this is a trend ive been seeing for about a week, since i changed the time of my evening levemir from 7pm to 830. at 7pm i was waking up at 110-115. so i changed it and now im waking up at 73, 75. its great to see that number but worries me a bit cuz if i sleep a bit later maybe ill hypo? i take 9 units of levemir at night and 2 in the morning. ive been trending a bit lower than normal for about a week, during the day and the night. i think my honeymoon is on its way back, as im not having to bolus for low carb meals and even if i eat a 15 carb dinner without a bolus, i am waking up in the 70s. should i wake up in the middle of the night to test and see if im hypoing in the night?
thanks.
Well, the "normal" range is roughly 75 to 90 and of course it varies greatly from individual to individual. That is a pretty sharp drop for you so you probably want to keep a close eye on it, see whether it stays where it is. If you're really concerned, try lowering the basal just a tiny bit (very small increment), give it 3 or 4 days to stabilize, and then see where you are. A key thing is to make SMALL changes and give them time to settle in before reaching conclusions.
And yes, if you're truly worried, a middle of the night test will either confirm that there is a problem, or else put your mind at rest.
so i would test at like 2am, no?
im only gonna lower it by 1 unit.
Sounds reasonable. I would check at a couple of different times (not on the same night - LOL) since the response curve of any given insulin varies greatly from individual to individual.
If I was waking up reliably in the 70s, I wouldn't bother testing at night. I'm fine with that although I cheat with a CGM...
why doesnt this just stay the same?!? ffs! i gave myself 9 units cuz im afraid to lower it now, just like i was afraid to raise it before. its like russian roulette here.
and this week is the seville fair, so i know i will be drinking alcohol and its gonna be eating out all week and its hard to carb count...i never thought id be cursing running on the low side!
The only thing that I would worry about waking up in the 70s is the chance that I was lower before I woke up. Before I had my CGM I knew that this occurred because the first little bit of carbs in the morning would send my BGs to 180+ (10 mmol/L). If I could reliably wake up in the 70s without going low during the night, that would be ideal.
Yes, I would spot check during the night until you find a basal dose that reliably works for you.
I know this isn't an immediate answer, but this is one reason why pumps are so much more effective at controlling basal levels, because our needs are different at different times.
Since you're also experiencing this with meals, it may not be changing the timing that's responsible. A difference of 1.5 hours shouldn't make a big difference. We go through periods of increased/decreased insulin sensitivity.
yeah gerri, i thought it was quite strange to see such a big difference. maybe im just more sensitive to insulin these days and i happened to change the time just when sensitivity was on its way up.
i checked before i went to bed last night and was at 173-bad carb counting-craisins in a salad-but didnt correct. woke up at 90. so thats way too much insulin!
thanks everyone for your advice and suggestions!
Amazing to come down 83 points from basal. Good thing you didn't correct! As David said, make small adjustments. Keep the new dose the same for several days before making another change.
I've been having this problem only worse. I was waking up in the mid 40's. Thankfully I get really hungry (which is a clue that I am low).
Anyway, I was dosing 14 units of Lantus every night. But after my last A1C my endo wanted me to drop down the Lantus to 11 units a night. Since then I've been waking up in the mid 60's.
With that said I always wake up around midnight to check and see if I am dipping too low. I'm not honeymooning but I'm really sensitive to insulin so it helps to double check just to be sure. And I keep a juice box by the bed.
OMG, waking up in the 70s!
Now THAT would be a problem!
pizza, mmmm. that looks like where i grew up in queens-awesome!
well, the spanish health system has made that decision for me, its a big no, even though i will keep moaning to my endinosaur. im not complaining, as everyone gets health care here, but it would be nice to have that option.
saying that, i saw my friends and was completely horrified by the size of the needle!
yeah, i guess i am. i thought it was over though....i hate diabetes.
waking up in the 40s-gross!
how do i know if im not honeymooning anymore? its not completely to do with insulin needs and weight, right? cuz i could be very sensitive to insulin and take less than the "normal"?
In the "old days" (c. 1985...) my BG went up. That was during maybe 4-6x day testing and logging maybe so it didn't really occur to me to "take more drugs" which would be the logical answer I developed as I got more experience. W/ a dx in 2011, I would be disinclined to think there's a whole lotta honeymoon going on. I'd say you could also test the rate of change by testing like when you wake up in bed and maybe 1/2 hour later, ideally staying in bed for 1/2 hour to minimize DP "wakeup" firing*. If DP is firing, you could be fairly certain you wouldn't go low, unless it misfires. If, OTOH, you get a 70 when you wake up and, 1/2 hour later are at 65, I would interpret that as something to adjust.
One reason I'm not a huge fan of the middle of the night testing (besides getting up in the middle of the night sucking...) is that there are totally different metabolic (?) phenomena operating. At 3:00 AM, you are sleeping and it should be fairly low activity while, by 6:00 AM, you are getting up and getting going. I have a totally unsubstantiated theory that DP would have evolved as a means to fuel hunting for berries, grubs and other paleolithic breakfast goodies. A lot of times, it seems like the theory of diabetes tends towards straight lines, input/output which may not work with that sort of "invisible hand" pulling strings.