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Originally Posted by Penny  Hi Adam.  If I get up between 5 and 6 hours, I am either very low or heading up. I have tried eating before I go to bed, doing some Novolog (this made a scary low.... So I need an answer to this problem too! |
If you are routinely going low overnight you are taking too much Lantus. It's SOOO.. easy to get hooked onto the Lantus treadmill. Take too much L... BG drops overnight then rebounds...high in morning...increase L dose to correct.
You need to set your basal dose. Walsh (Using Insulin) explains how to do this very clearly. Eat your evening meal relatively early (i.e. at least 4+ hours before you go to bed to allow your Novorapid/Humalog to clear). Do not have anything more to eat. Measure your BG last thing at night. If you take your L before going to bed, do so. Set an alarm clock to wake you up 3-4 h later. Test your BG again. Test again when you wake. If your 2 or 3 am reading is lower than your bedtime your basal is too high (you are taking too much L). If your 2 am BG is low, you will probably rebound giving you a high number when you wake up in the morning.
The correct amount of L should give you a 2 am reading that is more or less the same as your bedtime. If it is lower, start reducing your bedtime L. The recommendation is to do this 2U at a time and wait a few days for it to settle down although I found that I could get away with 2 U a night on successive nights.
Once you have got near to a correct basal, give it a few days to settle down and test again. You may need to adjust it a bit. If you find that your bedtime and 2/3 am readings are the same but you are higher in the morning, you have dawn phenomenonon. This is a PIA, but splitting the L dose sometimes helps.
After years of TMFL this worked like a treat for me - I reduced my L dose by >30% and knocked my A1C way down. You should remember that if your basal is set "flat" you are now in complete control of the ship (as it were). If you miscalculate your bolus and shoot up to say 180/10 you don't have a big dose of Lantus circulating to drag you down - you will just stay there until you make a correction, so you need to test OFTEN.
