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Dealing with Overnight Low Blood Sugars.

Quick confirmation:  Yes, you are reading this on the Internet.  No, this website is not written by a doctor.  Or a medical professional of any kind.  (Or a professional of any kind.) This is not medical advice.  I have been living with type 1 diabetes for over 30 years and this is just how I do it.

Such a good song.

Anyway, overnight low blood sugars are gross.  During the day, am I struck by the urge – need? – to consume 10 times more carbohydrates than I need to correct a low blood sugar?  Nope. I don’t eat glucose tabs by the fistful at 11 am.  But in the middle of the night I am able to consume 1400 calories without blinking twice thanks to the panic and chaos of middle of the night low blood sugars.

Over-treating lows has been a tricky trap for the last three decades, but there are a few strategies I use to hit back against hypos.

No IOB before BED.  
I try to keep my snacks very low-carb after 8 pm in order to keep my boluses at bay.  While I’d love to dive head first into a bowl of rotini before bed, I feel safest going to bed without insulin on board.  Sometimes it’s hard to avoid a bolus here and there, but on the whole, a big fat zero on my IOB brings better sleep for me.

Timing Exercise.  
This is a tricky one because my schedule changes every day, but I do my best to exercise before 4 pm on most days to mitigate midnight lows.  If I exercise in the evening, the chances of bottoming out overnight are high, so if I’m able to get things done before dinner, I feel safer.  (This does not always work out for my workouts because of kid 1, kid 2, work stuff, family schedule, etc. but I try.)

Pre-Counted Carbs.  
What do you mean, eating two nutella and peanut butter sandwiches to treat a 54 mg/dL at 3 am isn’t a good idea?  If I wake up low, I want to inhale the fridge.  Sometimes I over do it so hard that I’m bolusing while low to compensate for the carb overload.  This usually results in a high blood sugar.  And also bigger pants.  Keeping my low blood sugar treatments pre-carb counted helps a lot.  This means using glucose tabs or a juice box instead of a bag of candy that I can take too much of or a bottle of juice that I can drink too much of.

Bedside Snack Table.  
I need to keep snacks on the bedside table instead of daring my low legs to make it down the stairs.  My bedside table is almost always armed with a jar of glucose tabs or a juice box.  This is easiest because it keeps me from taking field trips while low.

Continuous Glucose Monitor.  
THIS.  This thing is the best battle tool against nighttime hypos because I can set my threshold to 80 mg/dL which, in turn, alarms and wakes me before I actually end up low.  In the last ten years, since starting on a CGM, my overnight hypos have decreased significantly simply because I catch them before they become disasters.  Of course lows sneak in here and there, but they are fewer in number thanks to this technology.

My next goal is to figure out how to stop the cleaning fits while low … although they are terribly productive …

7 Comments Post a comment
  1. Nutella. Pete bought a jar while I was away last weekend. I still haven’t decided if I love him or hate him for bringing it into the house. #blamePete

    04/27/17; 1:18 pm
  2. anna sabino #

    but what if I do ALLL those things and still wake up at 37…or the increasing piercing noise of the CGM, of the husband hitting me to not ignore the noise…or all three? OH right, the other human in our bed 😉

    04/27/17; 2:34 pm
  3. Nolan Kienitz #

    My CGM (for past 7 years) has been my savior. I’m also on Medicare and it now appears that my first “Medicare covered” shipment is happening. I’ve been on a cash pay for my G5 Dexcom system for the past two years.

    04/27/17; 8:38 pm
  4. Sandy T #

    Hahaha! The cleaning fits. So dang true.
    I have a clay figure that’s designed to hold kitchen sponges that I keep life savers in on my bedside table. If I’m reaching over and eating them, we know it’s a real low. And shortly I’ll be taking insulin for the large amount of carbs I’m going to inhale. Nice to know I’m not alone treating with lots of carbs. That being said when I take a bolus for the carbs (that I spread out over an hour) it keeps my levels normal when I wake up. No idea how high they go while I sleep.

    04/27/17; 9:29 pm
  5. My tip, Sheryl. She is like a blood sugar hawk. Everyone needs a Sheryl.

    04/30/17; 9:58 pm
  6. Ria #

    Love the new theme song for hypoglycemic treatment plan

    05/1/17; 10:59 pm
  7. Ria #

    love the choice of music for hypoglycemic plan

    05/1/17; 11:01 pm

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