Night Time hypos causing high levels In the morning

[mark_s_maynard]

I just saw a doctor at the hospital I have never seen before that said having hypos in the night and being unaware of them could be causing me to wake up with high levels.
I tend to wake up a few times a week with levels in the teens anything from just over 10 to 16 or 17 I have spoken to two previous doctors who said considering my hb1ac was really good that they were not overly concerned as long as I corrected with breakfast .
This new doctor suggested testing in the night to see if I hypo and to maybe increase my evening meal dose but I told her I go to bed at about 6 so taking a higher dose will definitely make me hypo.
I'm not really happy with her advice but was wondering if anyone else had ever had unnoticed hypos that made you wake up high?

 

[1abRat]

It's a thing I'm afraid!

It's called the Somogi effect http://www.diabetes.co.uk/blood-glucose/somogyi-phenomenon.html

The only way you can see if it's the cause of your highs is to either test a couple of times in the night at say, 1am and 4 am or invest in a Freestyle Libre or CGM system that will record your overnight sugars for you.

It's possible you might be able to get onto a free trial of the Freestyle Libre, speak to your diabetic nurse at the hospital to see,

 

[azure]

Yes, that could be one reason. It could also be Dawn Phenomenon - levels rising in the latter part of the night as your body gets ready to wake up.

The only way you'll find out is by doing some testing at various times of the night to,see if you can work out what's happening.

 

[slip]

I agree with what's been said above but it might not be caused by going low over night, could the high mornings follow a high fat or high protein intake the evening before? so a delayed high from previous meal - or some other effect like exercise or alcohol? Any pattern what so ever?

A freestyle Libre would (partially) negate setting the alarm clock for silly o'clock - just be aware if you go down this route theres also the possibility of having compression lows (hence the partially in brackets as to be certain a low recorded on the Libre is true you'd have to be sure the Libre is pretty much bang on every time or confirm 100% via a blood test at the time which defeats the object of the getting the Libre - but if you can get one free then defo go for it regardless!)

 

[mark_s_maynard]

Thanks for your responses. I have checked my bloods in the night before but mostly still been high but I will have a look and see.

 

[noblehead]

Thanks for your responses. I have checked my bloods in the night before but mostly still been high but I will have a look and see.

They say if your overnight bg levels fluctuate by more than 1.7mmol/l then your insulin (your basal if on MDI) will need adjusting, best bet is to test through the night as your Dr has suggested to get a better picture of things.

 

[catapillar]

The somogyi effect is a bit of a disputed thing - http://www.mdedge.com/clinicianreviews/dsm/2790/diabetes/somogyi-phenomenon - and whether a rebound high is what's sending you up to 17 seems worth investigating. Do some proper testing overnight so you can be sure of what's happening with your blood sugar when you wake up in the teens, if you rule out hypos then it's not somogyi. It might be dawn phenomenon. Or it might be related to last nights dinner - then you would need to consider increasing your bolus for your evening meal, or doing a second delayed bolus for it if there's a pizza effect going on.