Morning highs and evening lows

[Becky2804]

Hello! Over the last couple of months I really seem to be struggling with high readings in the mornings. This is following a low carb dinner and always a low reading before bed (in the 4-5s) but then I am waking up 9+.

I am on 10 units of Lantus a day and have been since my diagnosis 5 years ago but I am wondering if I need to up my dose? Or could I be having a hypo in the night and this is the ‘rebound high’ (although my doctor did once say he believed this to be a myth?).. any help is greatly appreciated as I’m starting to feel really frustrated/anxious with the high readings. Thankyou!

 

[Jaylee]

Hello! Over the last couple of months I really seem to be struggling with high readings in the mornings. This is following a low carb dinner and always a low reading before bed (in the 4-5s) but then I am waking up 9+.

I am on 10 units of Lantus a day and have been since my diagnosis 5 years ago but I am wondering if I need to up my dose? Or could I be having a hypo in the night and this is the ‘rebound high’ (although my doctor did once say he believed this to be a myth?).. any help is greatly appreciated as I’m starting to feel really frustrated/anxious with the high readings. Thankyou!

Hi,

Are you litterally waking with post 9'er + or is it testing after the morning routine?
What time do you take your Lantus?

 

[TypeZero.]

Hello! Over the last couple of months I really seem to be struggling with high readings in the mornings. This is following a low carb dinner and always a low reading before bed (in the 4-5s) but then I am waking up 9+.

I am on 10 units of Lantus a day and have been since my diagnosis 5 years ago but I am wondering if I need to up my dose? Or could I be having a hypo in the night and this is the ‘rebound high’ (although my doctor did once say he believed this to be a myth?).. any help is greatly appreciated as I’m starting to feel really frustrated/anxious with the high readings. Thankyou!

Dawn phenomenon may be the reason. Rush of hormones during the night make you more insulin resistant and also causes liver to increase glucose production, as a result you wake up to a morning high.

The low before bed could be because your dinner time carb-to-insulin ratio is not on point so you may be giving more insulin than you need

 

[Becky2804]

Hi,

Are you litterally waking with post 9'er + or is it testing after the morning routine?
What time do you take your Lantus?

Yes, the first thing I do is test when I wake up and it’s been consistently 9+ for what feels like ages! I take my Lantus in the am around 7 each day x

 

[Becky2804]

Dawn phenomenon may be the reason. Rush of hormones during the night make you more insulin resistant and also causes liver to increase glucose production, as a result you wake up to a morning high.

The low before bed could be because your dinner time carb-to-insulin ratio is not on point so you may be giving more insulin than you need

Is there any way to get tackle the Dawn phenomenon haha x

 

[TypeZero.]

Is there any way to get tackle the Dawn phenomenon haha x

From what I can remember you may have to change your basal insulin e.g. switch to Levemir so you can give a higher dose at night, some other suggestions include avoiding carbs before bed or even waking up in the middle of the night to give a unit or two of insulin to counter the dawn phenomenon.

Apart from that not much can be done. I think the only realistic options are either ignoring it or switching to Levemir and using a higher dose in the night

 

[MarkMunday]

... following a low carb dinner and always a low reading before bed (in the 4-5s) but then I am waking up 9+. ...

The low carb dinner could also have something to do with it. Fat in a meal reduces insulin sensitivity for hours after eating. If you eat low carb and high fat every night, you may want to increase basal action in the following hours.

 

[EllieM]

Yes, the first thing I do is test when I wake up and it’s been consistently 9+ for what feels like ages! I take my Lantus in the am around 7 each day x

Lantus doesn't always last 24 hours. Could it just be that it's run out by morning? I take my lantus at night for this reason and accept that my evening bolus may have to do some basal work before I go to bed.

Any chance you could either briefly access a cgm (sometimes clinics lend them out for a couple of weeks) or set an alarm to test at night, so as to see what is happening?

 

[hh1]

Hello! Over the last couple of months I really seem to be struggling with high readings in the mornings. This is following a low carb dinner and always a low reading before bed (in the 4-5s) but then I am waking up 9+.

I am on 10 units of Lantus a day and have been since my diagnosis 5 years ago but I am wondering if I need to up my dose? Or could I be having a hypo in the night and this is the ‘rebound high’ (although my doctor did once say he believed this to be a myth?).. any help is greatly appreciated as I’m starting to feel really frustrated/anxious with the high readings. Thankyou!

I use Lantus and have for years, injecting once a day at night. About 18 months/2 years ago I started to see continuous high morning readings. I don't seem to suffer from dawn phenomenon so I split my Lantus and hey! all normal again. Plus I discovered I need less overnight than I do during the day, I have no explanation for that, I think most people who split dose go 50/50. Prior to that I'd discovered, thanks to Libre, that I have occasional overnight hypos which had led to occasional morning highs, an entirely different scenario. My point about that however is that I'm amazed that your GP dismissed the idea of liveer dumping in response to an untreated hypo, and I wonder if you qualify for a Libre? It was revolutionary for me. Hope you get it sorted.

 

[PeteN11]

My point about that however is that I'm amazed that your GP dismissed the idea of liveer dumping in response to an untreated hypo,

There are many reason that people can have unexpected highs in the morning, often referred to as Dawn Phenomenon, but the Liver reacting to a Hypo is not proven to one of them. If it did then there would be no comas or deaths from Hypos.
https://www.diabetes.co.uk/blood-gl...non (also known,response to low blood glucose.

 

[PeteN11]

any help is greatly appreciated as I’m starting to feel really frustrated/anxious with the high readings. Thankyou!

As already suggested start getting up every 2-3 hours during the night to test and then take a dose of insulin to compensate if high.

 

[hh1]

The article you reference states that 'the Somogyi Effect is widely reported and well-known amongst healthcaare prfessionals'. Whilst the same article goes on to state that 'there is little scientific evidence to prove its existence', some of us, me included, have personal experience of it. Of course, not everyone with T1 reacts the same way to everything, hence YDMD.