Evening everyone,

[Ali2003io]

I’ve got a little curiosity...it happens to me to wake up with really HI levels(~15) but after I do the correction dose it still takes me about 4h to lower...is it anyone else having the same issue in here? Thanks and have a nice evening

 

[NicoleC1971]

I’ve got a little curiosity...it happens to me to wake up with really HI levels(~15) but after I do the correction dose it still takes me about 4h to lower...is it anyone else having the same issue in here? Thanks and have a nice evening

Yep! High ish all day.
The answer is that your bolus insulin works over 4 hours (don't know when the peak is ) but the key thing is not to stack insulin up i.e. take extra doses on top of the original correction or you risk chasing a hypo and going through the whole cycle again.

 

[Tony337]

Hi
I find if I exercise, and by exercise I mean a brisk walk, helps my levels reduce quicker.
I have been lambasted in the past by people who say exercise has the opposite effect but that's how my body works.
Its worth a try.

Good luck

Tony

 

[mike@work]

Hello Ali2003io

I'm not really sure I understand you absolutely right now, but I suppose you're asking if/when you wake up (in the morning?), you can have high values. And the following problem is, that it takes long time to get your values down?
If this is your question(s), I would say: Dawn Phenomenon, combined with a bit too many carbs in the evening before...

And edited some time later to say: Well - it wasn't really meant to question "if you wake up in the morning..." - that would be terrible...... sometimes it's just "me and my English"...

 

[KK123]

Hi
I find if I exercise, and by exercise I mean a brisk walk, helps my levels reduce quicker.
I have been lambasted in the past by people who say exercise has the opposite effect but that's how my body works.
Its worth a try.

Good luck

Tony

Tony, I agree with you. Yes, hard and long exercise might raise glucose levels directly after it but I find that for the rest of the day my levels are very much lower. If I exercise more gently (ie for under 40 minutes and at a slower speed), I don't get a rise at all and again, for the entire day my levels are much lower. Even for those who do experience a rise immediately after exercise I am convinced that the benefits (not just for diabetes either) far outweigh a momentary rise (in my case anyway). An initial rise for an hour or so followed by up to 23 hours of lower levels, I know which I prefer.

 

[Tony337]

Tony, I agree with you. Yes, hard and long exercise might raise glucose levels directly after it but I find that for the rest of the day my levels are very much lower. If I exercise more gently (ie for under 40 minutes and at a slower speed), I don't get a rise at all and again, for the entire day my levels are much lower. Even for those who do experience a rise immediately after exercise I am convinced that the benefits (not just for diabetes either) far outweigh a momentary rise (in my case anyway). An initial rise for an hour or so followed by up to 23 hours of lower levels, I know which I prefer.

I'm not the brightest button in the box and your above post is what I would have loved to have written.

Tony

 

[Fairygodmother]

Hi Ali, what are your overnight readings? Have you checked? It could be that the morning high’s a liver dump - sometimes the extra glucose that the liver releases to combat low blood glucose hangs around for a long time as the liver closes the door to taking it back again.
Can you get hold of a Libre or a Dexcom to find out what’s happening?

 

[Bluey1]

Anything with fat will cause BGL to stay high for longer, that is why the pumps have a special function. Your correction bolus has worked as it runs out and the food that is keeping you stubbornly high also runs out of producing more sugar. Exercise is a fantastic way of getting that excess glucose in to muscle that is crying out for it when it is working hard and turns the glucose into movement, heat and muscle building.

 

[Ali2003io]

Hi
I find if I exercise, and by exercise I mean a brisk walk, helps my levels reduce quicker.
I have been lambasted in the past by people who say exercise has the opposite effect but that's how my body works.
Its worth a try.

Good luck

Tony

Hi Tony, for me walking or exercising is not helping don’t know why...thank you

 

[Ali2003io]

Mike@work... hi I know I have a dawn phenomenon it’s just don’t get it why my sugar level is not going down after the correction dose but after more then 4 h when I end up in a hypo

 

[Ali2003io]

Hi Ali, what are your overnight readings? Have you checked? It could be that the morning high’s a liver dump - sometimes the extra glucose that the liver releases to combat low blood glucose hangs around for a long time as the liver closes the door to taking it back again.
Can you get hold of a Libre or a Dexcom to find out what’s happening?

