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Levemir Morning High Bgs

L

Luckiiiineko

Active Member
Messages
25
Location
West Midlands
Type of diabetes
Type 1
Treatment type
Insulin
Hey guys
I'm relatively new here! But I've got a huge concern with my levemir insulin at the moment, I'm on levemir/novorapid, been on levemir for quite a while but as of late (past 2-3 weeks) my morning BGs are ALWAYS high. I'm taking split levemir, so 15u in the morning (7am) and 18u at night (usually around 9pm)
I'm wondering why this is happening and what to do about it, would it benefit from taking different times etc, and also if anyone else is/has had this issue?
Cheers!
Kirsty
 
Throughout your diabetic life your basal needs will change, up and down.....for lots of different reasons.....

there may also be dawn phenomenon going on....

the procedure is to do a basal test overnight......so no carbs or bolus on board, test before bed, test at 3am, and then the waking test.....if its higher by more than 2mmol, then that indicated you need more Levemir at night...
 
Hi Kirsty
Welcome on board.
I'm on the same regime as you and have been for the last ten years or so.
I take my levemir 12 hours apart 6am and 6 pm and which peaks after about 9 hours.
Perhaps start by bringing forward your pm dose to 7pm to equal it out and see what difference that makes.
I take 10 units am then 14 pm and I recall upping the pm dose about 3 years ago.

I hope this helps and I wish you luck

Tony
 
Tony337 said:
Hi Kirsty
Welcome on board.
I'm on the same regime as you and have been for the last ten years or so.
I take my levemir 12 hours apart 6am and 6 pm and which peaks after about 9 hours.
Perhaps start by bringing forward your pm dose to 7pm to equal it out and see what difference that makes.
I take 10 units am then 14 pm and I recall upping the pm dose about 3 years ago.

I hope this helps and I wish you luck

Tony
Click to expand...

Cheers yeah I'm going to try the time adjustment and see how that goes to begin with!
 
Hi @Luckiiiineko, Congrats on your first question ! I agree with those above, and there may be changes due to seasonal events or your cycles which could change BSLs readings and stability of BSLs.
Hypos during sleep without sufficient symptoms to wake you could lead to a rebound effect where the adrenaline and glucagon (hormones released during low BSL (glucagon and adrenaline) and emergency (adrenaline) cause the liver to release stored glucose which raises the bsl leading to highish BSL on waking plus possibly tiredness, headache, wet night apparel etc)
Just to mention also the Dawn Phenomenon.(DP) There is topic info on site about this. Briefly our bodies prepare for waking up by the release of hormones from the body somewhere around or after 4 am. (Hence @novorapidboi26 's advice to test BSL at 3 am and then on waking to see if there has been a rise) The effect of these hormones causes insulin to be less effective and may account for raised BSL, however it would be a bit unusual for this DP to suddenly appear and not every diabetic suffers from it).
Best Wishes on sorting this out and please remember to discuss changes with your DSN or doctor.
 
Yeah I've had a good read about DP, also when I originally started on levemir I had this same high BGs in the morning for a while but on adjumstment it seemed to clear up, will definitely check bg's around 3am to try see what's happening!
 
It would be useful to know what time it starts to rise, during the night. I find with my night time basal, that if it goes above a certain level, then it will just become unstoppable.

It might mean that moving the time forward helps, because Levemir has a peak after a few hours, so if the point your blood sugar starts to rise is more within the peak, that might control it.

If that doesn't work you might have to put it up a little bit, for a little while.
 
Just thought I'd update, did my 18u of levemir at 7 pm. Checked blood at 9.30 before sleep and it was 10. Checked it at 3am to see what bloods were and it was 9.8, then I get up at 7 and it's back to 19 again ..
 
Luckiiiineko said:
Just thought I'd update, did my 18u of levemir at 7 pm. Checked blood at 9.30 before sleep and it was 10. Checked it at 3am to see what bloods were and it was 9.8, then I get up at 7 and it's back to 19 again ..
Click to expand...

So you know roughly now the time it's going up. It's not much consolation, but at least you know it wasn't high all night long, it's probably only been really high for a couple of hours, though that's bad enough, but at least not all night.

Sometimes our bodies just do these things, it sounds like a dawn phenomenon thing. You aren't anywhere near having a hypo so you could try a small increase, that should start to get it back under control.
 
Luckiiiineko said:
Well I upped my levemir by 3 units, woke up with even higher BG than yesterday!! :(
Click to expand...

That's not good. People do say a change to basal can take a couple of days to have an effect.

Something must be triggering a Dawn Phenomenon effect, but what is doing it is hard to find out.
 
Hi @Luckiiiineko, Only by waking up regularly to test BSLs say every 2 hours, or by wearing a continuous CGM device, (with glucose monitor to check any out of range readings, could you rule out a hypo followed by a rebound high blood sugar.
But as @Alison54321 has said most people allow at least 48 hours on the new dose before deciding if it has made a difference.
In my experience (which may be different from yours) I find that to make any difference by changing a dose, I need to add or subtract at least 20%. So the 3 units is a tad over 20% and will give you an idea of what % might work best for you.
Fingers crossed !!
 
Yeah I'll keep at it at the moment, as I said though I've been on levemir for two years and this started flaring up about 2 weeks ago! Very odd, also it's making me feel like absolute **** when I wake up in the morning!
 
Luckiiiineko said:
Yeah I'll keep at it at the moment, as I said though I've been on levemir for two years and this started flaring up about 2 weeks ago! Very odd, also it's making me feel like absolute **** when I wake up in the morning!
Click to expand...

I do think that sometimes a change of insulin is a good thing, just because. This is probably a bit of a cranky view, and has no basis in real science, and endocrinologists would laugh at me, if they heard me say this, but.........
 
kitedoc said:
Hi @Luckiiiineko, Only by waking up regularly to test BSLs say every 2 hours, or by wearing a continuous CGM device, (with glucose monitor to check any out of range readings, could you rule out a hypo followed by a rebound high blood sugar.
But as @Alison54321 has said most people allow at least 48 hours on the new dose before deciding if it has made a difference.
In my experience (which may be different from yours) I find that to make any difference by changing a dose, I need to add or subtract at least 20%. So the 3 units is a tad over 20% and will give you an idea of what % might work best for you.
Fingers crossed !!
Click to expand...
A higher BG... I deeply suspect a hypo then a hyper...
 
Luckiiiineko said:
Yeah I've had a good read about DP, also when I originally started on levemir I had this same high BGs in the morning for a while but on adjumstment it seemed to clear up, will definitely check bg's around 3am to try see what's happening!
Click to expand...
Could you fund a Libre. It would be very useful to see what's happening.
 
alphabeta said:
A higher BG... I deeply suspect a hypo then a hyper...
Click to expand...

It could be, but @Luckiiiineko did a 3am blood test, a couple of nights ago, which showed the Levemir hadn't changed much during the night, up until that time.

Unless she's going hypo at 5am, and going up massively after that.

Oh, this is all so difficult!!!
 
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