3am tests

I need to test my basal rates, which involves a 3am test (eek). I never eat after about 8pm, so I would have no qa insulin working at 3am. Do I still need to have a carb free dinner, to test this accurately?

Carb free dinner is not necessary Louise1988.
Take your dinner as normal with the matching QA. BI dose as normal, at normal time.
You are only checking that your BI is right. We all need an established background insulin level to keep us ticking over, especially when comparatively inactive. So I hope you find that your before bed, 3 am and before breakfast BGs are ideally within 1 mmol/L – don’t fret if they are not though. No changes really necessary if they are pretty even. You do need plenty of days results to compare with one another though as lots of other things get in the way of our understanding the body - it is a dynamic ‘fickle’ machine.
You may wish to post again in a week or so when you have data. Please let us know your particular BI and typical dose/s. Currently, I split Lantus 27u at 06:30 and 27u 18:00 to 19:00. But I’m sure someone here will be able to advise you better, if using your type of BI.
Regards
Garry

Hi Garry, thanks for your reply. I'm currently on just 8u of levemir, which I take at 9pm. I'm wondering whether I need to lower this, as I keep getting hypos during the day, so I'm trying to see how much of an effect my basal rate has on the rest of the day. My morning rates aren't too bad, around 5-6. I'm only on tiny doses as it is, and just want to get my levels up. Will post in a few days and let you know.

I'm not really sure what to do with my basal rate, keep it to the lower rate or 7units, or go back to the original 8? The reason I thought to lower this basal, was to try to stop myself from getting so low during the day. However, I'm finding that I am dropping quickly. Any opinions?

I can see your on a single dose of background, which would suggest Lantus. Is this correct? EDIT: I now see your on Levemir

You seem to be on the lower end of the DAFNE targets before bed (I would be happy between 4-7 at this time), and so you have been giving yourself either some dextrose tablets or last night, some chocolate. These carbs working overnight could be effecting your waking readings, even if they are small amounts [dextrose tabs and DARK chocolate]

The best thing to do is try and aim for a higher reading before bed, you could try chopping of a unit a dinner time to achieve this maybe, then test before bed and have no carbs/hypo resolve. This will then give you an accurate picture of what is happening overnight by looking at your pre bed and waking results.

This should be done for 2-3 days consecutively before you make any dose change.....its good practice even with Levemir

Once you can see a steady overnight pattern, then you can tackle lows in the day time, which may mean dropping your ratios to below 1:1, like 0.5:1, or looking at splitting your BI dose, so that the night and day time BI needs are managed separately.....

What were you this morning?

I'm actually on Levemir. Yesterday, I had 3 dextrose 3pm and 4pm, in a bid to get my bg levels up a bit during the evening. I can't seem to get my bg levels up to the higher end of DAFNE. I forgot to mention that last night I actually had 5cp's, rather than 4, and gave myself 4 units of NovoRapid.

I was 10.3 at 3am this morning, and 7.7 at 7am...

There wasn't much change from 21:03 to 03:00 then, which is a good sign, small drop from 03:00 to 07:00 though.....

I would just repeat what you done for a day or two more and compare each nights results......

Your only small amounts of Levemir, but it can be split fairly easily, have you considered splitting?

I haven't considered splitting. I don't know much about what the benefit of that would be

One dose over 24 hours has to deal with varying BI needs over that time, basically and commonly most people need different doses for the AM and PM portions of the day.

In fact the amount of BI you need changes by the hour, the only way to achieve accurate dosing for BI is on the pump.

By splitting your dose you will be giving one dose before bed to hold you steady till morning, and then another dose at breakfast/waking to hold you steady till the bedtime.

This means that if you go low overnight due to too much basal, you can reduce your dose without that reduction affecting your daytime blood sugar.

Currently this is how you are doing it.........for example the 7 your own currently could be fine to hold you steady till morning, but you may need more or less than that 7 to hold you steady during the day........

Another benefit is its much more flexible for things like exercise and alcohol.......

If you were going hill walking for example all day, you could actually reduce your morning dose to compensate for the reduction in BG you will experience due to the extra physical exertion... If drinking of a night, due to the lowering effects alcohol has on BG, you could reduce your bedtime dose in order to prevent a hypo, and even reduce the next mornings dose if the alcohol is still inn your system.......

Its the only way to go really, in my opinion, but not everyone can see the benefits in their particular circumstances.....

That makes complete sense. When I've done 3am tests in the past, I have seemed to go higher, and then dropped again by morning. So in theory, if I were to do 4u at night, and then 3u in the morning, this could ensure I don't drop as much during the night, and then maintain the next day's bg levels? Have I got that right?

If so, I think I'll make an appointment to see my DSN