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Discussion Starter · #1 ·
During the day at work my blood stays between 80 and 98

But during the evening and night time hours when I am sleeping

My readings drop to 58 to 67

I don't understand why
 

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If you could divulge a little more info, we might be able to help you understand why.

Some things that could help:
  • What are your meds, dosages, times?
  • What is your diet like, meals, snacks?
  • These 58 to 67 numbers, when are you catching them, fasting?
  • Have you gotten up in the middle of the night to test your BG?
  • How often do you test your BG?
  • What were your numbers before going to bed?
  • When did this start? Can you think of anything that changed around that time?
  • The more you can tell, the more light will be shined on what's going on.
 

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Discussion Starter · #3 ·
During the day at work my blood stays between 80 and 98

But during the evening and night time hours when I am sleeping

My readings drop to 58 to 67

I don't understand why
Hi
I take 2mg of glimepiride normally around 3:30am , once a day
I only eat once a day , normally around 5pm and I only eat meat
Chicken , hamburger , porkchop's, steak , fish
And limit my carb intake to 0 or as close to 0 as I can get
I don't vegetables or fruit

My low numbers usually happen around 6 hrs after eating , I use a freestyle libre 2 system now and my numbers are between 90 to 105 when I go to bed

This all started a few weeks ago when I started using the freestyle system because

I finally gave up eating anything with sugar in for good
I used to take 4mg of glimepiride but I reduced it to 2mg because it was causing me to hit 50 at night

The only reason I noticed was because of the alarm going off on my reader

This all seemed to start after giving up sugar for good
I test a lot now , being it's so easy plus the reader does it by itself
 

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Discussion Starter · #4 ·
Hi
I take 2mg of glimepiride normally around 3:30am , once a day
I only eat once a day , normally around 5pm and I only eat meat
Chicken , hamburger , porkchop's, steak , fish
And limit my carb intake to 0 or as close to 0 as I can get
I don't vegetables or fruit

My low numbers usually happen around 6 hrs after eating , I use a freestyle libre 2 system now and my numbers are between 90 to 105 when I go to bed

This all started a few weeks ago when I started using the freestyle system because

I finally gave up eating anything with sugar in for good
I used to take 4mg of glimepiride but I reduced it to 2mg because it was causing me to hit 50 at night

The only reason I noticed was because of the alarm going off on my reader

This all seemed to start after giving up sugar for good
I test a lot now , being it's so easy plus the reader does it by itself
Yester
Hi
I take 2mg of glimepiride normally around 3:30am , once a day
I only eat once a day , normally around 5pm and I only eat meat
Chicken , hamburger , porkchop's, steak , fish
And limit my carb intake to 0 or as close to 0 as I can get
I don't vegetables or fruit

My low numbers usually happen around 6 hrs after eating , I use a freestyle libre 2 system now and my numbers are between 90 to 105 when I go to bed

This all started a few weeks ago when I started using the freestyle system because

I finally gave up eating anything with sugar in for good
I used to take 4mg of glimepiride but I reduced it to 2mg because it was causing me to hit 50 at night

The only reason I noticed was because of the alarm going off on my reader

This all seemed to start after giving up sugar for good
I test a lot now , being it's so easy plus the reader does it by itself
What's weird is
People say say I should feel funny when I am down to the low 60's
But I don't , I feel fine
 

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Thanks for the extra info, it should help a lot in helping to figure out why. I hope this gets several responses, because there is a lot of experience here on the forum. It will be tonight before I can get a chance.

Just quickly I can say low BG by definition is below 70mg/dL. 60s haven't bothered me either, nor could I tell a difference in the upper 50s, but i don't think mine get there very quickly and I shouldn't have low BG unawareness.
Later.
 

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I wonder if there is something going on with gluconeogenesis. I've seen this as part of ketogenic eating plans that are fairly heavy in protein.

"In response to protein, blood sugar rises on a keto diet" (full-carnivore filling that role for you). This article goes into more of the biology of it. Make of that particular study what you will, but I'm wondering if maybe the timing of the glimepride dose might be part of this (and are you really taking it at 3:30 in the morning?)
 

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Discussion Starter · #7 ·
Yes , I am

I take it , right before I leave for work

I have been work 5am til 3:30 for the last few months
When I am on 8 hours , I take it at 4:30 am

Another weird day today

I left work for my normal one hour ride home do to all the road construction
When I left , I was 83
And about 50 minutes after leaving work the alarm started going off because I was down to 61

And of course the rotisserie chicken I ate has no carbs so , I will guzzle some milk to get my blood sugar up around 100

But it will come crashing down in no time as I lay on the couch

My numbers from today are
1:43am , 56
2:14am ,61
3:27am 154 because I got pissed and slammed a half a gallon of milk after being 61

At 4:43am , 121
At 6:11 , 109
8:46am 110
9:47 ,109
9:57 ,104
11:42, 92
12 :46 ,142 because I ate 2 ,1oz bags of plain chips at 15grams of carbs each
By 1:50 , 94
3:27 , 82
4:27 , 61
5:39 , 63
 

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So, yesdear, what time was your meal in the middle of all this?

So approximately 96 grams of carbs in the milk (a little more if it was skim milk) but your BG went down to close to normal within a couple of hours and the 30 grams of chips was down to normal in an hour.

Is it possible to split the glimepride dose? Not sure how it was prescribed for you. And was going from 4g to 2g your idea (no judgment; just wondering if your primary care professional was involved in changing the dose)?
 

