overnight BGs

Can't seem to get me BIs right for overnight control, any suggestions?

From the above, it really appears that you are constantly correcting with QA throughout the day and before bed which indicates to me that your BI doses are just too low. The DAFNE guidelines suggest changing BI by 10% or 1-2 units at a time. I'd suggest increasing both your morning and evening BI doses by 1 unit - so 10 in the morning, and 10 in the evening, waiting for a couple of days to see if that helps your BG levels come down within the desired range, and if you are still having trouble with them always being high, then repeating the increase.

To be honest, I expect that you will find that your BI doses need to be 11 or 12 each time, but changes need to be made slowly, so just increase by 1 unit every 2-3 days for now until you stop needing to correct with QA at every meal. It is important to leave 2-3 days between each increase so your body can adjust to the increases.

All the best with getting this under control.

Warwick.

Apologies. I shouldn't have replied to this. I am not a HCP. My bad.

Warwick.

I don't think there is any problem with Graduates replying to threads in this forum if they give sensible answers like yours. I susepct a HCP response would be along the same lines. Although I would ask why you reduced your BI in the first place ?

I reduced my BI's due to overnight hypos, tried BIs of 9 and 10 last night which seemed to work, but I'll give it a few days and do another overnight profile at the weekend.

Hi Warwick, you are right that my BI levels are too low during the day, I've been aware of this for a while, but whenever I try to raise them I end up going hypo overnight, so I end up taking a couple of extra units at lunchtime to compensate. The whole situation is really frustrating.

What sort of basal insulin are you on? Do you know its profile? E.g, does it last for 12 hours, 18 hours, 24 hours? If it only lasts for 12 hours, then I would suggest that you could leave your night time BI at 9 or 10, but increase the daytime BI by 1 or 2. If it lasts 18 or 24 hours, then it would be more complicated and need someone else to answer your query.

Thanks,
Warwick.

It's Levemir which lasts for 18 hours

I don't feel qualified to comment sorry. Perhaps a HCP can comment?

Thanks,
Warwick.

Hi Elvie,

The first thing I noticed was that you're taking your evening BI at tea-time. For the majority of people following DAFNE and using BI twice a day, you will get the maximum benefit from taking your morning dose on getting up and your evening dose as you go to bed (ensuring they are 7hrs apart overnight) - this helps to control those morning (Dawn Phenomenon) BG better.

If you have done CP-free meals in the day to test out your morning BI and found that it needs to be higher, please bear in mind that once you have increased it you may need to re-evaluate your QA:CP ratios as they may need to be reduced with better BI coverage - follow the Step-Wise Approach

As always, usually best to speak to your local Educator team if possible as they will know your medical history better.

Good luck,

Carolin