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Diabetes - Juvenile Community
This patient support community is for questions related to juvenile diabetes including celiac disease, depression, diabetic complications, hyperglycemia / diabetic keto-acidosis, hypoglycemia, islet cell transplantation, nutritional issues, parenting a diabetic child, pregnancy, pump therapy, school issues, and teens with diabetes.
High Sugars thoughout the night
by scw33, Mar 23, 2008 09:43AM
Hello, I am a 28 year old male Type 1 Diabetic with an A1C of 108/6.0, and am on 20 units of Lantus a day, and take a ratio of 5g carbs per 1 unit of NovoRapid.
I am at my wits end about how to control my sugar levels once I go to bed. Throughout the day my sugars are fine. I used to be fussy about the "dawn phenomenon" and why my morning sugar levels were so high (ie. 180+), but now I realise that at midnight, 2am, 4am and when I wake in the morning I have very high numbers (180 to 320). When I go to bed my levels are generally very good and I have supper every night between 5pm & 7pm). Nights are a nightmare for me because I can't sleep due to having to go to the toilet all the time.
Usually, when I wake in the night and am very high I try and correct myself, but I find that my corrections do little to nothing; for example last night I was 270 and took 4 units of NovoRapid to get me down under 150 but I only marginally went lower to 234. I often repeat this activity again and again during the same night (it seems like I am just wasting insulin).. Furthermore, I am not experiencing rebound highs as has been suggested to me in the past!
Some of the futile things that I have done to address this problem are: changing insulin (Lantus & Rapid - in case they have expired), exercise more often and more vigorously, omitting having supper, and having a glass of red wine before bed... I have been told that eating a very low carb meal for supper is the best way to achieve a consistent night - but I have found that even plain garden salads do little to check my rise.
HOWEVER, last week I travelled to the UK for a conference and for the entire week I had healthy sugar levels. My bedtime, midnight, 3am and morning levels were nearly all the same (90 - 126)..... I am so confused!
My endocrinologist has no solutions and he reckons my liver is behaving normally, so please if anybody can suggest/help me with this mystery I would be very very grateful and hopefully can enjoy a nights sleep without having to make half a dozen trips to the toilet.
Thank you and I eagerly anticipate your comments.
Stuart
I am at my wits end about how to control my sugar levels once I go to bed. Throughout the day my sugars are fine. I used to be fussy about the "dawn phenomenon" and why my morning sugar levels were so high (ie. 180+), but now I realise that at midnight, 2am, 4am and when I wake in the morning I have very high numbers (180 to 320). When I go to bed my levels are generally very good and I have supper every night between 5pm & 7pm). Nights are a nightmare for me because I can't sleep due to having to go to the toilet all the time.
Usually, when I wake in the night and am very high I try and correct myself, but I find that my corrections do little to nothing; for example last night I was 270 and took 4 units of NovoRapid to get me down under 150 but I only marginally went lower to 234. I often repeat this activity again and again during the same night (it seems like I am just wasting insulin).. Furthermore, I am not experiencing rebound highs as has been suggested to me in the past!
Some of the futile things that I have done to address this problem are: changing insulin (Lantus & Rapid - in case they have expired), exercise more often and more vigorously, omitting having supper, and having a glass of red wine before bed... I have been told that eating a very low carb meal for supper is the best way to achieve a consistent night - but I have found that even plain garden salads do little to check my rise.
HOWEVER, last week I travelled to the UK for a conference and for the entire week I had healthy sugar levels. My bedtime, midnight, 3am and morning levels were nearly all the same (90 - 126)..... I am so confused!
My endocrinologist has no solutions and he reckons my liver is behaving normally, so please if anybody can suggest/help me with this mystery I would be very very grateful and hopefully can enjoy a nights sleep without having to make half a dozen trips to the toilet.
Thank you and I eagerly anticipate your comments.
Stuart
Doctor's Answer
by JDRF Volunteer SG, Mar 25, 2008 04:54AM
, Mar 25, 2008 04:54AM
You did not mention what time of the day you are taking your Lantus. If you are taking it at night, then it should be peaking (about 4 hours after injection) during the night, so the Lantus shouldn't be the problem). But if you take it in the morning, then a split dose of some in the morning and some at night may be a solution, for if taking it in the morning, it may be wearing off completely as you sleep.
I agree that low carb evening meals seem to be the best way for me to keep consistent glucose readings while sleeping. The thing to avoid is eating high fat, high carb evening meals which continue to digest long after you go to bed and after your NovoRapid wears off. Eating dinner earlier may help, too, so you have a better idea of whether your dinner quick-acting insulin was enough.
I agree that low carb evening meals seem to be the best way for me to keep consistent glucose readings while sleeping. The thing to avoid is eating high fat, high carb evening meals which continue to digest long after you go to bed and after your NovoRapid wears off. Eating dinner earlier may help, too, so you have a better idea of whether your dinner quick-acting insulin was enough.
As for high fat meals - the most fat I usually have with a meal derives from the actual meat (chicken, fish, beef) and from the olive oil that I use to cook...
I find this daily pattern very strange, because it seems that as soon as I close my eyes my body (or specifically - my liver) mobilises and starts pumping-out sugar. I am unclear if this is related to what I eat or as you possibly suggest because of Lantus...