Blood sugars rising during sleep

[Rashley]

I have not read everything, but what you don’t say is if you have uninterrupted sleep all night, I have the same problem however my nurse & doctors have pin pouted this to the fact I work unsociable hours & have to get up at various times throughout the night so my body produces more sugar to give me the energy to cope with this.
I am now taking a tablet boaster at night & it has bought me down to between 10-13. I am normally between 6-10 can’t remember the tablets name but speak to your diabetes specialist, they will be able to help

 

[PD Oz]

I haven’t followed the whole thread but I find that a few things can increase BGL by morning. 1. Fatty or oilier foods than usual at dinner. Eg pie with thick oily pastry. 2. And lack of afternoon exercise. There is nothing better than having plenty of exercise in the afternoon. A good brisk walk after dinner for 30-40 min works or if too cold where you are maybe an indoor exercise bike or walking machine. They are expensive purchases so maybe second hand can be affordable if you check around. Well worth it as exercise can be a big difference. Diet may need review too.

 

[mount]

I don't usually post here but i have experience in this issue and its a nightmare ! The way i solved it was to get hold of a Libre or CGM for a month and look at my night sugars, print them off if you have to but you need to be looking at them all side by side.
If you try to keep food consumption and timings constant you should start to see patterns over night when your sugars start to climb (at least i did).
Once you know what a usual night looks like hour by hour then you can begin to take action. Sadly this is v hard with an injection delivery system because its not specific enough (I,.E you cant target a specific time in the night to release more insulin to combat the spike unless you keep getting up and doing it) what changed the game for me was a pump, i use the Omnipod because its all bluetooth with no wires. What this allowed me to do was program a background insulin delivery schedule which i could change to deliver more or less background at certain points. This enabled me to specifically target those sugar spikes with higher background and then pull back insulin delivery when i didn't need it. The best part is the pump does this all when you are asleep which enables better sleep and thus better sugar control because of the better sleep (its all connected)

My final improvement was to start throwing in exercise which helped to flatten out the whole picture.
It takes some time to get it beaten but once you do its brilliant to wake up and find your at 6 not 16

you probably all know this stuff but just thought it might help.

Thanks

 

[Jimford91]

I started having this issue a few years ago and did some research and found in my case it was in fact the "Dawn Phenomenon" that people have mentioned, where your body basically is starting to get you ready for the day. I have had experiences when going low and it has "rebounded" and ive woke up in the morning rather high, but I'll focus on the "Dawn Phenomenon" here because it can be a bit more difficult and to me sounds like what you might be experiencing (Im not an expert though)

Im on Novorapid / Levemir for short / long acting respectively (sorry i never really use basal / bolus terminology). I found that no matter how Basal (long lasting) I had, the rise would just keep on going up and would be slowed by a Bolus injection. But that was only temporary, it seems quite counter productive but I HAD to eat something, like cereal or a slice of toast, to stop the dawn phenomenon from continuing.

I know that everyone is different, I have always managed my diabetes in a slightly different way (which it took any new doctors a while to realise) but it works really well for me! So some of the tips i mention may not apply.

Sorry if you are already doing some of this stuff and Im telling you to do what you are already doing, but I'll just mention everything you might find helps.

Ill start out with some non-diabetes related solutions you could try that I have found helped:

• Regular routine in meals and sleeping pattern, this will get your body used to when to start giving you energy for the mornings.
• Comfortable surroundings - Now this is gonna sound rather weird, but when I was living away for a year, my Dawn Phenomenon was worse and more severe. AS SOON as I went home it was INSTANTLY back to normal. I put this down to it being more comfortable spaces that I was more at ease in and this had some sort of underlying effect on it. (Diabetes for ya!)
• Food types to avoid. I could eat any food and with the right adjustment of insulin, quantities of food and exercise I would be fine. In the past few years this has had to change. I've found that foods that are high in carbs and fats (that you might have for treats) are stuff i no longer touch with barge pole. They outlast my bolus by a good few hours and at night time can cause me to spike high the middle of the night with no prior warning. Rice can also cause this, it seems to kick in after my bolus has passed its prime and then requires a 2nd injection, same as above about the middle of the night. So now i just stick to lower quantities of rice. If diet could be an issue, try eating maybe lower carb meals and then when you get a handle on it look at expanding your foods. Again sorry if you already eating low carb meals and everything!

Some diabetes related things:

• The libre! A few people have already mentioned it, but even if you look at getting it / self funding it for a month or so it will let you see trends. I started out self funding on it and it was like night and day! I could see exactly when i would start to rise, my trend in the night and how different things I tried had different effects.
• Monitor sugars before bed, I know you said your sugars are spot on before bed, but do you know the trend, are they level? Are they dropping (could be you going low in the night and "Rebounding"? Are they already rising and then going even worse?
• Pump, if you can maybe a pump will work since it can help you when you sleep. Im not on a pump, I know... I need to look at getting one and I'm behind the times on it!

Personally, I have always adjusted my insulin as I see and need fit and its always worked well for me. I know some people don't like to do this or aren't confident with it, so ONLY TRY THESE STEPS IF YOU ARE CONFIDENT CHANGING YOUR INSULIN AMOUNTS! Otherwise speak to your diabetic nurses / doctors:

• If you are on a basal / bolus regime (like me) try looking at when you take your Basal (long lasting). If it has a "peak" time you could try timing that for during the spike you experience. (I take mine at 11-12pm, just before i go to bed)
• Maybe look at increasing your basal (long lasting), even though i said mine rose though anything, yours might not or it might atleast lessen the effects. But be careful with this, because during the day you might start to have lower blood sugars or earlier in the night before the rise happens (which can be even more dangerous)!
• When it got bad and i would rise from 5am and it would just nuts until i woke at 8, I started having a small amount of bolus (short acting) at around 5:30 to stop it from going out of control until i woke up. This can be quite risky if you aren't used to doing this so please only try this if you have no other options that are helping and are VERY confident in changing dosages and injecting as and when you need!
• Splitting your basal. I don't personally, but i know a lot of people do and it has helped them. Maybe try looking into that, I don't know about it so definitely speak to people before doing this.

