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Diabetes type 2 for 22 year years

B

bharat99

Member
Messages
5
Location
Barnet
Type of diabetes
Treatment type
Insulin
Dislikes
smoking
I am type 2 diabetes and recently put on Insulin Novorapid after stopping Gliclazide MR orally and continue with Levemir insulin at night time. I am trying to adjust the doses of Levemir night time by increassing the dose starting 12 iU and now at 15 iu and increasing the dose of Novorapid slowly by 1unit at meal times. i still after 3 weeks find that my morning reading stays around 7 to 10 mmoles and my evening reading shoots up drastically after tea time ( no novorapid) to reach 12 to 18 mmoles and then to have supper around 7.00pm with novorapid 12 units and Levemir 15 iu now at 10pm. I have also couple of days noticed my sugar level drops down at night time around 2am to 2.4 and 2.7 mmoles if I cut down my food intake because of high evening reading and then I would have half a glass of tropicana orange juice and six grapes,the reading shoots up to 10mmol before breakfast in morning. I have tried to consult my diabetic nurse on couple of occasions but just keep on monitoring. Has any body had any experience why blood glucose drops at night time and suddenly increases by morning to high level and any adjustments to insulin doses that needs doing. I am quite frustrated with my evening and morning readings. Many thanks and any suggestions will be welcome.
BR 99
 
If you go too low then your liver will release glucose during the night to bring it back up - rebound effect
Also there is dawn phenomenon where the liver randomly releases glucose around 3-4 am ( think its something to do with hormonal levels)
The best thing to tell the difference is to monitor BMs at around 2 & 4 am and again first thing for a couple of days. If your BMs are too low in the night then high in the morning then probably rebound, if they're ok in the night and high am then it's dawn phenomenon.
For rebound you would need to eat or adjust medication before bed to prevent going too low in the first place
 
Many thanks for your information and I will try to adjust my food intake in the evening which I did in between with no hypos, but the reading were a bit high in region of 10 mmols AM before breakfast. I am trying to adjust my Levemir dosage accordingly. I can't balance my Novorapid evening and Levemir at night dosage to get around 5-7mmol in the morning with the additional rebound release of glucose may be from liver. I want to get my AM glucose to normal and may be reduce my teatime snacks which are about 8 carb and see the readings. I will post you again after any good results and may be any more ideas will be welcome. Many thanks, BR99
 
bharat99 said:
Many thanks for your information and I will try to adjust my food intake in the evening which I did in between with no hypos, but the reading were a bit high in region of 10 mmols AM before breakfast. I am trying to adjust my Levemir dosage accordingly. I can't balance my Novorapid evening and Levemir at night dosage to get around 5-7mmol in the morning with the additional rebound release of glucose may be from liver. I want to get my AM glucose to normal and may be reduce my teatime snacks which are about 8 carb and see the readings. I will post you again after any good results and may be any more ideas will be welcome. Many thanks, BR99
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The readings have been great after couple of day of not eating crackers at teatime and keeping night time reading to around 10 mmol/l but still the AM reading comes to around 8mmole/l which I want to keep under 5 prebreakfast.. It is definately rebound and I presume there is no adjustment for insulin Levemir that may help or any more ideas! BR99
 
Can't help with the meds - I'm on gliclazide so got no experience of your ones
I was having high am readings and the medics wanted to put me onto stronger meds ( i'vebeen on glic for 17 years) but I wasn't happy With that idea so I decided to try low carbing instead - that sorted out the readings and allowed me to cut the amount of glic I take by a third and also to cut Bo meds by a similar amount. Don't know it low carbing would work for you but keeping carbs under 60g works a treat for me ( been doing it for nearly a year now)
 
Thank you for mentioning about low carb keeping upto 60g which I would definately try.Unfortunately I was on 3 gliclazide MR 30mg increased from 2 each morning lately and I did not have any effect on my sugar levels, so talking to my diabetic nurse I stopped my gliclazide and decided to go on Insulin Novorapid and staying on Levemir. My doctor also suggested there is no insulin produced from pancreas and eventually which does happen for many patients after certain time. I am otherwise quite happy with everything except injecting 4 needles every day, and the result so far is good except with morning highs which I thing will be sorted out by increasining 1 unit levemir each day until I balance my morning readings and my nightime lows by reducing novorapid dose by 1 unit and keeping carb to max 60g a day. Thanks once again and catch up with you as I get ahead for better results. BR99
 
bharat99 said:
Thank you for mentioning about low carb keeping upto 60g which I would definately try.Unfortunately I was on 3 gliclazide MR 30mg increased from 2 each morning lately and I did not have any effect on my sugar levels, so talking to my diabetic nurse I stopped my gliclazide and decided to go on Insulin Novorapid and staying on Levemir. My doctor also suggested there is no insulin produced from pancreas and eventually which does happen for many patients after certain time. I am otherwise quite happy with everything except injecting 4 needles every day, and the result so far is good except with morning highs which I thing will be sorted out by increasining 1 unit levemir each day until I balance my morning readings and my nightime lows by reducing novorapid dose by 1 unit and keeping carb to max 60g a day. Thanks once again and catch up with you as I get ahead for better results. BR99
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Great, after couple of days trying by cutting down tea time crackers, increasing my levemir dosage by 1 unit per day over 3 days every night, and reducing the supper Novorapid insulin dosage by 1 unit at supper time over 3 days has steadied the morning pre-breakfast readings better to 7.2 1st day, 7.1 2nd day and 6.1 the 3rd day and haven't had any hypos. I hope I am getting the grips with this and obviously my carb intake I have't monitored which probably needs to be looked further, but I roughly think I am taking almost about 90g to 100g approx. per day and can vary, but will work my way through by learning more about Carb intake and GI . Thank you for the help! BR99
 
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