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BG rise AFTER basal insulin

Newbie 2 LADA

Newbie 2 LADA

Member
Messages
17
Location
N Ireland
Type of diabetes
LADA
Treatment type
Insulin
Hi,
I'm new to this and just trying to get a handle on my numbers and am totally confused with the reading I just got
Over the last 4-5 days I have managed to keep my levels between 6 and 9 (I know 9 is high but still experimenting) on basal insulin only.
My diet has been fairly similar every day (adding in bits and bobs to see what it does to my readings) and exercise has also remained the same.
My BG before dinner was 8.4 and 2 hours post dinner was 9.
I took my basal (9 units at 2230) and then because I'm up later than usual decided to test my BG again at 0030 just out of interest but having expected it to have gone down. It has gone up to 11.1
I'm confused, because apart from a cup of coffee (which doesn't seem to make any difference during the day) between 2230 and 0030 I haven't eaten anything.
Would anyone have any idea why my BG would have gone up by 2 when I have just taken insulin and eaten nothing??
Any help / advice gratefully received
Thanks
Anne
 
Hello, some foods spike later and longer than other foods, pizza, for instance is notorious for that, but I also found that when I eat dorito's or coated nuts or such before bed (I know, shouldn't do that anyway) my sugar rises 5 or 6 hours later.
Besides the kind of food, you're new to this, which means you're not very experienced in what different foods and different amounts of insulin do to your blood sugar. Easily remedied: give yourself time to learn, test often and keep a diary of foods and blood sugars so you can find trends.
And the last reason is you're LADA, and a new one at that, so you're pancreas is probably still making it's own insulin. Problem with this honeymoon period is that your pancreas splutters and burps, and may work better one day and doesn't feel like doing anything the next. I'm lucky, mine seems to be pretty stable, although I suspect it of still giving me insulin. Yours might do the same which will make it easier to manage your sugars. Only way to find out is by testing often and keeping a diary.
Good luck, and very well done keeping your levels mostly between 6 and 9! You're not in a hurry to get them even lower, take your time and be kind to yourself if it doesn't always go as planned :)

edited to add: the long acting insulin should work slowly through the day, so you shouldn't notice much difference whether you took it an hour or 8 hours before eating.
 
Long acting insulins don't act immediately. They take a couple of hours to have an effect. Lantus particularly has a slow onset and drop off.

If you are only taking 9 units of it as basal once per day, then what's likely is that by the time you take your evening dose it's worn off or almost worn off, so your period from roughly 9pm-midnight is likely to not have as much covering liver glucose production.

If you drink coffee in this period, then you'll add to the liver glucose production (as a result of the fight or flight stimulation that caffeine generates) and (even though LADA so producing a little insulin) it will cause your levels to rise.
 
Besides the kind of food, you're new to this, which means you're not very experienced in what different foods and different amounts of insulin do to your blood sugar. Easily remedied: give yourself time to learn, test often and keep a diary of foods and blood sugars so you can find trends.
And the last reason is you're LADA, and a new one at that, so you're pancreas is probably still making it's own insulin. Problem with this honeymoon period is that your pancreas splutters and burps, and may work better one day and doesn't feel like doing anything the next. I'm lucky, mine seems to be pretty stable, although I suspect it of still giving me insulin. Yours might do the same which will make it easier to manage your sugars. Only way to find out is by testing often and keeping a diary.
Good luck, and very well done keeping your levels mostly between 6 and 9! You're not in a hurry to get them even lower, take your time and be kind to yourself if it doesn't always go as planned :)

edited to add: the long acting insulin should work slowly through the day, so you shouldn't notice much difference whether you took it an hour or 8 hours before eating.[/QUOTE]
Thank you so much...have been keeping a food diary as you suggested so hopefully I'll be able to see some trends...Ha ha..hard to be kind to yourself at times but I'll keep trying!! Thanks again
 
tim2000s said:
Long acting insulins don't act immediately. They take a couple of hours to have an effect. Lantus particularly has a slow onset and drop off.

