I am brand new to the diabetes community. I was just diagnosed 2.5 weeks ago. I am a nurse and so as far as the normal things I kinda knew the basics. My question is since starting my Lantus at night I wake up with a horrible headache every morning as well as I will wake up in the middle of the night with my heart racing. Is this something diabetes/insulin related or is just my anxiety since diagnosis? Thank you in advance!
I’d suggest checking your sugar if you wake up at night. Morning headaches were a common feature following a hypo for me.
And heart racing would be during the low.
Have you checked your BG when this happens?
Maybe try a libre cgm to follow trend of what your bg is doing.
If bg ok, maybe reaction to additives in Lantus, or as you mention, anxiety/stress?
Do you also do a mealtime insulin? If so, how long before bed?
Welcome to TuD @Kelsey1! Sorry you qualify to join our club but community is one of things that makes life a little easier for us. If you stick around, you’ll learn useful things you won’t hear elsewhere.
Taking Lantus at night won’t likely cause a headache or a racing heart. The stress of the diagnosis and the overload of new information, however, might.
A low or high blood sugar can cause some uncomfortable symptoms. How have your blood glucose levels been? Are you using a fingerstick meter? Are you just taking Lantus or are you also taking a mealtime insulin? Are you using pens?
When I was first diagnosed with type 1, my heart would race and I also got headaches and weird pulsing feelings in my ears.
Even though my sugars were in range as much as my meter could back then, but really I was just getting used to my new normal. If you were running in the 300s and now you are at 100 your body is in a sort of panic mode.
If you do a finger stick and it’s in the normal range, then probably you just need to get used to the normal range.
The first insulin they gave me was Lantus with directions to keep increasing it every 2 days until I reached the level that worked. The problem is the amount that worked during the day was too high of a dose for at night. I would wake up shaky and my heart racing and sweating because I was having a hypo on some nights. Lantus is actually kind of notorious for that. And the headache can be from a low or a high BG level or during the night.
I don’t know your age, but usually the older you are the longer you will have what we call a honeymoon period. Your pancreas will still work some for a certain amount of time, sometimes years. So the dose that seemed like it was working yesterday might be too much on the day your pancreas still decides to help some. It is a little erratic unfortunately.
In the US they like to give a long acting insulin at first, some other countries start you with a fast acting. A fast acting while scarier, can be better used because the amount can be adjusted as you need to adjust. Optimally a lower than needed dose of a long acting like Lantus (for when your pancreas is working better so you don’t hypo), along with a fast acting like Humalog, which can be adjusted to what you eat and what your BG levels are I think is best. That way you can up your fast acting to deal with a higher BG level for that day… You don’t really want to keep adjusting a long acting unless it’s needed. Plus it will help you get used to carb counting and adjusting doses as needed, getting used to it by using tiny doses of insulin. But at first they might just be trying to get you used to using insulin with the long acting insulin.
One of the most important things whenever on any insulin…hypo treatments. Glucose tabs, juice etc by the bed side and always carry some with you. Try to get a CGM as soon as possible, Dexcom is definitely the best but a LIbre will do. That way when you wake up in the middle of the night you can glance over and see what Bg level you are “about” at. Or at work. Always test with a meter as needed.
Thank you! I will def check it to see if that is what is causing it!
Yes I do take Novolog with meals- and it just depends on the time I eat anywhere from 6-7:30 PM and then I take my long acting around 9PM
I am doing manual finger sticks at the moment- hoping to switch to a CGM soon. I take the Lantus at night and then I do the Novolog for meals/corrections. My BG has been kinda all over the place still. I tend to have higher ones first thing in the morning I’m noticing. This morning I woke up at 203 which I swear I dosed right before bed so I guess I don’t have the hang of it yet
i wondered that- if it was just my body trying to adjust
I am 25 years old- and I think that may be what is happening. I notice when I wake up and my heart is pounding and Im sweaty Im usually just so tired I’ve just ignored it but maybe I need to start checking to try to see if that is the case. I too am increasing my dose to get in that “sweet spot” but I prob need to check at night a little more often until I get a CGM
You have to remember you are eating during the day and not making enough insulin to cope with that food. If your numbers are staying higher during the day, you are probably not using enough fast acting insulin with your meals. But at night you are not eating and and hence it is too strong of a dose. You can try splitting the Lantus dose so it’s twice a day. That way you can lessen the night dose and see if that works. Some people actually prefer that as it doesn’t really last 24 hours. Not lasting 24 hours could help explain the high number when you wake up.
