causing the rise; try having a low-protein dinner some night and see if your fasting numbers look different as a place to investigate. Contrary to what you might have been told, protein ultimately IS metabolized into blood glucose, but it typically takes anywhere from 6-10 hours before it shows up. If that is the case, then adjusting a basal insulin like Levemir might not be a good idea, as it may cause you to go low all day just for a normal fasting reading. If you’re on a pump, you can adjust your basals accordingly, injections, some people find that a small dose of NPH overnight does the trick.

It seems the Levemir/Novolog combination just isn’t doing it for you. The problem with Levemir and Lantus is that have been designed to deal with flat basal insulin requirements. It would be nice if we all worked that we, but we don’t.

The first thing you need to do is test your basal requirements in the evening. You do this by skipping the evening meal and its bolus, and testing every hour. If your blood glucose rises, you need extra basal action at that time. You can try delivering it by increasing your Levemir and/or injecting it earlier in the evening. Increasing the Levemir could make you go low at other times of the day, in which case you need to introduce another insulin - one with a peak.

You could try adding some Regular or even NPH into the mix. Regular is longer acting than Novolog and peaks at 2-4 hours. So you could try covering your evening meal with Regular or injecting it before bed. If Regular isn’t long-acting enough, you could try injecting a few units of NPH with your evening meal. It peaks at 6-10 hours and should keep your night time numbers down.

We are all a bit different. I use regular to cover breakfast and to counteract the Dawn Phenomenon, and it works very well. Have fun figuring it out …