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Asking for my 3 year old daughter. She currently takes a fast acting insulin before each meal and slow acting nightly. Even getting her glucose around 180 before bed doesn't keep her from dropping.
Talk to her Dr. about decreasing the long acting insulin. Also check her blood sugar b4 bed and give her a night snack like a sandwich or some type of protein that breaks down l8r in the night and will help keep keep her blood sugar up at that time. Blood sugars are known to fluctuate at 3am .
I've had T1D for 46 years but have used a pump for the last 30 of them so I was unfamiliar with the basal insulins, as they didn't exist 30 years ago. When I had to be without my pump for a period of time, I was shocked by the lows caused by taking Lantus with less than 24 hours between the doses! I agree with all of the above answers but the things that I personally found most helpful were (1.) dividing my long acting dose into two equal doses, given 12 hours apart and, (2.) whether it's given as one or two doses a day, giving long acting insulin at exactly the same time every day. I realize that another shot or a pump for a three year old may not be feasible but, hopefully, you'll find answers!
I love my insulin pump. It only gives short-acting insulin and will provide her with more if she goes out of range or stops the basal so I don't drop low. I've had T1d for 48 years. After I got the pump, I could finally sleep through the night.
Managing overnight lows in type 1 diabetes can be challenging. Here are some strategies based on my knowledge base:
1. Ultra Long-Acting Insulin: Consider discussing with your healthcare provider the possibility of switching to ultra long-acting insulin like insulin degludec (Tresiba) or insulin glargine U-300 (Toujeo) Show Full Answer
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