High Blood Sugar While sleeping

Anyone have any sleeping tips to keep blood sugar under control? Mine seems to spike when I fall
asleep.

hi @ebt1d Welcome to Type One Nation. Overnights can be difficult, because no one wants to run low at night. I have long since dialed in my basal rates so my overnights are mostly predictable. If I eat a very fatty dinner I can expect a slow rise all night long. If I eat at 6ish and go to bed at 11 ish I usually have time to get things pretty flat before gong to sleep.

when you say spike… ? a fast rise right when you fall asleep? a long slow rise resulting in a high morning blood sugar,? an early morning sudden rise? also it’s helpful to know if you have a pump, CGM, both, neither. cheers good luck!

This happens to my daughter as well. Almost every night she starts going up around 20 through midnight. She stays high (200+) until around 3, then starts coming down. She is on Omnipod 5. I get up all night bolusing her to try and get down.

It seems like the minute I fall asleep it starts rising. Sometimes it’s a slow rise throughout the night and others it’s a quick spike and levels out but stays high until I get up in the morning. When I do wake up in the morning there is another spike, always. But since I’m up that is easier to manage. What I eat and when I last eat usually affect my overnight blood sugar, of course. But where I struggle is deciding how much insulin to take before bed. I’m using Libre 3 CGM.

Hi @ebt1d ok. This (high overnight blood sugar) is really a question for your doctor, but more information would be helpful. So what kind of insulin are you taking for long acting? When do you take that shot? Is it something like lantus in the morning?

18 units Lantus, before dinner.

I was diagnosed in 1963 and was on injections until the mid 90s when I got my first pump. For as long as I can recall I had a bedtime snack (I fondly called it a “midnight feeding” even though it was between 10-11:00) to prevent going low in my sleep. Old habits die hard, so I continued the practice even after I started on Tandem CIQ. With proper settings in place I really didn’t need those midnight feeding anymore, so I if I didn’t bolus when I ate them I had to do so overnight until I learned my lesson. All of which is to say, if you’re having a snack before bed and are not covering it with insulin, that could be the culprit.
Speaking of insulin - Lantus is a basal insulin - do you take any fast acting with meals and snacks?

I’ve read that some people on injections find it helpful to change the time of their basal insulin so its peak time works best for them. Even so that may not be enough if you’re not covering meal carbs with fast- or rapid-acting insulin. Check with your doctor. Even if Lantus alone is working well in the daytime you might need something with dinner.

I would recommend you take your data to your doctor. When I was on long acting I could never get the dose just right, I had 2 “modes” I could be in: and so I had to choose between good overnights (and being low throughout the day requiring a lot of juice and glucoses) or high overnights and better control during the day. It happens to be the main reason I pump.

Lots of people split lantus into 2 doses. Many people are on longer flatter basal insulin (longer acting than lantus). Again it’s a good topic with a doctor. Good luck! :four_leaf_clover:

1 Like

You are experiencing the same struggles as i did, i could fight bg levels all night or all day when i used a basal type insulin. I require a much higher basal rate when i sleep as well, i work a swing shift and my sleep requirements follow me no matter the time of day. I use a pump so i can dial in my rate to my activities. AS Joe previously mentioned that is what made me seek out a pump many years ago.

My son (9 YO) always had this problem. His BG would shoot up as though he drank a glass of juice. We give him 1 unit about 20-30 mins before he goes to bed and sometimes another .5/1 unit about 1.5 hr later and that would keep him level for the night. Now that he’s on Omnipod5, we still get him up around 1 unit prior to getting to bed and the POD does the rest. This has prevented him from getting above 160 on any given night. I recommend getting on a pump, it’s been a game changer for his night number and much easier to manage his days at school.

The only way I’ve been able to keep my BG in range during the night is being in AUTOMODE on my Pump/CGM. In manual mode, I struggled for a long time to get my basal rates right, but still had frequent Suspend before low alerts, which is disruptive to my sleep. AUTOMODE does a good job of addressing this. So, as long as I remain in AUTOMODE, it works out and I have straight lines all across for the night. The only issue is if I can’t stay in AUTOMODE due to Sensor Updating or other issue that takes me out of AUTOMODE. That’s an issue for me.

What pump are you using?

No pump. I inject humalog with meals/snacks (1unit for every 10g of carbs) and Lantus (18 units before dinner).

Thanks for sharing. I am seeing frequently on this thread that a pump helps many with overnight highs. I’m so comfortable injecting and need to investigate pumps.

Appreciate your feedback, good advice.

Breaks my heart to think about kids having T1D. I was diagnosed at 35. I just can’t imagine my kid dealing with this. I think it would be more
stressful for me!

Thanks, I will check them out.

Humalog with snacks
and meals. I inject 1u for every 10g carbs, give or take.

There was a time diabetes a considered an adult’s disease. And while no one wants anyone to develop it, kids can be more flexible and adaptable than adults (their parents). In not saying is necessarily easy for kids, but some parents on the forum have shared that their child was adjusting well while they (the parents) were a nervous wreck. Hopefully the resilience of youth and the fact that they don’t have to deal with the effects of aging, give them an advantage.

@ebt1d Hi Eric! I used to have the same problem as you - high overnights that got higher in the morning. I took my basal dose before I went to bed so that it was acting during the night and I still had to get up some nights to take a bolus correction. This was part of the reason I decided to go onto a pump (Omnipod 5.) Between late fat rise from dinner and general ‘dawn effect’ my time in range was only 50-60%. I have only been a T1D for less than 2 years and didn’t mind giving myself shots - it was the overnight highs that were driving me crazy.

The Pod has really helped me out on the overnights. I now have a few low alerts at night (I’m working with my doctor on those) but I am now waking up between 110-130 which is great for me. While the Pod isn’t perfect (I’m still learning a lot in my first 60 days), it has made a huge difference in how I feel and my TIR.

I hope all works well for you. Keep us updated on how you make out.

MF