The other thing that can explain a high number when you wake is some people get what we call DP (dawn phenomenon). It’s a release of hormones, usually about 5 am, and your liver releases blood glucose to get ready for the day. In a normal person you make insulin to deal with it. And of course we don’t so we wake with higher numbers when it happens.
Also another thing it can be is a rebound effect from dropping too low at night. Your body if it still makes Glycogen, will release blood sugar with too low of a drop. Don’t count on that as a lot of us lose the ability to release glycogen. Plus if you ignore the hypo feelings, you can lower the level you feel them or lose the ability to feel them at all and that’s worse.
At 25 you will probably lose the ability to make insulin pretty quick, so your needs will go up as it happens.
A CGM will do wonders for your glucose management. It can reveal things unique to your body. It helps with alerts and warnings but it really shines in its ability to educate.
In addition to a possible under-dose of the previous night’s Lantus dose, this can sometimes be caused by eating too close to bedtime and by delayed absorption of fat and protein in a meal. I agree with the other comments that a partially and intermittently working pancreas can also cause this.
A CGM would really help you. If you have access through insurance, there is no good reason to delay. Sometimes doctors drag their feet in supporting early adoption of diabetes tech for overly cautious reasons.
If it’s not too troublesome for you, I recommend keeping some notes. Write down things like what you ate what your blood sugar was and when. Over time you will be able to detect definite trends that would not be readily apparent without note-taking. It can shorten your learning curve.
Another welcome to the forum and to the T1 club, subgroup “We got it in our twenties!” (Ok, I just made that up, but quite a few of us were dx’d around then—I was 28.)
I didn’t see anyone else mention it, so: that sounds like “Dawn Phenomenon” or DP. Very common to have your BG start ascending in the early hours before getting up. You might want to peruse the Terms and Acronyms threads pinned at the top of the main Forum page. But basically it’s your liver dumping glucose to prepare you to wake up in your cave, start the fire, and get ready to go hunt bison and fight off tigers. Or some such evolutionary thing. Often exacerbated by “Feet on the floor” syndrome which is more or less the same thing.
I struggled with DP for years when I was on Lantus/Novolog MDI (Multiple Daily Injections). Tried various things, including the risky one of taking a little bump of Novolog at bedtime (don’t do this) before I knew what I was dealing with. Dr put me on Metformin at night, which helped a little but it wasn’t really going to the root problem, which is just: this is something your metabolic system is designed to do.
Only thing that DID work, finally, was switching to pump therapy. Old school pumps let you dial in different basal rates for different times of day—I have mine set to go way up starting at 3:30 a.m.—and newer ones that are tied into a CGM are designed to compensate for this kind of thing automatically.
You’re a ways out from Pump/CGM, but one thing people on MDI do is split their Lantus dose to account for these kinds of vagaries. Lantus fades, for one thing. Sounds like you’re already doing that, though, but something to discuss with your Dr. There are other basal insulins that may do better for you, short of moving to pump/CGM which takes some time to get trained up in. Main thing is, it’s not because you’re doing something wrong! It’s just your metabolism trying to do its normal thing, but part of the system doesn’t work anymore so it’s messing you up.
It might also be a reactive high. When your sugar goes low, your liver will dump glycogen to bring you back up, but livers tend to over do it.
Thank you so much for explaining it all- it really helps more than you know!
Thank you so much! I have been keeping a log of my BG’s, what I am eating, and my insulin so that way I can hopefully get some sense as to what affects it more.
I will try the splitting method to see if that helps make it not dip so bad. I hate waking up so sweaty and my heart pounding following by a horrible headache later.
You may want to consider using a Libre cgm to get good idea of your bgs 24x7, as you tweak your dosing.
Or check if your doctor would do a Dexcom G6 Pro.
“The Dexcom G6 Pro Continuous Glucose Monitoring (CGM) System is a practice-owned diabetes management tool with the accuracy of the personal Dexcom G6 CGM System.”
Fixed, Post Gone!