Struggling to keep BG down in mornings...

[Indy1282]

I get foot to the floor Syndrome when I wake. I take insulin before I get out of bed but I am really struggling to keep levels down in the morning. It seems to take aaaaages for my not so Novorapid to kick in and as a result i cannot eat breakfast or anything before lunch as I will spike..

I started this morning at 5.3 and have risen up to 9.4 ( still going up! ) despite taking 8 units in total with no food.

I have asked my dsn if I can change to Fiasp but they have to check with my consultant.

Any help or ideas??

 

[Fairygodmother]

Some people say they find having something to eat first thing, e.g. a couple of spoons of yoghurt or a bit of cheese, lets the liver know it doesn’t have to dump. Worth a try?

 

[Deleted Account]

I would not expect Fiasp to help with Dawn Phenomenon. Your liver will still dump glucose.

I agree with @Fairygodmother about trying to eat something - your BG is going up because your liver thinks it needs to add sugar to your blood .. because you are not dong so with food.

Another tack is to think about your basal?
When do you take it? If you take it in the morning, it is possible it is running out.
Some Basal insulins are longer lasting with a flatter profile so may help.

 

[Juicyj]

Hi @Indy1282 The trick is fooling your liver, so eating first thing something is telling your liver to stop dumping glucose which it's doing to fuel your energy levels, people think they cannot eat as they are rising, but you do need to do this at least for a few days to get into this adjustment. I agree with Fairy it doesn't need to be a big bowl of cereal, just anything that get's your digestion going, so few berries and plain yoghurt is a good starting point.

 

[Indy1282]

I would not expect Fiasp to help with Dawn Phenomenon. Your liver will still dump glucose.

I agree with @Fairygodmother about trying to eat something - your BG is going up because your liver thinks it needs to add sugar to your blood .. because you are not dong so with food.

Another tack is to think about your basal?
When do you take it? If you take it in the morning, it is possible it is running out.
Some Basal insulins are longer lasting with a flatter profile so may help.

It's not Dawn Phenomenon as I'm steady overnight and dont start going up until I'm out of bed and moving.

I split my basal - I take 14 units when I wake ( approx. 7am ) and 10 units around dinnertime ( 6.30 - 7.00 ) I did think about splitting dinner in half so 5 at dinner and 5 before bed so about 10.30pm.

I will also try eating something for breakfast - although in the past I have always spiked when eating in the morning.

 

[Antje77]

Exactly the reason why I changed to Fiasp. Well, one of the reasons, but this was the most frustrating part of novorapid for me.

 

[Antje77]

I would not expect Fiasp to help with Dawn Phenomenon. Your liver will still dump glucose.

Works a charm for me! On novorapid I took a dose before getting out of bed when waking with normal numbers, and my bg would shoot up to 11 before the insulin kicked in. On fiasp I usually hardly notice a bump on my Libre graph

 

[derry60]

Some people say they find having something to eat first thing, e.g. a couple of spoons of yoghurt or a bit of cheese, lets the liver know it doesn’t have to dump. Worth a try?

Cheese usually works very well for me also

 

[evilclive]

It's not Dawn Phenomenon as I'm steady overnight and dont start going up until I'm out of bed and moving.

That's classic DP - just because it isn't happening as the sun is rising, doesn't mean it isn't the same thing

 

[Indy1282]

That's classic DP - just because it isn't happening as the sun is rising, doesn't mean it isn't the same thing

It definitely isn't DP. I could get up at 6am or 10am and my levels will be steady and low. It only happens when I start moving.

 

[Antje77]

That's classic DP - just because it isn't happening as the sun is rising, doesn't mean it isn't the same thing

As far as I understand the 'classic' one happens every night at around the same time, whereas 'feet on the floor effect' happens upon getting up.

 

[evilclive]

It definitely isn't DP. I could get up at 6am or 10am and my levels will be steady and low. It only happens when I start moving.

And your liver is noticing that and throwing glucose at you. Like I said, classic DP.

 

[Indy1282]

And your liver is noticing that and throwing glucose at you. Like I said, classic DP.

DP starts around the early hours of the morning, which is why people wake up with high BS. I dont have high numbers in the morning, quite the opposite sometimes.

 

[evilclive]

DP starts around the early hours of the morning, which is why people wake up with high BS. I dont have high numbers in the morning, quite the opposite sometimes.

It doesn't really matter what you want to call it, the problem is still the same - the liver throwing glucose at you as it detects you're doing stuff. Which you can try and address with a lump of bolus insulin, and by eating at least something so the liver knows it doesn't need to prepare you for activity on its own.

