Hypos at 3-4 am

Curious to know....

Hypoglycemia at 3-4 am is brought on by the before dinner shot or the before bedtime N shot?

[JDRF-Team-cd]

Cinnabon,
Here is information on the different insulins and their peaking times.  Maybe you can tell from this.

Novolog (aspart),onset 5-10 mins, peak 1-3 hrs, duration 3-5 hrs
Humalog (lispro), onset <15 mins, peak .5-1.5 hrs, duration 2-4
Regular, onset .5-1 hour, peak 2-3 hrs, duration 3-6 hours
NPH, onset 2-4 hrs, peak 4-10 hrs, duration 10-16 hours
Lente, onset 3-4 hrs, peak 4-12 hrs, duration 12-18 hours
Ultralente, onset 6-10 hrs, peak ----, duration 18-20 hours
Lantus (glargine), onset 1.1 hour, peak ----, duration 24 hours

Be sure to talk to your doctor and/or diabetes educator for possible adjustments.

Have a wonderful day.
Carol

[Markie]

One way to find out what is causing the lows is to change the timing of your long acting insulin injection. If you are injecting NPH before bed, you can expect it to cause a low at about 3am. Try having this injection in the morning instead. If the night time lows stop, you have solved the problem. If they don't stop, it could be because of the combined effect of exercise and the dinner time short-acting shot.

For the best results, split your long acting insulin between morning and evening shots.

Cheers,

Mark

[JDRF-Team-LRS]

Cinnabon,
It's another good question that you ask.  We're not physicians here, so please do run our opinions by your endo.

Assuming that you're having dinner at normal dinner time (somewhere 5pm -9pm) and that you're bolusing correctly for your carbos (do you know your insulin/carbo ratios?), then my best guess is that it's the shot of N that's causing it.

If this is a rather common experience for you, then talk to your endo about adjusting the dose or timing of your N shot.  We need basal insulin on board all the time and yet insulins like N have a peak that can cause lows.

You might talk with your endo about using Lantus -- a very long acting insulin that has almost no peak.  Some folk take split doses and others take one dose a day.  A potential disadvantage to Lantus is that it CANNOT be mixed in a syringe with short acting insulin.  This characteristic requires taht folks take more shots usually.  If the results are good and if you can afford the additional syringes, it is often a good treatment plan.

Good luck & let us know how you're doing...