Hi everyone!
For almost 2 years now I’ve been using an insulin pump and a Dexcom sensor (but not a closed-loop)
When I first got introduced to the pump, my night time Blood sugar levels were pretty good for a month - a straight line.
Then suddenly, I would wake up with high BS levels that happened slowly overnight. I did a few changes of my basal rates, but the "good results " only seems to last for not more than a month.
Then one year ago, my endo desided I should switch my insulin (as I was using Fiasp) to NovoRapid.
Then again, my BS levels were perfect during night time…but only for a month.
3 months ago I went to a new doctor, who did a lot of changes to my basal settings and everything seemed to be perfect - for a little over a month (again!!!).
But my blood sugar rise is pretty inconsistent- for a few days there might be a spike right after I fall asleep, then for a day or two there might not be any spike.
Then, like yesterday, my BS levels were perfect until 2am and then started to rise…
So now I have set up an alarm in the middle of each night so I can “make corrections” if necessary, also my sensor alarm for high BS is set to 10.0 mmol/l… but this is now distribing my sleep and my stress levels are pretty high.
Also, I am strickly calculating everything I eat, but there seems to be no logic.
I even tried to eat the same meal for dinner for 3 consecutive days - and the sugar levels were totaly different from one another.
I have no idea what is going on with my body during sleep but it’s getting harder for me each day to “predict” what is going to happen and how I can “control” it as much as possible.
How long ago were you diagnosed with Type1? You said your numbers were sometimes erratic after dinner despite eating the same foods, and your body’s unpredictable “donation” of insulin during the honeymoon - which could last a few years - might explain that.
When you said your overnight numbers starting rising every month or so my first thought was cycles. Menstrual was first on my mind of course, but there are also lunar cycles which might affect health. An article in healthline dot com found that the moon had an effect on glucose in patients with Type2 - that could be true for us with Type1.
There are also cycles involved with work and personal life - some people work a different schedule, or have relatives visiting or handle caregiving every few weeks. It would make sense for normal patterns to be off due to the stress of those days but then you would think they would go back to where they were before🤔. But it might be the body finds a new “baseline.” This might happen in people without diabetes as well, but we’re not measuring it so we don’t know. Talk with your doctor about this but you may need to start a slightly higher overnight basal rate once you see the pattern beginning. Hopefully this will level out eventually so I would set up a separate profile you could turn off if you no longer need it.
its not crazy to have insulin needs change over time, or change periodically. For myself - I see a definite change and have to adjust basal rates in the spring and fall. This has been going on for 40+ years.
there is no right answer here - you take more or less insulin to do the best you can to have “in range” blood sugar. Speaking again about myself - stress, activity and diet have a huge affect on the amount of insulin I need.
Type 1 is difficult to “control”, and does require knowing what you are doing next (eating, moving, sleeping) because insulin (even rapid insulin) is incredibly slow in changing blood sugar and sugar changes blood sugar incredibly fast.
I just started using an AID (automatic insulin delivery) pump from Tandem and the number 1 thing I see is nearly perfect overnight blood sugars because the pump adjusts, every 10 minutes, to whatever is happening per my CGM.
Overnight hormones are… well… weird. when I am using a regular pump with no AID (no feedback) I have also seen trends (rising, falling, etc.) and sudden surges and drops in blood sugar due to a variety of things that happen to us while we sleep. All you can do on a basal program is the best you can do and adjustments are necessary. You can consider tighter alarms on your CGM so that it will wake you up and you can make your own adjustments, but getting up at all hours is a kind of a torture for me and I’d rather fix a non-emergency in the morning. Dexcom allows you to change alarm limits based on time of day. Your doctor will always be conservative and prefer you are a little higher than a little lower,
don’t get too stressed, changing insulin requirements happen. keep an eye out on what you are eating for dinner… trying to go low carbs can sometimes work against you as it tends to increase insulin resistance, as does certain fats. cheers and good luck!
Thank you for your answer!
I was diagnosed with DT1 25 years ago, when I was 10.
Yes, the hormones during the month do cause deviation in my blood sugar levels, but there is still no logic during night time sugar levels.
For an example, right now my hormones have settled down and my BS during the day is Perfect!
I spoke with my endo and she did some changes to my night basal, so two nights ago I’ve had my best BS levels during sleep and I was so happy with the results, so I left the same settings. But last night I woke up again with my alarm for high blood sugar…
I wonder if the quality of my sleep can cause that deviation as well, I do tend to dream a lot during my sleep and I wonder how much can this affect sugar levels. But I cant seem to find more detailed information about this
Ever since I got my insulin pump I tried to go on a low carb diet and it actually works pretty good for me.
I also keep notes of everything I eat and when I eat it, so I can track if any patterns appear.
Unfortunately, as you said, very often there are no actual patterns during night time - I’m thinking of buying a good quality watch to track my sleep. I do fall asleep super fast…but I tend to notice that I’m very tired when I wake up and it might turns out that I dont have enough deep sleep. I dont know if this can cause that deviation but I wonder if this can be a reason for releasing more stress hormones during sleep.
My everyday life ia pretty much the same - I work in an office and after I finish I always go for a 1 hour walk with my dog, then go back home and preprare my own meal, I never eat any takeaway, so the food must not be the reason for this.
But indeed, the fact the I wake up every night to correct my insulin is starting to affect my life and this is why I need to figure out the real cause and try to solve the problem.
Sleep and sleep quality can definitely affect glucose, and when the concern about your overnight numbers affects your sleep the irony is unmistakeable.
People aiming for tight control might strive to keep their numbers under 140, and some will not be happy if they’re not even lower than that. What do you consider “high”? I’m wondering if your numbers are on the high side of normal (around 180), and what might happen if you set your alarm at a higher level? I’m suggesting that based on the theory (theory mind you and as yet untested) that the stress of hearing those alerts is making your numbers rise or is keeping them up there, when they might drop on their own without them given your basal programming. It might be worth experimenting with for a few days as long as it is safe to do so; however I am not a medical professional so you should ask your doctor where to draw that line.
Hi @AnasstasiaKup I am definitely new to type 1. However, I have noticed that if I eat a higher fat dinner or evening snack, my blood sugar rises when I sleep. Maybe this is part of the issue? Especially since you tend to eat lower carb.
