Nighttime rollercoaster

Hey guys:

I just got my dexcom a couple of days ago, so I’m not anywhere near a flat line. I do have a question I hope you guys can answer.

Last night, while I was sleeping, my blood sugars kept going up and down and up and down. They never actually went high or low, but they kept having a rollercoaster. I could understand this happening somewhat if I were on the pump, but I’m on lantus, so I’d think my sugars would be steady. I took a picture of a 3-hour window, but it was the same from when I went to bed until I ate breakfast. So my questions are:

  1. Is that normal? Is it just because of differences in blood sugars or is it something blood sugars normally do?

  2. Is there anything I can do to keep them level? I feel like it can’t be that good for me to keep going up and down all night…

Dexcom3.19%20morning.jpg

Hi Anna! Thanks for joining, posting, and of course we hope to see more trends.

This one you posted looks really good. Your fluctuations look like 10mg up and downs - nothing to worry about. I dont take lantus, so I dont know how it delivers, but there is a good number of variables that come into play, Your 3 hour trend started at 100 and ended at 121, which is pretty dang good.

Lets look at some things and see if we cant figure the humps out. First off, what did you eat for dinner? What did your days trends previously look like? Is the sensor new? In the beginning the sensors do a training thing and might not record things just right. I think its 7 days that lasts. Also, someone who is on Lantus, might be able to shed more light on its delivery patterns.

To me, it looks like little liver dumps – just to be sure you don’t go too low. Even in non-diabetics, there are variations in BGs while they sleep – I don’t know how much, but there is never a true flat line.

Why don’t you keep on watching for a few days and see if this stays the same or flattens out. I’d be curious!

Anna, Lantus is not necessarily going to keep your BS steady – a lot of people do find that Lantus has some really bad peaks & valleys. You said you could see having a rollercoaster if you had a pump but actually, a pump can give you a steadier basal rate because you can program a bunch of different rates throughout the day and meet your bodies requirements.

Have you ever done basal testing? Basal is not just for pumpers – I did it frequently when I was on MDI. That is one way to find out how steady your Lantus is. Gary Scheiner recommends that your BS not go up or down by more than 30 points for the basal test. John Walsh recommends that it not go up more than 15 points but it should not drop by more than 30. If you go by Gary Scheiner, that is a 60 point spread and according to John Walsh, it would be a 45 point spread. Both of those spreads have some fluctuation in them and your basals would be considered correct if you met either of those.

Like Onesaint said, you also need to look at what time you ate dinner & even what you ate. Protein & fat digest slowly. If you ate a later dinner of protein & fat, that could be part of the problem. If you lay down after eating, that can also slow your digestion down.

I am not convinced that your BG went up and down. The sensor readings are affected by pressure. It is very likely that the pattern reflects how you toss and turn. I place my sensor close to my navel because this is the only area that I don’t sleep on.