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So 3 changes: started using FreeStyle Libre and change of diet about the same time, followed by a reduction in meds.
Started using Libre - I wouldn't think the Libre would be the issue.
But it can be part of the solution. It can take readings every minute and store 8 hours worth. What are those trends showing after eating until you get up?​
The change in diet - possibly.
Reduction of carbs would lower BG.​
Only eating one meal a day (wasn't a change) Just eating would be a cause for an initial insulin response, even without carbs. Whats going on after you eat?​
Eating the sacks of chips looks like it too has been followed with a lowering of BG into the 60s, but after a spike.​
The milk didn't get same response of going lower. Lactose metabolizes slower? More insulin resistant at that time of day?​
The reduction in the meds possibly a contributor but not the cause (possibly not enough reduction a cause?)
Glimepiride stimulates the pancreas to release more insulin (needed or not??). May enhance the normal calls for insulin (over response??)​
It is supposed to start working as soon as it is metabolized (usually within first 4 hours)​
The timing of meds. I read where glimepiride is recommended to take with the first main meal of the day. Not sure of lasting effects of daily dose but it seems your dose is taken at the other end of the 24 hour clock from your late night/early morning lows. Timing may not be a issue.​
Dose - maybe your carb reduction was greater than your insulin reduction and that is lowering your BG after a meal.​
It is also a possibility that this was going on before the changes but not discovered until the Libre.

Looks like more questions arise. Sounds like homework time. Might let the doctor know and see if he would agree to stop the glimepiride and watch the results. He may be able to tell you how long it would be working after you stopped it. He might appreciate being in the loop, he might not.
 
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Discussion Starter · #10 ·
So 3 changes: started using FreeStyle Libre and change of diet about the same time, followed by a reduction in meds.
Started using Libre - I wouldn't think the Libre would be the issue.
But it can be part of the solution. It can take readings every minute and store 8 hours worth. What are those trends showing after eating until you get up?​
The change in diet - possibly.
Reduction of carbs would lower BG.​
Only eating one meal a day (wasn't a change) Just eating would be a cause for an initial insulin response, even without carbs. Whats going on after you eat?​
Eating the sacks of chips looks like it too has been followed with a lowering of BG into the 60s, but after a spike.​
The milk didn't get same response of going lower. Lactose metabolizes slower? More insulin resistant at that time of day?​
The reduction in the meds possibly a contributor but not the cause (possibly not enough reduction a cause?)
Glimepiride stimulates the pancreas to release more insulin (needed or not??). May enhance the normal calls for insulin (over response??)​
It is supposed to start working as soon as it is metabolized (usually within first 4 hours)​
The timing of meds. I read where glimepiride is recommended to take with the first main meal of the day. Not sure of lasting effects of daily dose but it seems your dose is taken at the other end of the 24 hour clock from your late night/early morning lows. Timing may not be a issue.​
Dose - maybe your carb reduction was greater than your insulin reduction and that is lowering your BG after a meal.​
It is also a possibility that this was going on before the changes but not discovered until the Libre.

Looks like more questions arise. Sounds like homework time. Might let the doctor know and see if he would agree to stop the glimepiride and watch the results. He may be able to tell you how long it would be working after you stopped it. He might appreciate being in the loop, he might not.
Good news everyone

My new diabetes specialist called

She's happy to know , I gave up sweets and the readings to prove it
So
I am to cut my glimepiride down to 1mg once a day

And I have to report my readings in 2 weeks if I am unable to link my libre 2 reader to them
And cut 7 of my 2mg pills in half

Currently I am at 61
So I need to , Take a big sip of milk to stop the freefall
For the last time , " hopefully "

I want to give a special thanks to everyone for your help
With my situation

Thank you all
 

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Discussion Starter · #11 ·
Good news everyone

My new diabetes specialist called

She's happy to know , I gave up sweets and the readings to prove it
So
I am to cut my glimepiride down to 1mg once a day

And I have to report my readings in 2 weeks if I am unable to link my libre 2 reader to them
And cut 7 of my 2mg pills in half

Currently I am at 61
So I need to , Take a big sip of milk to stop the freefall
For the last time , " hopefully "

I want to give a special thanks to everyone for your help
With my situation

Thank you all
And I also compared my Libre 2 sensor , with my
One touch verio and a finger prick

And there is only a 5 digit difference

My old meter is 5 digits higher

So my Libre 2 seems to he pretty accurate
 

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Congrats. Sounds like the new doc is a keeper. Keep us posted how it goes.
 
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Yester

What's weird is
People say say I should feel funny when I am down to the low 60's
But I don't , I feel fine
We are on a MAD-diet for seizure control (20 g of carb or less). We have been low carb and decreasing carbs as we strive to maintain A 5.2 or less A1c. Ronnie has been hypoglycemic unaware for years and now since we have eaten less and less carbs. He tolerates bg as low as 65 with no problems. I do begin to treat at 79 because from experience, he is going to go lower. Around 11:00 -12:00 pm, he has lower bg. I have to set basal rate very low beginning around 10:00 pm and then raise the basal up starting at 3pm to adjust for dawn phenomena. It keeps him in range most of the time except for change of seasons and change in level of daily exercise. Your level of exercise may be the variable causing the night time lows. Ronnie drops lower during the night when we exercise more than the 1 hour a day of mild to moderate level. I youse dexcom’s clarity app to track and adjust the basa
L ratted knowing that the basal rate an hour before the low, is the rate that needs to be lowered.
Take care. It is seasonal change adjustment time do I will get busy on the computer to analyze where to adjust the rates ( only a small incremental adjustment at one time)
 
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