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Bloodsugar rises in the morning

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Niclas

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Hi everyone,

I am a new forum user from Sweden and English isn't my native language so don't be too harsh :)

As the subject suggests i'm trying to solve the increase of my blood sugar levels in the morning and i cant seem to find any information anywhere, hence my question to you guys!

Here's the full bio in order to give you some background:
I'm 43 years old and have been a type 1 diabetic since i was 10 years old.
My diet is fairly vegetarian (but not completely) and i try to stay away from carbs as much as i can.
The daily routine involves at least 10km of walking and some other not always so regular exercise.
I'm 180cm/65kg (5'9"/143lbs) and i've got an HbA1c of 6,4% (46mmol/mol).
I'm treated with novorapid (2-4ie/meal) and tresiba (12ie at 18:00 (6pm) and 8ie at 06:00 (6am))
And one other thing - i never eat breakfast!

I have uploaded a pic of this mornings increase in bloodsugar. I didn't eat anything besides coffee (black, no sugar).
The blue line is when i woke up and as you can see its a fairly substantial increase over the next few hours.
I normally take 2 or 3 ie of novorapid in order to prevent this increase but today i forgot and this is the result.

My question is WHY does the bloodsugar increase this much every morning and what can i change in my life to prevent it?
This increase is one of the reasons why i don't eat breakfast, because if i do it almost impossible to control the bloodsugar.
 

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Hi @Niclas

It's pretty common - Dawn phenomenon or feet on the floor, as we wake our liver dumps glucose into our blood to get us up and about, i've found the easiest way to deal with it is to eat upon waking, only something small but gives the body something to work on instead of the liver dump, I tend to only eat around 10g of carb so a few spoons of greek yoghurt or a few eggs does the trick for me as I prefer to avoid eating lots of carbs at breakfast but will still need a bolus for the carbs in yoghurt or any protein I eat, and a correction if my reading suggests it.
 
Welcome to the forum.
This looks like Dawn Phenomenon to me - our body helpfully releases glucose at the start of the day to give us the energy to get moving. A healthy pancreas pumps out enough insulin and the body is happy, alert and awake. A less healthy pancreas will not be able to do this and relies on insulin from an external source (injections).

I know some people with diabetes minimise this through low carb diet (which you have already) and watching what they eat the night before.
Reducing the affect of Dawn Phenomenon is one of the great benefits of having a pump because it allows you to vary the amount of basal insulin to, for example, give you an insulin boost when you wake.
 
Hi @Juicyj and @helensaramay and thank you for your fast responses.

Would there be any point in eating yoghurt in the morning since it still will require me to take insulin, and more of it?
I need insulin now in the morning even though i don't eat anything so i don't understand how my life would be any better if i had breakfast instead of just a correction?

I have considered a pump and i will get one when i can get one that will pair with a cgm-meter and automatically adjust the levels of insulin. I don't mind the injections and my values are rather good so i don't really need a pump if i cant get a model with that functionality.

What i really don't like about pumps is that then there's another thing attached to my body since i already got a meter (Freestyle libre).
To me its a matter of both aesthetics and practicality.
 
Hello @Niclas I find eating something no matter how small in the morning prevents the liver dump as it's giving my body something to work on rather than giving me glucose, you're going to have to take insulin whether you eat or not as you will still have to correct for your rising blood glucose levels, but you don't have to eat much to achieve this.

Yes a pump can be programmed to deliver insulin when you need it via the basal program so this is a good alternative if you prefer not to eat, a Medtronic 640g will work with a CGM, however it really does not get in the way, I happily cycle, swim and run using a pump, and you very quickly forget you are attached to it.
 
Hi Niclas,
By the sound of it we have a similar diet and the same eating habits. My blood sugar keeps rising for up to 3-4 hrs and can go from 5mmol all the way up over 11mmol/l without a lot additional bolusing (I'm on a pump now so that is easy), the graph you posted could easily be one of my graphs pre pump. The cause is the liver starts to release glucose many have assumed this is to provide energy when you wake up and all well behaved pancreases release insulin to deal with it. If you are woken by an alarm clock and don't have a regular bed time you will notice that the rise in BGL does not occur when you open your eyes to switch off the alarm, but it may have already started or may not start for 30 minutes or a bit more as your liver obeys your body not your alarm clock.

I agree eating anything for breakfast just makes the problem worse. I'm certain even the smell of cereal increases my BGL and I dare not eat it. Although I don't think you have the answer you wanted at least you know you are not alone.

In the USA there is the Medtronic 670G pump that is what they call an artificial pancreas and does exactly what you are wanting. I live in Australia and it's about to be approved for use here, I would assume it's not to far away from approval in Europe. A pump attached is a very common concern and one that I had before getting a pump, it's something you get used to very quickly and is a non issue. It took me less that 3 days to get used to it. I let roam free in bed and I toss and turn a lot. On the rare occasion I get up in the middle of the night still half or almost fully asleep I automatically pick it up out of habit. I forget I have a pump during the day and it's habit I pull it out of my pocket about 20 min before I eat, enter the carbs (or a good guess if eating out).
 
Have exactly the same issues. Changed my brekkie to 10 carbs only. A few berries and yoghurt. ( still miss my Shredded Wheat ☹️) in agreement with @Juicyj. If I don’t eat anything the problem is worse. I take 3 units in the morning to cover breakfast. If I don’t eat tend to need more insulin as the morning progresses. That bit of food although not curing the problem helps.
 
Also just wanted to add - I don't eat carbs for breakfast as yes this does make my control worse, I generally eat anything low carb such as yoghurt, omelette, friend eggs, cheese, bacon, or I mix coconut milk with chia seeds and leave in the fridge overnight and take a small bolus for it, but if I eat bread or cereals then it makes my control alot worse, I sometimes can't get my BG levels down until lunchtime if I do. I had chia seeds this morning and currently sat at 5.3mmol/l :)
 
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