# New to this but need advice!



## Jade88 (Oct 4, 2019)

Hi, I just wanted to know if any other type 1 diabetics suffer from rising blood sugars throughout the night every night? 
Also my husband (who has been diagnosed with diabetes since January 2015) suffers really bad leg pains in his calves and feet, it’s like restless leg but painful and he had to run or train them with weights but it’s getting more frequent and more painful now. Have you heard of this before? 

Jade


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## Martin9 (Oct 4, 2019)

Are you actually monitoring throughout the night, or are you referring to a higher BG result in morning , this is known as ‘Dawn Phenomenon’  in which the pancreas & liver provide more sugar in bloodstream to get up and deal with the demands of the day.
There are also more higher levels of adrenaline and noradrenaline which help increase BP etc to some people detriment, like me, with over high BP in mornings


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## Jade88 (Oct 4, 2019)

Yes he monitors it throughout the night once or twice, it wakes him up, and he doesn’t know why it climbs even if it’s normal before sleep, it will be 10-15mmol higher in the morning or after sleep with no food or drink in between 
How do you over come higher BG, do you take your long acting insulin before bed, or just monitor and inject through the night?


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## Martin9 (Oct 4, 2019)

Jade88 said:


> Yes he monitors it throughout the night once or twice, it wakes him up, and he doesn’t know why it climbs even if it’s normal before sleep, it will be 10-15mmol higher in the morning or after sleep with no food or drink in between
> How do you over come higher BG, do you take your long acting insulin before bed, or just monitor and inject through the night?


Needs advice from a T1 which I can’t provide, but part of it might be the Dawn phonemen thing...


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## Robin (Oct 4, 2019)

Can I ask what long acting insulin he is on? It sounds like he isn’t getting enough through the night.
This could be because he needs more generally, has he been told how to do basal testing to check if its holding him steady through the day?
Or it could be that his basal is running out during the night (depending on which brand he’s on, some don’t last the full 24hours even though they are supposed to)


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## Bruce Stephens (Oct 4, 2019)

Jade88 said:


> How do you over come higher BG, do you take your long acting insulin before bed, or just monitor and inject through the night?



Injecting short acting insulin during the night is a bit risky (lows when you're asleep are things to avoid, and making decisions like that when you're sleepy is asking for trouble). So normally the advice would be to increase the long-acting dose a little. However, ask the healthcare team for medical advice, since they may suggest something different.

(In my case, my long acting insulin is Levemir which acts for over 12 hours and less than 24, so I take two doses daily. So it's easy for me, I'd increase the evening dose a little.)

Especially if this is a sudden change: ask about it, since it may indicate something's wrong. Stress of various sorts tends to raise blood glucose (so injury, infection, etc.).

As to why it happens: the liver releases glucose continuously (including overnight) so that needs insulin to control it. And for some reason whatever dose he's currently taking isn't quite enough. (It's usual for doses to need to change for a variety of reasons. Again, contact your healthcare team if you're unsure what to do.)


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## Drummer (Oct 6, 2019)

I can't help at all with medication, but could the cramps be dehydration? A normal reaction to higher BG levels is to increase output of urine, but it can seem counter intuitive to take a drink of water, but that is what I found eased and prevented the cramps I had before diagnosis.


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## Eddy Edson (Oct 6, 2019)

Jade88 said:


> really bad leg pains in his calves and feet, it’s like restless leg but painful



Is this something that happens in bed at night, or ...?


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## Jade88 (Oct 10, 2019)

He’s on Lantus solo star long acting insulin

What’s basal testing? He tests using the finger prick tests 
I thought this was basal 

We could ask for a longer one I think this is only 12 hours too 

The cramps happen all day and it feels like the muscle is eating itself and only relieves when exercising like there’s something wrong on the inside so not restlessness


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## SB2015 (Oct 10, 2019)

A high in the morning could indicate: 

- a bounce after a hypo during the night, when the liver dumps glucose into the system to compensate for the low BG.  He could set an alarm and do a check at 3:00 am which is often when we get a dip, 

- that he does not have enough background insulin
This dose needs checking, again by setting alarms and finger pricking overnight to check what is happening.

- this is the dawn phenomenon where the liver dumps a bit of glucose when you wake up to get things going.
This would be shown by a quick rise  in the morning after waking.  Check by testing immediately he wakes, and then again once he is up but before he eats.  This can be overcome by eating a little something non carbs when you wake up to con your system and stop it releasing the additional glucose.

Hope this helps.


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## Jade88 (Nov 2, 2019)

Think we have found that it’s protein consumption he takes 4 raw eggs before bedtime and this can increase BG but you can’t predict the effect. 
Wanted you to know I’m case it affected you guys


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## SB2015 (Nov 7, 2019)

Jade88 said:


> Think we have found that it’s protein consumption he takes 4 raw eggs before bedtime and this can increase BG but you can’t predict the effect.
> Wanted you to know I’m case it affected you guys


Thanks Jade
I know that when I tried very low carbs meals I suddenly had to take account of protein, as in the absence of carbs the body will use those for the glucose that it needs.  I took my carbs up a bit as there isn’t enough space in y head to be counting protein as well as carbs and working out new ratios for protein too in order to dose my insulin.


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## khskel (Nov 7, 2019)

Basal testing explained here http://diatribe.org/issues/13/learning-curve if that doesn't work it's the top item in the pumping section of the forum. I found it invaluable.


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## Drummer (Nov 7, 2019)

Perhaps the poblem was not enough fat, so you continued using glucose, and producing it, rather than going into ketosis.


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## rebrascora (Nov 7, 2019)

Pleased you got it figured out.
I agree with @SB2015 that including a small amount of carbs with each meal helps to prevent the body from looking elsewhere for it's glucose (protein and fat) and mostly I try to do that whilst maintaining a low carb diet rather than try to calculate the effect the protein is having when no carbs are available. The nurse suggested a 25g protein to 1 unit of insulin ratio but since I am quite insulin sensitive 1:30g might be prudent. If your husband wants to continue with the eggs that might be something to experiment with.


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