Should you correct before bed?

I started Tresiba some weeks ago and have found that it works much better over night keeping my blood sugar flat overnight. When I was on a split injection of Levemir I had to struggle with much more of a varying blood sugar profile overnight where my blood sugar would rise at like 3am. Now, it just is steady. But increasingly the problem is that it just sits there. With Levemir if I went to bed a little high the Levemir would beat down that blood sugar overnight. Not so with Tresiba.

So when I go to bed with a high blood sugar I’ll just stay high overnight. I’m thinking I need to correct high blood sugars before bed but it makes me nervous. I do have a CGM which provides some protection against a low, but it isn’t perfect. What do others do? Do you correct before bed? Does it make you nervous?

How high at bedtime? Do you have a pretty good idea of your correction factor?

Last night I just sat there at 140-150 mg/dl all night, but I’ve also had nights where I sat at 200 mg/dl as well as some nights that I went to bed at 100mg/dl and awoke at the same.

And the correction factor is part of what makes me nervous. My response to corrections is highly variable depending on the time of day, activity and phase of the moon.

I would correct a 150 before bed. Especially since you know that the Tresiba is not going to drive it down, too. Maybe you could just be conservative and give half or three quarters what you would give when you’re awake. Another option would be to give a full correction and set an alarm to check. This is where Afrezza shines. It’s never driven me too low when sleeping. I looks like your Tresiba is doing a good job for you.


Do you take Tresiba once a day?
Do you take it at night before bed?

I would increase my basal dose if I was in your position

That being said, I do not bolus yet
And I do not have correction meds.

So increasing basal would be my only weapon, anyway.
For whatever it is worth.

If I increase my Tresiba then I go low during the day.

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Took the words out of my mouth Terry. If I’m higher than 130 before bed I will correct with Afrezza and have no worry of a low overnight. Before Afrezza, I did a half correction before bed just to be safe.

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Duh to me, @Brian_BSC!
I should have figured that one out!!

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No, Duh. You made a perfectly reasonable suggestion.

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I remember this same thing when I switched from lantus. At first I found it a little frustrating-- but the more time went by the more I embraced it as the basal working correctly instead of having learned to work around the sloppiness of lantus / levemir.

I would just correct (maybe a little more conservatively than otherwise) before bed… Some of the fears of correcting can be alleviated by what you described yourself, that with a good basal like tresiba, the basal itself isn’t going to continue driving your bg lower after the bolus wears off…

Or of course like mike and terry say you could just get some afrezza and never worry about it again…


I’ve not tried Tresiba, but have extremely stable BG’s overnight with my pump (except for some DP lately, that happens near-to or just after I wake up). My overnight BG is stable enough, that I never worry about going to bed even as low as 75. I do have a CGM to wake me in the event something does happen, but over the last few months, it has not given me a low alarm AT ALL other than the occasional false alarm - usually the first day of a new sensor.

So… to avoid making a short story even longer :slight_smile:, I correct any and all elevated BG’s before bed without concern.

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I’ve never tried Tresiba either and don’t have a CGM to check BG closely. But I’ve taken enough readings at various times of the night to have a good idea that the 8 units Lantus I take at 6 PM keeps me quite level until DP starts around 3 or 4 AM. So I correct any BG’s over 100 at bedtime.

With a correction factor of 34 or 42 (depending upon which bolus insulin I’m using), and insulin pens that require injections in full units only, that just means that if my BG is somewhere between 101 and 134, I take a small snack to make up the difference, along with one unit of insulin. Usually peanuts or cheese as a snack. Since I target a BG of 100, that allows for 30 points of error due to higher than usual insulin sensitivity caused by exercise or some other factor without going hypo in the night. Following this routine I’ve only gone low in the night twice in over three years, the lowest of those was a 52. I usually wake up to a number between 85 and 110 if I get up around 4:00 or under 140 if I sleep in as late as 10:00.

I should note, though, that I try to take my bedtime reading at least four hours and preferably five hours after my dinner bolus, to make it as accurate as possible. Taking that bedtime reading too soon can really mess up the calculations. I noted a few weeks ago that my BG dropped 65 points between readings 3.25 hours after bolus and 4.3 hours after dinner bolus of 8 units - enough for 64 grams carb.


Interesting variations of experiences here!

My newbie experience, FWIW,
Is that not only does Tresiba keep me relatively flat thruout the day and night

But that it limits my lows.

Maybe I’m just too new to this game, but I have not had a true hypo yet.

Lowest reading ever was fasting at 57 on Tresiba.

Easy enough to fix with a cup of coffee or a small handful of nuts.

I don’t know if this is an unusual experience. I know for some, 57 is too low. Not for me.

I do prefer to be 70-95, which is usually what I measure, unless I’m getting sick.

And post prandial has been predictable at 95-120, unless extenuating factors involved.

On LCHF diet of <40 carbs per day.

Certainly better than my diagnostic level of 465.


I always correct if I’m out of desired range before bed, though like @mikep said, I’ll usually dial it back a bit just as a precaution.

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For my daughter, I correct anything over 100 at bedtime, because the Dexcom alarm will wake me if she goes below 65.

Do you mean you correct aggressively because the CGM wakes you? I sleep deeply and if I set of my alarm regularly I might have trouble with the “boss.”

In the past I thought you have mentioned that you don’t really have lows? Has that changed?

I use Lantus at bedtime and tend to have a drop (“adjustment”?) about 3 am so I tend not to correct at 140. My correction factor is more reliable now that I don’t take Metformin so I feel more comfortable correcting a higher high BG…unless I’ve had a lot of exercise or some vino. Like you, I can only correct in full doses so I tend to be more cautious. Next time it happens I am going to give the Afrezza samples ai have a try.

ETA: The family wanted to eat at the new Vietnamese place tonight. I figure, no problem, I have Afrezza to correct if my bolus is off. Well, I needed a correction and got the samples out. Of course, wouldn’t you know, there’s NO inhaler! :scream: So down to the elliptical I go…

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Yes, fortunately I’ve always woken up to the Dexcom Share alarms.

FWIW, since this stuff is so individual and time-variable . . . .

I use a split dose of Levemir, 10 PM and 9 AM. 120, give or take, is my pivot point. Much less and I will not correct. Much more and I will. I know my ratios and factors quite well, so I can dial in the right correction pretty reliably. Haven’t gotten into trouble yet. But of course that’s just one anecdotal case.