Low dose of Basal Insulin

Hi! I have LADA for the past 5 yr and I am currently taking humalog with meals (approximately 1-3 units per meal depending on what I eat - normally low carb) I use a CGM device, rotate between dexcom and freestyle libre.
Bellow is a few days showing my curve at night, it’s very interesting it goes up and down (maybe it’s because of cortisol release?)
Since it’s been constantly above 100 and I wake up around 145 I was considering starting on a very low dose of basal insulin (Lantus) maybe start at 4 units at night? Could you share your experience with basal use? I am 60kg. My endocrinologist says I don’t need it, only if I am constantly above 160 at night; what seems quite high… I appreciate your insight. I know that if I go backpacking or do long hours of aerobic exercise during the day I wouldn’t need the basal; or if I drink alcohol at night (that seems to lower my overnight blood glucose as well)

I think you are getting to the point where you need basal insulin but your Dr will most likely not want to give you a prescription yet. Those up and down CGM traces are either indicative of cortisol release or just your pancreas producing insulin less and less reliably.

I don’t personally worry about my BG while I’m asleep until it gets up to 170 but I know many people who practice tight control would not be okay with a BG that high. I do use Control IQ though so I am usually not that high either anymore. Your Dr will need to be more afraid of the consequences of high BG than the risk of low BG to put you on a basal insulin though unless you can convince him/her why you feel it is time to go to that next step.