Night time lows - Do they make us purposely run high?

Hello All,

Just wondering how the fear of nocturnal hypoglycemia plays in our overall diabetes glucose control.

Sometimes. Generally speaking, I can go to bed at 90 and wake up at 95, which I try to do often. If Im feeling a bit timid, I have a kavli crisp with cream cheese and 1 tsp of PB. its a total of 6 carbs with about 20g fat. Psychologically, I think the carbs will bump me 20mg and the fat will carry to morning. I do that if Im <80mg/dl. Otherwise, my trends run on a 4-6 hour span and I dont sleep more than 5-6 hours a night. That means most days Im pretty confident and not thwarting all my control.

Going low at night does not have much affect on my daytime BG. I don’t like it and it’s scary enough for me to check my BG at least once at night around the time when I would usually go low. I used to just wake up in response to lows in the 60s but I’ve decided to take a bit more precaution these days.

No, I would never purposely stay high at bedtime to avoid overnight lows. First of all, unlike many I hear about, my bedtime numbers don’t bear much connection to my overnight or fasting. I can be high at bedtime and wake up just fine. Or I can be fine at bedtime and wake up low or high. I don’t snack at night. If I’m 70 or below, just for safety I will take a couple glucose tabs. If I were consistently experiencing a pattern of lows at night I would lessen my basal.

Since I started on my pump I’ve had many nights of lows and waking up high… to the point where the nights that I eat a small snack like some dried fruit I tend to be normal in the morning.

I just have a snack before bed - either pita bread and hummus or apple and yogurt. It keeps me nice and smooth through the night.

Do you check every night FHS?

When I first went low carb I had some 40s at night and the Dexcom along with my wife were my saviors. She would wake me up as I slept through the alarms. Happened twice to me.

I don’t have all that much fear of hypos. I have a slight basal bump at like 5:00 AM to get a head start on shoveling out the DP gunk and then hit it w/ about .2 or .3U before I shower to keep it pretty reasonable. A lot of times, I can keep pretty flat lines all night. I don’t mind waking up @60 or so b/c I’m usually in a stupor at that hour of the AM anyway. I like to eat junk food at night and will have a hit of that around 9:00 and then check at 11:00 and don’t usually get a huge spike out of it. As long as I don’t have any insulin on board, I will usually be pretty smooth in the evenings. This is not every night but isn’t that unusual:


I also think that ‘fear of lows’ probably inclined me to run higher @ night, before I got the pump and was able to buzz off DP? Particularly on shots, I had plenty of nights (on R/N) where I’d sweat through sheets, blankets, duvets, etc. from what I presume were hypos. The week after I got the pump, we had a freak New Madrid Earthquake in Champaign, IL and MrsAcidRock, who’d been briefed on watching out for hypos stirred and said “wake up! You’re shaking the bed you’re so low!!!”

Yeah onesaint, for all intents and purposes, I do. It’s just automatic now. Somewhere between 2 and 3 in the morining, I’ll wake up and go check my BG. 75% of the time, I’m fine and my Dex is reading within 20% of my meter. If I’m low, my Dex usually wakes me up if it goes off. Otherwise, it’s just me getting up on my own. I had a bit of scare last night, my Dex woke me up when it hit 60, but I was 48 based on the meter. That’s a bit low for my comfort. My Dex caught up about 10 minutes later and showed 50 with a slight down arrow.

My SO sleeps way more soundly than I do. She’s only woken up to my Dex alarm once.

I don’t have too much trouble with nocturnal hypoglycemia but I aim a little higher over night because I have trouble with lows after breakfast if I start the day out much below 85. I do some insulin juggling and it usually works out but I’d rather wake at 115 than 75.

Maurie

I take the opposite approach and do all I can to avoid a high (in my book, high is 170 and above). So I routinely go to bed at 70 and I’m totally comfortable turning the lights out in the 60s. I always sleep soundly and usually wake up between 60 and 77, which I consider perfect. I’ve been doing it this was since I got my first meter in 1975. I’ve never had a hypo or a seizure in 51 years of D; never been incapacitated by a high or a low in all those years. I can only speak for myself, but I make sure if I err, I err on the low side rather than high.

I have a standard 3am that I do sometimes. Although not regular. Thats just wild.
My Dex is set to 70mg/dl in order to catch those lows. You know, always off by 10 points! =^D

I had mine set to 70 at one point, but it just kept going off all the time. That’s part of the reason why I get up in the morning to test now. It was either set it to 70 and be awake all the time, or set it to 60 and wake up at a regular time to check.


My reading show that I kinda bounce around sometimes. So I might hit 70, bounce up to 80, then drop again. Really strange.

It’s not unusual at all for me to wake up in the monring somewhere around 70. I couldn’t stand the Dex waking me up at 4:00 in the morning for a 70 BG when I had to be up at 5:00 am anyway. >(

I turned mine down to 60 as well. Even if it’s set to vibrate the MM gets jazzed up and bleeps crazier and crazier the longer you ignore it, sort of like R2D2. 70 was not useful.

I blow off waking up at night. The ‘downside’ of exercising for me has been that I am an inanimate object when it’s “Check Out Time”

Dont exercise near as much as you two and Ive been “checked out” all my life. Sometimes when I’m awake too! =^)

If I catch the Dex at 70, that generally means I’m at 55-60 and need a correction. I sleep through the buzzes like its nothing. I usually wake up between 70-100 depending on my intake the night before.

The worst part, I would set my alarm for 3am, pass out on the couch not to wake the wife and sleep right through the alarm. Wake up 70. I just figured out how to increase the vol on the alarm last night. Us PWD are doomed to never sleep right.

I sleep like a log most of the time. The puppy clinking around in her cage wakes me up more than the gizmo.

I just started insulin in December and really my “only” concern is nighttime lows. My biggest problem, I exercise in the evenings (8-10pm) during the week. If I have nutrition post workout and bolus, I worry about dropping. I’ve had Late Onset Hypos, two hours after exercise. It seems unpredictable. I also still have a great variation in where my blood sugar goes during exercise (weights), sometimes I’ll be 100 mg/dl and sometimes 200 mg/dl. So far I’ve been limiting carbs and not covering because of concerns. I guess everybody is different. I need a lot more experience, I need to wake myself more and determine how I react to these things. But I just know that exercising in the evening sets me up to possibly have a hypo 2 hours later and I need to be careful.

Hey bsc, I know you’ve probably heard this and thought about it even, but I’ll put in my 2 cts and suggest a CGM.

But remember, I am taking insulin in direct opposition to my doctors. I’m unlikely to be granted even a loaner CGM right now.