If you are only taking 9 units of it as basal once per day, then what's likely is that by the time you take your evening dose it's worn off or almost worn off, so your period from roughly 9pm-midnight is likely to not have as much covering liver glucose production.

If you drink coffee in this period, then you'll add to the liver glucose production (as a result of the fight or flight stimulation that caffeine generates) and (even though LADA so producing a little insulin) it will cause your levels to rise.
Click to expand...
Thanks for your reply on this - it's very helpful......and I didn't know about caffeine!! Eek...another thing to give up!? Is decaf ok or am I clutching at straws?
 
Newbie 2 LADA said:
Thanks for your reply on this - it's very helpful......and I didn't know about caffeine!! Eek...another thing to give up!? Is decaf ok or am I clutching at straws?
Click to expand...

Ridiculous, I would NEVER give up coffee. Also, it's one of those things where some people say it spikes them and for others it has no effect. It's one of my favourite drinks because besides having wonderful caffeine, it has no sugar in it (unless you add it, which you shouldn't). It's possible that coffee gave you a slight rise, but I think the bigger problem is that you have a gap in basal coverage. You can compensate for this by splitting your basal dose to get more consistent 24-hour coverage, taking a dose of rapid-acting insulin to cover the gap, or getting an insulin pump which actually provides 24-hour basal delivery.
 
tim2000s said:
If you drink coffee in this period, then you'll add to the liver glucose production (as a result of the fight or flight stimulation that caffeine generates) and (even though LADA so producing a little insulin) it will cause your levels to rise.
Click to expand...

I've seen many people say coffee spikes them, but I'm wondering if it's just because most people drink their coffee in the morning and are seeing the effects of the dawn phenomenon/feet on the floor phenomenon and are attributing this to coffee. I'm not saying a spike is impossible and it's possible that coffee might intensify DP - it just isn't something I've experienced (and I say this as a dedicated coffee addict) and not a drink I would ever need to bolus for.
 
scotteric said:
Ridiculous, I would NEVER give up coffee. Also, it's one of those things where some people say it spikes them and for others it has no effect. It's one of my favourite drinks because besides having wonderful caffeine, it has no sugar in it (unless you add it, which you shouldn't). It's possible that coffee gave you a slight rise, but I think the bigger problem is that you have a gap in basal coverage. You can compensate for this by splitting your basal dose to get more consistent 24-hour coverage, taking a dose of rapid-acting insulin to cover the gap, or getting an insulin pump which actually provides 24-hour basal delivery.
Click to expand...
Ha ha ...I agree. Am keeping fingers crossed that I'm not one of the unlucky ones who suffers spikes with it!! I'm seeing the nurse tomorrow so will mention the split dose to her...may be the way to go. Thanks for the suggestion...Now off in search of coffee........
 
scotteric said:
I've seen many people say coffee spikes them, but I'm wondering if it's just because most people drink their coffee in the morning and are seeing the effects of the dawn phenomenon/feet on the floor phenomenon and are attributing this to coffee. I'm not saying a spike is impossible and it's possible that coffee might intensify DP - it just isn't something I've experienced (and I say this as a dedicated coffee addict) and not a drink I would ever need to bolus for.
Click to expand...
Funnily enough I am just researching the Dawn Phenomenon now. A whole new concept to me. SO much to learn and get my head around !!
 
Newbie 2 LADA said:
Funnily enough I am just researching the Dawn Phenomenon now. A whole new concept to me. SO much to learn and get my head around !!
Click to expand...

