Constant fasting hyperglycaemia -help

Hi @peromingoj

Did this only happen when you changed your insulin? Was there a reason for the change?

peromingoj said:

This is my first time posting but I do regularly use this site to help with issues with my diabetes management.

Since my medication was changed mid February I have been suffering from the
dawn phenomenon. I was on lantus and humalog for approximately 11years (since type 1 diagnosis in 2006 after gestational diabetes). Since February I take Tresiba and humalog.

When I changed meds I used a cgm to have a fuller picture of my bloods but I'm back to normal measuring between 6 and 8 times a day. I can control my bloods during the day but I go to bed with BG of 100 -160 and wake up at 6 with over 300 most nights. I eat min carbs after 7 pm ( less than 4 CP). I cycle 10 km at 7:30 am and 6 pm for my commute to work. The days I don't cycle I run between 3 and 4 km before bed. I'm pretty active at the weekends. However, I'm living with headaches and nausea as a result of the highs

On the back of my morning high I appear to be more resistant to my humalog.

Can anyone offer any help???

Thanks

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Hello

When you were using CGM, was there a certain time frame in the early hours where you'd see your BG climbing? It's a bit unusual that your DP has started 11 years post diagnosis - and even more coinicidental that it's started at the same time as your insulin was changed. Dawn phenomenon is a hormonal issue and is therefore typically present regardless of what type of insulin is taken, this is why a insulin pump is the only true answer to combating DP.

If I were you, I'd start by looking into your insulin doses and timings. From what I've read, Tresiba can be a tricky insulin to set up properly, due to the extra long duration of action.

Am I right in saying that 4 carbohydrate portions is 60g carbs? If that's outwith meal times (grazing after your last meal of the day), it's actually a fair amount of carbs and may be contributing to your raised overnight levels.

One of the issues with eating carbohydrates close to bed time is that we can often go to sleep when those carbs are still doing things to our bloods. This is especially true if the carbohydrates you're eating are also combined with a decent amount of fat. The fat causes a delayed BG rise which can happen many, many hours after eating - so this can always be something to look out for - especially if your BG is climbing in the night.

It may be worth trying a few nights where you don't eat anything after your evening meal and see how they impacts your morning BGL.

Infection could definitely be contributing, yes. Are you getting that sorted out? If so, you could wait to see if antibiotics and dental treatment solve the problem, or at least reduce it.

peromingoj said:

My bloods start to climb at 3am like clock work.
4cp are 40 g and that's my meal. Grazing is long since a thing of the past for me

. I don't eat after my evening meal.

Thanks for your help. I really don't want a pump

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Hmm, that does sound like DP then. The infection could be worsening this though. Perhaps your bolus insulin helps keep it more in check during the day (the infection highs) and then it reveals itself during the night.

The resistance to your Humalog could be to do with the infection too.

I have a pump and I love it It's made me feel normal again and smoothed my sugars right out