High morning blood sugar levels (DAFNE)

[Joolie]

For the last couple of months I've been experiencing high morning blood glucose readings, which I've treated by increasing my breakfast Novorapid injection accordingly. I've been getting readings in the 17.0 - 20.0 region.

I visited my GP this week and asked if my levels could be dropping in the night and the high levels are my body's response to that. He didn't think that would be possible as I'm a Type 1. Having said that, I've reduced my evening meal ratio and the last few mornings seem to better (fingers crossed it stays that way!). He did a blood test and my hba1c came back yesterday as 7.4%.

Any help would be greatly appreciated!

 

[jopar]

Joolie

You are right with what you are saying it is possible..

To really have a idea if this happening to you...

Is to take your BG reading when you go to bed, and then one when you get up, and compare these results... These should be roughly the same..

If not, then over a couple of nights, take a reading durning the night, 3am is considered to be the point when hormonly the body is at it's lowest ebb, so start with this one, the a 2am, 4am etc.. to see if you can see any patterns.

Another tell tell sign, that might suggest that you've sufferes a mild hypo while sleeping is when you wake up, if feels like you've got a hang over!!

It could also be that you are suffering with Dawn Phenomenon, this is were the body starts it wake up process, where it increases the level and amount of hormones, along side increaseing the amount of glucose being delivered into your system, from your liver..

To counter act this effect, is to split your background insulin into two injection to am/pm then you can adjust the dose to suit the needs of the morning and/or the night time needs to pervent and stablise your levels.

 

[hanadr]

You are probably right and a 7.4% HbA1c suggests that you are running above ideal BG numbers for some time each day.

 

[JER]

Joolie,
The problem you describe is almost exactly what plagued me prior to going on DAFNE. Even now my biggest difficulty is keeping my blood levels right through the night. But I now have 85% success in having a Blood Sugar between 5 - 8.5 when I awake (often my morning blood sugar is almost equal to my bedtime blood sugar) and hardly ever hypo during the night.
Similar to what Jopar has recommended the key is definately splitting your BI and the timing of this in the evening is critical. In addition getting your ratio right for your evening meal is also very important and it takes a bit of time to get that right. Also if you do decide, after chatting with your Diabetic doctor/consultant, to split your BI then I would definately recommend changing to Levimir as it is designed to be used as a split dose as well as once a day. It really works for me it is far better than Lantus.
This was a huge problem for me I was scared to go to sleep because of the terrible hypos I was having during the night and often I felt rotten when I woke up as I had a high Blood sugar. i don't tolerate a B.S. > 13.
The final thing I would say is that if like me you are determined to sort it you will it takes a bit of trial and error but you will manage it.
If you want more help or to discusss this please get in touch because I know how difficult this can be and I think I have sorted it. My HbA1c has improved from 7.5 to 6.5.
Cheers
JER

 

[LittleSue]

Hi Joolie
I agree, you may well be going hypo in the night and rebounding. Best to check some early morning bloods to be sure. If your evening ratio is too big you could be hypoing quite early, so maybe test as early as midnight or 1am. Despite what doctors may say, you won't necessarily wake up if you go hypo in the night. Testing several times overnight at different times should show the overall pattern, the other way is to test every 2 hours over 2 nights. Alternatively your local hospital diabetes team may be able to provide a continuous monitor for 72 hours, suspicion of night hypos seems to be a recognised justification for this.

 

[mere193]

In type 1 diabet does amount of our insulin will increase day by day like in type 2. When we get older our body resistance against insulin they said insulin make cell walls ticker is it true?

 

[Stubydoo]

I'm type 1 too and experience exactly the same thing. I'm on an insulin pump and i needed to tailor the basal (background insulin) delivery during the night to suit. It always frustrated me that i could tackle the daytime as apprpriate although when i went to bed and my BS was fine, i'd wake up first thing at it was totally out of range...yet i'd been asleep! They asked me to take a 3 day BS test with a 24hr BS monitor (basically the same as a pump although to monitor BS over 24 hrs) and carb diary for them to see exactly how i reacted to carbs, particularly during the night. To see the results through the night (where my BS dropped around 3.30am, then increase as a result facinated me.

At the time my consultant and specialist nurse explained that the body stores carbs in the muscles and liver etc. and when your BS goes low during the night it naturally draws upon the stored supplies, hence the high BS first thing. An alternative is that as your body prepares to wake up it releases all manner of hormones that again draw on the stored carbs driving up your BS. The Americans have referred to it as the 'dawn phenomenon' (sufficiently dramatic i feel....).

It's a really difficult one to tackle as your body is going to react completely differently from one day to the next, although based upon my experiences with the consultant and specialist nurse, their advice was spot on.