Sorry for the essay! Sorry if some things don't apply, I couldn't get a full understanding of your situation from what i saw, but i hope some things help.

Anything can effect sugars like stress or even the weather, so try a few things out lifestyle wise and see if they help.

TL;DR version:

Sounds like the "Dawn Phenomenon". Everyone is different but above are some lifestyle tips / monitoring tips / insulin changes (BE CAREFUL WITH THESE) that might help.
Good luck!

 

[Ricky]

I know I am not being very helpful here but you lot have made me feel so much better. I am type 2 and I control with low carb/low GI diet + exercise and of late my fasting numbers have been going up . They are now consistently in the 7's and I have even had 8.5. My doctor doesn't want to know as he says he goes by the HbA1c which a couple of weeks ago was 47 (6.5). By lunchtime 5 hours after breakfast my numbers are in the 5's and 6 hours later after lunch are in the low 5's.
My sleep is awful in that it is disturbed as I wake so often but I do go straight back to sleep. A Functional Medicine practitioner told me that my problem is high cortisol levels and that is what is waking me. The only way it can be sorted is t go to bed at 10.30 and sleep through to 6.30 - well no way as I am a night owl. I have been taking a product that I have red glowing reports on bringing down cortisol levels and helping sleep. Tonight will mark a week of taking this and so far I am seeing no difference in my sleep!! Maybe it needs a lot longer!!

 

[Capwhittaker]

I am type 1 and have the same issue. One thing I would say to start is remember the positivity of your day control being good. You may never get perfect control but day control is great.

The libre helped me a lot. Do not take no for an answer on it. Ask them what the criteria are to get one. If you are asking your GP, get referred to a diabetes centre. For me, I had to have a hba1c bad enough that i should be doing 8 blood tests a day. Good diabetes nurses will keep you healthy but play the system to get you one.

I found eating earlier, eating less fat and carbs helps. Also splitting my before tea insulin dose helps. But the libre really helps to see where the peaks start and end and act accordingly.

 

[foxhaven19]

Can someone help to reduce this? Doctors and nurses aren’t doing jack shizz.

no one helped me answer it in my previous thread

The reason is simple. A trillion years ago when homo sapiens where hunter gathers they had to be ready to either run like hell or stand and fight as soon as they awoke if an attack by one of the monstrously large prehistoric animals hove into sight. Glucose is energy and good old mother nature made sure that there was sufficient amounts to fuel either one or the other. It's called the 'Fight or flight' syndrome. So in the middle of the night when there's no danger our BG falls because large amounts are not needed but as dawn arrives and there could be the need to react quickly, (like getting out of bed without falling over!) up goes our BG to compensate. You can do all sorts of things to lower waking figures by experimenting with amounts and timing if you're using insulin, but do you really need too?

 

[Everyusernameseemstaken]

It is normal that your liver "synthesises" glucose overnight to keep your glucose levels sufficiently high during what is effectively an 8-12 hour fast fro most people. In normal people, insulin deals with the surge which normally occurs between 0400 and 0800. In diabetics or prediabetics the insukin is less effective and blood glucose will rise.. It is called the "dawn effect". If this level is consistently rising, it can be an indication of a deteriorating metabolic response to insulin. What is more important is the HbA1c level. The only way recommended to deal with the dawn effect is to ensure at least 7 hours of good quality sleep per night and to deal with issues such as sleep apnea which aggravates metabolic syndrome.

This is a very useful reply. I am a Type 2 diabetic diagnosed 3 years ago, until last year I managed solely through diet, but last year I was put on Metformin. In recent months I have struggling keeping my blood/glucose level down in the mornings. From the above advice I deduce that as well as keeping my carb intake low of an evening I should eat earlier rather than later and take steps to improve the quality of my sleep. Of late I have been somewhat congested and this is causing me to wake in the night, so perhaps taking a decongestant would improve matters.

 

[davidnicholas59]

Get a freestyle libre CGM. The sensors last 2 weeks and cost around A$100 full retail. You need either a modern phone with a near field capability, or a standalone reader, again about A$100. The data you get is invaluable, you will see at what time overnight your BSL starts rising. You will see if you are sleeping through a hypo. There is a lot of speculation in this thread, just get the data. It isn't cheap, but it also isn't expensive compared to many procedures.
freestylediabetes.co.uk/freestyle-libre

 

[Shinealight]

My daughter's blood sugar was rising through the night every night for months. Even if I gave her a compensatory dose or two of insulin her level would drop only a little and then continue to rise. She has just switched to a pump and it has been a godsend. Her blood sugar levels are now stable through the night.

 

[A.LatifMemon]

Can someone help to reduce this? Doctors and nurses aren’t doing jack shizz.

no one helped me answer it in my previous thread

I used to face same problem
I think you are taking high units of insulin at night and during mid night you went into hypoglycemia so your liver produces glucose and as a result your blood sugar increases in morning
Make an alarm and You should check your blood sugar level at midnight, if you are in hypoglycemia than that means you are taking high units of insulin at night

 

[karen8967]

My levels start rising from about 3am onwards i take a couple of units bolus which slows it down and i have to have breskfast cos if i dont it continues to rise