What the hell is going on?!

[alhubb]

So, I was diagnosed with type 1 Dec 2016. Everything has been going fine and I have been very stable until the last week or so. I wake up within range at 0600 (5.X) but by the time I get to work at 0745 I am higher (6.X or 7.X). I usually have 6 unit lantus and 4 units rapid and recently 2 hours after breakfast I am 8.X, I have upped my lantus by 2 units and novorapid by 1 unit since this started happening and I am still 8.X after breakfast. I eat 2 wheetabix and a piece of fruit for breakfast. I initially had to lower my lantus and rapid in the morning as I kept going low by mid morning and I have started going low again by mid morning because I have had to increase it. Any advice?

 

[tim2000s]

Hi @alhubb, a raise of roughly 2mmol/l after eating is actually fairly normal, and nothing to worry about, and happens for both Ds and non-Ds. It's probably worth you reading "Think Like a Pancreas" by Gary Scheiner to understand what's going on. At this stage, it sounds as though your previous dosing was good enough.

Normal recommendation is that you should see about a 2mmol rise two hours after eating, with levels returning to normal after 4. This is mainly due to how the insulin works. If you want to see less of a rise post eating, many of us bolus a little earlier so that the insulin has a chance to start work ahead of your meal and be better timed with your food.

 

[devexity]

Dawn phenomenon and morning insulin resistance is a very common feature of diabetic life. My blood glucose often doubles between first testing at 5.30 and getting to work at 8.30. I have found that eating an extremely low carb diet (20-40g per day) eliminates the problem. I have also found that I am bad at sticking to such a diet...

 

[alhubb]

Thank you very much!! That is really helpful. New to all this, my insulin in take has increased since Jan, so worried I am coming out of the honeymoon period

 

[asparagusp]

Do you have breakfast?

 

[alhubb]

Yes, @asparagusp, I do when I get to work at 0745

 

[Juicyj]

So, I was diagnosed with type 1 Dec 2016. Everything has been going fine and I have been very stable until the last week or so. I wake up within range at 0600 (5.X) but by the time I get to work at 0745 I am higher (6.X or 7.X). I usually have 6 unit lantus and 4 units rapid and recently 2 hours after breakfast I am 8.X, I have upped my lantus by 2 units and novorapid by 1 unit since this started happening and I am still 8.X after breakfast. I eat 2 wheetabix and a piece of fruit for breakfast. I initially had to lower my lantus and rapid in the morning as I kept going low by mid morning and I have started going low again by mid morning because I have had to increase it. Any advice?

My personal suggestion to counter the rise is to eat upon waking, yes it's something else to get used to but it gives the body the fuel it needs and insulin dose to counter the rise, so saves it becoming a pro-longed event which you can manage first thing instead of later on

 

[noblehead]

Yes, @asparagusp, I do when I get to work at 0745

Try and have breakfast (and insulin) before leaving for work to see if that makes a difference, but being newly diagnosed your insulin doses will change as you move out of the Honeymoon Period.

Even us old timers have to adjust our insulin doses from time-to-time

 

[Kristin251]

I need to eat right when I get up. Even if I just take insulin and don't eat I get an even higher rise. So I eat a very low carb fatty meal ( avocado) for bf but still need another small dose an hour or so later to stop the further rise. I can't take it all at once or I go low and pop back up. So I take what I need for food and then more for the rise a bit later. After noon I don't have this problem but mornings are the worst. And the worst time to eat carbs. Generally as the day progresses we become more insulin sensitive.

My insulin needs change fairly often. I'm learning to go with the flow. I just test test test. We can try to find our routines but blood sugar can be a wild card with no rhyme or reason.

 

[therower]

@alhubb . One more bit of advice to go with all the other you've received so far.
Try to avoid altering insulin dosages of both insulins in the same day/time period.
You'll get a much clearer picture if you alter one at a time.
Get your basal/ lantus requirements sorted first and your bolus/ novo will be far easier to get sorted.

 

[alhubb]

Thanks all. @therower, yeah I didn't do it in one day, I changed both my basal/bolus on different days over the course of a week. My basal is fine, I have been playing with that since I started and (at the moment) I think it is pretty perfect as I do 8 lantus in the morning and 10 lantus in the evening. I wake up 5.X and don't go low during the day unless I do exercise. My bolus is what seems to need changing a lot! Such a pain