Can I have some diabetes advice please?

[LittleBlackCat22]

My partner is type 1, and more often now he’s been waking up hypoglycaemic and is very confused in the mornings and can sometimes try to hurt himself. How can we stop this from happening? I don’t think he’s been eating enough in the day but he always has a large meal and snacks before bed and does his insulin. He’s just getting harder to wrangle as I’m 20 weeks pregnant and it’s upsetting for our daughter.

He needs to get proper medical advice, immediately.

He needs to speak to his doctor.

Is he on a pump or injections? Either way if he’s waking up fasting it’s likely his basal insulin that’d need adjusting. Much easier to do on a pump.
I’m on a pump and would probably put myself on a temporary basal rate reduction to stop it happening then do some overnight testing (not fun but useful) to work out where the issue is and adjust from there. He should really check in with his diabetes nurse for advise though if he’s not confident in how to tackle it.

Doctor. This was happening to my OH and they changed his nighttime insulin and it never really happens now unless he hasn’t eaten correctly. He had just started to live with it for months until one morning we couldn’t get his sugars back up and he ended up in hospital (they changed his meds there)

Waking up low I mean, so it’s a fasting reading

Yep, as others are saying if he is eating a big meal before bed but still waking up low, his basal is likely too high. Can he call his diabetes team for advice on adjusting his dosage?

Definitely needs to call his team to have his insulin looked at. It's probably his background one.

Ok Thankyou. He’s gone back to sleep now but when he wakes up till tell him to get on to the doctors.

Is it normal for him to fall back to sleep at this time? That in itself would ring alarm bells for me

My husband went through a phase of this. He has started splitting his blue nighttime injection between evening and morning. Also sometimes has a bowl of cereal before bed.

Yeah very normal for him to fall back to sleep. He’s ok, I’m talking to him and he’s responding. He’s working a lot atm and I think it’s catching up with him.

Can he ask to go on a course to learn to adjust his own insulin doses?

It sounds like he needs less basal insulin - if he's been working hard, and it's hot, these are both likely to cause hypos so a reduction should help.

These courses might help - free.

elearning.mytype1diabetes.nhs.uk/

Hi mum to a type one diabetic here, sounds like his long acting insulin dose may be too high, or his evening carb:insulin ratio needs adjusting. I would suggest weighing his carb portion in the evening and getting in contact with his diabetes nurse.

As an adult he should be able to confidently adjust his own insulin.

Basal needs dropping by a few units.

Just wanted to say, alcohol in the evening can make your bloods drop very low too. So if he’s drinking a lot before bed that could cause a hypo early morning x

@FireUnderpants

As an adult he should be able to confidently adjust his own insulin.

Basal needs dropping by a few units.

And yet this has been going on for a while and he hasn’t done this which suggests he either lacks confidence or isn’t engaging at the moment with it.

Also a possibility that he has done this and it still isn’t working.

In all cases, professional support is needed due to it being an ongoing issue.

Has he got a Libre? If not he needs to try and get one.
He needs to see what his basal insulin is doing overnight.
What's his BG before bed?
What is it on waking?
BG always drops a b bit in the night (even for non diabetics) and then begins to rise as hormones kick in to wake you.
Does he know how to adjust his dosage? If not, he needs to contact his DSN. It's serious so don't ignore it.
Sounds like his basal rate is too high.

I am type 1 diabetic. Id think he'd need to lower his night time Insulin and have supper before bed. Does he use a long acting Insulin as well as a fast acting one with meals?

If he's low its a case of reducing basal and easing off on dinner ratio until he's not hypo in the morning. That's all medical staff will suggest.

Is he doing it deliberately to reduce his Hba1c?

Thanks all, he’s called the doctors, he has to call back in the morning.

He should call the diabetic team at the hospital. There is always someone on call to help patients with insulin. GPs really don't have the breadth of experience to deal with this. I would call the hospital now.