 

[endocrinegremlin]

Yeah, DP is a bad name for it because then people who have it, like you, think you don't. But this screams that you do. Food might take it. OR you might need to look into pump therapy so that you can have ever changing basals as you get up to combat the rise your liver is going to throw at you regardless. It doesn't matter when I wake. It is when I move that my body goes LIONSTIGERBEARSOHMAI. Just the way it goes.

 

[Antje77]

It doesn't really matter what you want to call it, the problem is still the same - the liver throwing glucose at you as it detects you're doing stuff.

Yeah, DP is a bad name for it because then people who have it, like you, think you don't.

And your liver is noticing that and throwing glucose at you. Like I said, classic DP.

The difference is that DP at a certain time of night usually happens while sleeping, so it's impossible to do something about it unless on a pump or willing to wake up to inject for it.
Feet on the floor, however, is glucose being dumped into your bloodstream upon waking up. To my thinking it doesn't matter if it's my liver dumping the glucose or my food dumping the glucose through carbs, either way I need insulin to process this glucose. With feet on the floor we are awake when the glucose enters our bloodstream (as opposed to a liver dump when asleep) so we can inject to use that glucose. Just like non-D's have a liver dump to get them going for the day with the accompanying insulin from their pancreas.
The main difference is that injected insulin just doesn't work as quick as insulin from our pancreas (pre-bolusing for food, anyone? The pancreas doesn't need that!), enter Fiasp. For some of us. It doesn't seem to work equally good for all of us.

 

[endocrinegremlin]

The difference is that DP at a certain time of night usually happens while sleeping, so it's impossible to do something about it unless on a pump or willing to wake up to inject for it.
Feet on the floor, however, is glucose being dumped into your bloodstream upon waking up. To my thinking it doesn't matter if it's my liver dumping the glucose or my food dumping the glucose through carbs, either way I need insulin to process this glucose. With feet on the floor we are awake when the glucose enters our bloodstream (as opposed to a liver dump when asleep) so we can inject to use that glucose. Just like non-D's have a liver dump to get them going for the day with the accompanying insulin from their pancreas.
The main difference is that injected insulin just doesn't work as quick as insulin from our pancreas (pre-bolusing for food, anyone? The pancreas doesn't need that!), enter Fiasp. For some of us. It doesn't seem to work equally good for all of us.

I assure you that my, and my other's DP happens on a schedule whether we are awake or asleep. Ten past five each morning is when it kicks in for me. Most of us then see another spike when we get up, feet on floor, so to speak. It is just different patterns of the same complication.

 

[Glucobabu]

This may sound stupid, but I have been turning my brain to yogurt trying to work out what ‘Fiasp’ means! Someone please put me out of my misery!

 

[Glucobabu]

This may sound stupid, but I have been turning my brain to yogurt trying to work out what ‘Fiasp’ means! Someone please put me out of my misery!

This may sound stupid, but I have been turning my brain to yogurt trying to work out what ‘Fiasp’ means! Someone please put me out of my misery!

Just googled it. So it’s a new kind of ultrafast insulin! I could do with it because I have exactly the same issue as Indy1282.

 

[Marie 2]

I have DP, but sometimes if I don’t have it at my usual about 5:30 am, my BG’s will then climb after I am awake, that can happen as late as 9:00 am. I always climb one way or another in the am. It does not work for me to eat as I just climb out of control too easily. I can go from a nice 5.6 to over 14 without eating if I don’t make adjustments for it. Although it is slowly getting better. But for me forget eating. Someone explained that with DP because of the hormones released you have insulin resistance for a few hours following and that totally makes sense. If I eat anything in the morning I use 1 unit for every 3 carbs, in the afternoon or in the evening it’s 1 unit for every 6 or 7 carbs. But I can’t seem to absorb the insulin properly in the am to make up for eating.


The best way I have controlled it is by a insulin pump, I literally take 3 times my normal basal insulin for 3 hours from 5:30-8:30 am. When I haven’t spiked yet I have to temporary lower it and give myself 3-4 extra doses along the am. I either don’t eat in the am or I will have something low carb. A pump would allow you to have the increase programmed in after you woke up each day. Before I had my pump I used to give myself a shot when I first got up. That was a lot harder to judge what you needed each morning. A CGM I consider critical to control it. Before I had my CGM I didn’t even know I had DP, I just thought I had some wacky numbers when I got up , I didn’t figure it out because sometimes my BG’s went up after I checked them.