Blood sugar fluctuation

[JohnClifford]

Hi all,
New here so take it easy on me.
Type 1 diabetic for the last 12 years, using novorapid and levemir. Control has been generally good, however some difficulty recently in managing blood sugar levels.

Bloods are dropping steadily overnight rather than staying flat and then have a sharp spike as soon as I wake up by about 6 points (this is before any food or drink). Throughout the morning bloods seem to be reasonably steady but then seem to rise in the afternoon.
I would suggest that the fall in bloods overnight is due to slow release insulin (levemir) dose being too high, but then the rise in the afternoons would suggest the opposite.

Has anyone had anything similar to this or can anyone recommend anythihng?

Thanks,
John

 

[Antje77]

I would suggest that the fall in bloods overnight is due to slow release insulin (levemir) dose being too high, but then the rise in the afternoons would suggest the opposite.

I agree with your thoughts on the dose.
As for the sharp rise upon waking up, this sounds like 'Foot on the floor', where your friendly liver dumps some glucose in your bloodstream to give you an energy boost for the day. The liver doesn't realise you're not dealing too well with sudden glucose dumps.
Some of us have found it helps to take a small dose of quick acting insulin before getting out of bed. To my thinking it doesn't matter if the glucose comes from my liver or from food, it needs insulin either way.

But be very careful, and don't mess with your doses on your own if you're not used to adjust your insulin! You can always contact your diabetes nurse to discuss this approach.

Throughout the morning bloods seem to be reasonably steady but then seem to rise in the afternoon.

Do you take your Levemir once a day in the evening or do you split it?
If taken once a day, it can taper off in the hours before the next dose, leading to a rise.
It can also be your insulin to carbs ratio is a bit off in the afternoon of course.

 

[JohnClifford]

I agree with your thoughts on the dose.
As for the sharp rise upon waking up, this sounds like 'Foot on the floor', where your friendly liver dumps some glucose in your bloodstream to give you an energy boost for the day. The liver doesn't realise you're not dealing too well with sudden glucose dumps.
Some of us have found it helps to take a small dose of quick acting insulin before getting out of bed. To my thinking it doesn't matter if the glucose comes from my liver or from food, it needs insulin either way.

But be very careful, and don't mess with your doses on your own if you're not used to adjust your insulin! You can always contact your diabetes nurse to discuss this approach.

Do you take your Levemir once a day in the evening or do you split it?
If taken once a day, it can taper off in the hours before the next dose, leading to a rise.
It can also be your insulin to carbs ratio is a bit off in the afternoon of course.

Hi,

Thanks very much for the reply! Have tried taking a standard two units of rapid every morning as I get up and this seems to fix it. Was just concerned about the reason for this spike. It's good to know this can be a common occurrence so will continue with this method.
As for the levemir, yes I just take one dose at night. Was considering taking a smaller dose at night time to prevent the overnight drop and then perhaps one around midday to combat the afternoon rises. Do you think this is a good idea?
Thanks,

 

[Antje77]

As for the levemir, yes I just take one dose at night. Was considering taking a smaller dose at night time to prevent the overnight drop and then perhaps one around midday to combat the afternoon rises. Do you think this is a good idea?

Levemir is often used as a split insulin so this might work well for you too.
But I really can't advise you on trying it or not, dosing is between you and your health care provider.

 

[JohnClifford]

Levemir is often used as a split insulin so this might work well for you too.
But I really can't advice you on trying it or not, dosing is between you and your health care provider.

Thanks!