Type 1 Morning highs

[DiabeticSkater]

I suffer badly from morning high bg's. When I first started Lantus a few years ago the docs told me this would solve the problem. It does if I take enough Lantus to make me hypo all day long. :lol:
So I have to inject atleast 4 units of Apidra as soon as I wake otherwise I'm battling 16 plus for four hours. Without the shot which is ontop of my breakfast bolus I go from 5.4 to 16 in 20 minutes.
Alot of hard work just to beable to get up normally and have a "normal" :lol: day.

 

[loaded]

Hello DiabeticSkater,

Have you tried splitting your lantus dose 50/50 and injecting morning and night?

Regards,
Tony.

 

[DiabeticSkater]

yeah already did that from the second week of use. otherwise it runs out after about 18 hours. maybe I'm just weird.

 

[DiabeticSkater]

do suffer from hypos duing the night occassionally. But not in this case. I dont wake up high, I wake up within a normal range and then within 20 minutes by BG shoots up.

 

[Tinkerbelly]

Hi

Its very common to get up in the morning with an ok bg but find that your bg starts to go up in the morning using Lantus at bedtime and not injecting any bolus in the morning and not eating any carb either. Why this is so, who knows?

Try increasing the Apidra a bit at breakfast and dont do a correction mid morning. That way things should work out much better for you. You will probably have to eat xxxx?? amount of carb mid morning if your bg is on 7 or below but will be better than having a bg of 16. It will be trial and error in finding your ideal carb intake.

Hope this helps

 

[DiabeticSkater]

Beleive me Ive tried it all, every avenue, no stone left unturned. 30 years of practice you see. I'm sort of beyond expert and feared by most doctors as my knowledge and experiance is greater.

Which leaves me wondering why the hell I'm asking this question in the first place :wink:

I was just wondering if anyone had found a better way of sorting this particular problem without the need for a shot instantly upon waking. Don't get me wrong injections don't bother me at all. I inject upto 10 times a day sometimes and have grown up with diabetes. Injecting is nurtured for me.

 

[timo2]

Hello DiabeticSkater,

I notice in a previous post, you mention that you're a smoker. Do you smoke first thing in
the morning?

Nicotine will raise blood sugars, and exaggerate the effect of dawn phenomenon
(blood sugars will continue to rise higher in the absence of digested carbohydrate)

Regards,
timo.

 

[TROUBR]

Hi Timo

I don't smoke but I get get the same as diabetic skater, not too bad (maybe slightly higher then when I go to bed) but by the time I get to work and have my breakfast (usually a couple of hours later) I have gone up a couple of points. I haven't yet had a nightitime hypo so not sure why. I am guessing they will put me on more lantus when I next go to see my DN

 

[DiabeticSkater]

I try to avoid coffee and cigarettes first thing as it seems to make the problem worse. As as I catch it i'm ok but the high make me really unwell. I'd rather wake up hypo as its easier to sort and has less of an impact on the rest of my day.
From what I can understand the liver dumps glucose/stored carbs or glucogen whatever its called. To get the organs up and running first thing in a morning and breakfast is required to replace this stored glucose.
Before I started using Lantus a few years ago the bg's were in the 20's every morning. I'm gonna try taking a larger dose before bed and a smaller one in the morning. Otherwise it means increasing the overall dosage and increasing the risk of hypo. Which is tricky because hypos caused by a long acting like lantus tend to creep up on you over a few hours or hit you when exercising.
Oh yes, the consultant suggested that I take the night time latus dose later on in the evening but the math doesn't work out.

 

[moggi10]

Hi, it sounds like you need to increase your fast acting insulin for your breakfast. If you are currently on a 1:1 ration of insulin, ie 1 unit of quick acting to 10g of carbs, you may need to increase this to 1.5:1 so that you put 1.5 times quick acting in to every 10g of carb you eat.

Try it and i reckon it will work. Everyone has different insulin requirements which believe it or not can change as the day progresses. I need less insulin in the morning but twice as much by the evening meal.

You should be able to tinker with your own doses quite safely, just be sensible. Don't increase too much too quickly and keep checking your BG before every meal and write them down. You will soon spot a pattern forming and this will tell you your insulin ratio's that YOU require depending on the time of the day.

No doctor or nurse can tell you this onformation, you have to record it yourself and try adjusting your doses.

 

[l0vaduck]

I have a similar issue - I have slightly better results with Levemir, but generally speaking I have to have my Apidra first thing in the morning - I've got used to this and it isn't a problem for me.