I really don't think it's well explained to most diabetics by the medical community and I don't think I fully understood it until I got a CGM. Many including me suffer from "feet on the floor phenomenon", which means that the minute I get out of bed my BG will start skyrocketing unless I take insulin or increase my basal on my pump. This is a consistent effect regardless of what time I get up, but it's made worse by stress or physical activity of any kind. If I walk my dog before work for example I need even more insulin, not less! This lasts for a good 2-3 hours or so after waking.
 
scotteric said:
I've seen many people say coffee spikes them, but I'm wondering if it's just because most people drink their coffee in the morning and are seeing the effects of the dawn phenomenon/feet on the floor phenomenon and are attributing this to coffee. I'm not saying a spike is impossible and it's possible that coffee might intensify DP - it just isn't something I've experienced (and I say this as a dedicated coffee addict) and not a drink I would ever need to bolus for.
Click to expand...

Newbie 2 LADA said:
Thanks for your reply on this - it's very helpful......and I didn't know about caffeine!! Eek...another thing to give up!? Is decaf ok or am I clutching at straws?
Click to expand...

I've enough data points to know that it does... not that it stops me drinking it. And many of those data points are not DP related (to the extent I've used it as a way of triggering a glucagon release to head off a hypo). You don't need to stop coffee, as the effects are relatively small (I usually reckon about 1-1.5mmol rise).

becca59 said:
Even Dr Bernstein is adamant a black coffee will not effect blood. And reading his book he thinks every other thing does.
Click to expand...
Dr Bernstein also doesn't believe in CGM or pumps. So he'd probably never be able to see the data that shows it has an effect. Whilst Bernstein is very knowledgeable he's also incredibly stubborn.
 
tim2000s said:
Dr Bernstein also doesn't believe in CGM or pumps
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He wears a Dexcom now and swears by it. His pump comments are ignorant, but he's very extreme in his views and set in his ways until he tries something new. I feel like if he actually tried a pump and it worked for him, he'd start saying pumps are the only way and no diabetic should ever be without one!
 
Newbie 2 LADA said:
His book has landed on my mat but haven't managed to read it yet. Sounds like a bit of a 'bible' Thanks Becca59
Click to expand...

I found it interesting. The results all in American format were a big irritation. I think all should read it and then make their own mind up.

I know this way of life is a growing movement, but for me I find it too extreme. There are those that follow this route and those that follow an apposing route eating anything. Then there is the middle ground.

For me it is the middle ground. As healthy as possible with quite small insulin doses most of the time. In fact most days l have only one meal a day around 2/3pm. However, if I eat out I don’t worry too much. I never have the pud and don’t like chips but I can always find something to eat. For me it is about moderation and enjoyment.

I respect the rights of everyone to tackle this disease in the best way for them. However, it becomes a little tiresome when you get shot down for not following the ultra low carb route.
 
becca59 said:
I found it interesting. The results all in American format were a big irritation. I think all should read it and then make their own mind up.

I know this way of life is a growing movement, but for me I find it too extreme. There are those that follow this route and those that follow an apposing route eating anything. Then there is the middle ground.

For me it is the middle ground. As healthy as possible with quite small insulin doses most of the time. In fact most days l have only one meal a day around 2/3pm. However, if I eat out I don’t worry too much. I never have the pud and don’t like chips but I can always find something to eat. For me it is about moderation and enjoyment.

I respect the rights of everyone to tackle this disease in the best way for them. However, it becomes a little tiresome when you get shot down for not following the ultra low carb route.
Click to expand...

I've tried his methods and couldn't last more than a couple of days honestly. Maybe I wasn't getting enough protein, but I felt really malnourished/sick and had trouble thinking and carrying on conversations with people. I also found that once I got past day 1 protein had a huge effect on my blood sugar that was difficult to predict/dose for since it was all converting to glucose. I think his methods were more applicable before the days of pumps, CGMs and rapid-acting insulin. I think he is too extreme when he says you need to maintain an A1C in the 4s or risk complications and death. I heard him say someone with an A1C of 5.3 was "out of control" and needed to get that way down. I think it's like anything - we should all strive to eat healthier, exercise more, etc. whether or not we are diabetic. Perfection isn't required or obtainable for most people and there's a cost to it.
 
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