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71 year old female, Type 1 diabetes, diagnosed in 2016. A1c is 6.8, I walk 1.5 to 2 miles a day, daily carb intake is 110 to 250 per day. I'm 5'7" and weigh 160. 30 units levemir in am, 10 to 12 units novolog per meal, 15 units levemir before bed, along with a Glucerna drink. I recently got a Dexcom CGM and have discovered that I'm having lows in the 55 to 70 range while I'm sleeping. When I wake up in the am, I'm at around 100. I assume this has been going on for some time, but I didn't have a doggone beeping alarm waking me up when it happened! I can't get out of bed every time this happens and get something to eat! I can't go back to sleep if I do that! I've had this CGM for 4 days now and am exhausted from being up and down all night. I don't see my Endo again until November; of course, I will go over this with him then. I keep glucose tabs by my bed and use them, but they don't keep my blood sugar up for very long and the alarm goes off again in an hour or so. Any advice?
 

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Have you tried a more complex carbohydrate than pure glucose? In other words, would maybe some peanut butter crackers or such provide the needed carbs and some protein/fat for your body to work with? Or maybe a small protein snack with an orange juice "chaser"? Or even modifying your before-sleep routine to include a little food that might address the low?
 

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Discussion Starter · #3 ·
Have you tried a more complex carbohydrate than pure glucose? In other words, would maybe some peanut butter crackers or such provide the needed carbs and some protein/fat for your body to work with? Or maybe a small protein snack with an orange juice "chaser"? Or even modifying your before-sleep routine to include a little food that might address the low?
Well, I hate peanut butter, so that won't do, lol. Last night I had a piece of whole grain toast w/butter around 11. Didn't seem to make any difference. Tonight I'll try tuna salad and crackers. I really thought (pre-CGM) that the Glucerna was addressing this, but I guess not. Thank you.
 

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How are you determining your insulin dosages, do you know your insulin:carb ratio, correction factor? Do you adjust your insulin based on your BG readings prior to taking it?
 
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How are you determining your insulin dosages, do you know your insulin:carb ratio, correction factor? Do you adjust your insulin based on your BG readings prior to taking it?
In 2016 I read "Think Like a Pancreas". I did a LOT of studying and calculations then. I don't remember how I arrived at my decisions then. I DO know that my novolog dosage depends on my intended carb intake and it works. I almost never have extreme highs (over 250). My levemir dosage is what my Endo recommended. It may be important that until 2021 I had several doctors who INSISTED I was a type 2 and refused my requests for a C-peptide test, and told me I didn't need an Endocrinologist! Their responses were for me to eat less (I got down to 100#!!!) and take more metformin! They apparently were convinced that I was senile and delusional. Bunch of freakin' quacks. Anyway, I moved to another part of the state. I have a doctor I love, who works WITH me, and an endocrinologist who pays close attention. He does not question my judgement, but he does talk things over with me and refines my judgement. He took me off metformin too. Prior to moving here, I was never able to get my A1c under 9. My endo feels that I have made great strides in getting things right and wants me to keep doing what I'm doing. Now, that was BEFORE the CGM, when neither of us knew I was going so low at night. I'm wondering if I'm taking too much levemir, but I won't change that unless the endo tells me to. I feel like "if it ain't broke, don't fix it", but maybe it's a little bit broken, but I'm afraid to make any changes until I see him again.
 

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Sounds like you got it going on!!! Maybe your Dexcom will reveal a simple fix, I was thinking maybe a change in the Levemir as well. If the lows at night continue to be a problem, eating something as itissteve suggests a little more complex carb-y before bed could help. If not then maybe a phone call consult could get some advisement from your doctor before November.

I don't know why some doctors have to be so hard headed. Glad you found some that will work with you.
 

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Interesting. Never thought that that might cause inaccurate readings! Not saying it doesn't -- just that it never occurred to me.
 

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Have u thought that maybe u might be sleeping on the sensor? For instance when I have it in my right upper arm and if I should sleep on that side I frequently get a false low. It's a known issue. I try to not sleep on side I'm wearing it or somehow prop a pillow or something to take pressure off the sensor
OH! That is interesting! I wonder if the same applies to the Freestyle Libre 2, because I do go low overnight (low enough for the alarm to wake me up) and I’ve been playing with insulin and food etc to try to get it to behave, without sending me high.

Much to consider! Thanks fr your post!
 

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I've gotten false lows using the Libre2 and it is always related to sleeping on the sensor. I keep a testing kit at my bedside to confirm the low reading before taking anything. It has helped. I do find that I have some wonky lows during the night and that my body will recover. But it was really scary at first....
 

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I sleep on my sensor quite regularly, but fingersticks have confirmed the accuracy of my blood sugar dropping as low as 60 when I sleep. It always self-corrects, and I am not on anything that will cause low blood sugar, so I don’t worry about it. And I use the Libre 14 day instead of the Libre 2 because I cannot disable the critical low alarm on the Libre 2.
 
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