Overnight are fine 6 or 7 maximum the HI ist one but after getting up they can be really bad (~up to 20)

 

[Ali2003io]

Thank you everyone for you time to reply... hope you have good reading

 

[donnellysdogs]

That is the target to get back to normal levels by 4-5 hours... mine is based at 5 hours to be within my target levels...any quicker than that I will go hypo..

 

[donnellysdogs]

Mike@work... hi I know I have a dawn phenomenon it’s just don’t get it why my sugar level is not going down after the correction dose but after more then 4 h when I end up in a hypo

Are you saying that levels don’t drop at all for 4 hours???

You do need to find out what time the rises in your levels start. Mine start at 3.30am and I have my first injection of the day at 3am each day. Then another 2 injections before my feet hit the floor.

It sound if you also have waking phenomenon if your levels are rising up to 20 on getting up.

 

[mike@work]

Are you saying that levels don’t drop at all for 4 hours???

You do need to find out what time the rises in your levels start. Mine start at 3.30am and I have my first injection of the day at 3am each day. Then another 2 injections before my feet hit the floor.

It sound if you also have waking phenomenon if your levels are rising up to 20 on getting up.

Yes - I have to revise my former statement a bit. I think your answer is more accurate, when you say there is (maybe also) a "feet on the floor"-problem.

May I ask you "Ali2003io" - what kind of insulin do you use, and if you maybe use both fast-acting and long-acting. Especially if you use both, it could be important to get a hint about how you use them. Maybe we could then, give some more informed suggestions...
If you use "fast" and "slow" insulins in combination, there is a possibility that your fast-acting dose is not enough to cover the BSL-rise, and your BSL lowering happens, only after your long-acting starts to have effect.
To this problem, you could also add the following...
"This may be further compounded in the early morning hours because our body is more insulin resistant compared to the rest of the day" - taken from:
https://blog.virtahealth.com/dawn-phenomenon/

 

[kitedoc]

Hi @Ali2003io, Why does a correction dose take so long to work? As a T1D, not professional advice or opinion and always asking you to take suggestions to and discussing them with your doctor or DN. Possibilities and thoughts:
1) The DP causes increase in insulin resistance - so the 'usual correction dose' is less effective in the 4 hour time span compared to another time of day.
2) If you are also having breakfast that is an extra reason for BSLs not settling as quickly and, if DP is in part responsible, the dose of quick-acting insulin for carbs of breakfast may be too low.
3) The basal insulin may be at a lower point at the time and the DP may also be affecting its effectiveness, even though its contribution to blood sugar lowering is less than the short-acting insulin.
4) Some people would be about to start lunch about 4 to 5 hours after breakfast so if lunch is later perhaps the correction dose of short-acting insulin plus long-acting basal) insulin has had sufficient effect along with the basal insulin for a hypo to occur.
5) As others have said or inferred, dealing with the cause of the highish fasting BSL is one important step.
6) The other is patience. I have been known to metaphorically push in the insulin to annihilate that so and so high BSL only to suffer the ill-effects of hypo later. Whilst less dramatic, but certainly safer, I now use a more graduated set of correction doses of short/quick-acting insulin say , ever 2 hours with BSL testing, and this stops the hyper/hypo see-saw dead. (At least most of the time)!
There are ways to bring down a BSL more quickly but that is a discussion for another day regarding emergency measures for very high BSLs and illness etc.

 

[Ali2003io]

Yes - I have to revise my former statement a bit. I think your answer is more accurate, when you say there is (maybe also) a "feet on the floor"-problem.

May I ask you "Ali2003io" - what kind of insulin do you use, and if you maybe use both fast-acting and long-acting. Especially if you use both, it could be important to get a hint about how you use them. Maybe we could then, give some more informed suggestions...
If you use "fast" and "slow" insulins in combination, there is a possibility that your fast-acting dose is not enough to cover the BSL-rise, and your BSL lowering happens, only after your long-acting starts to have effect.
To this problem, you could also add the following...
"This may be further compounded in the early morning hours because our body is more insulin resistant compared to the rest of the day" - taken from:
https://blog.virtahealth.com/dawn-phenomenon/

Hi again, I use Levemir 30u before bed Plus 20 u in the morning and Humalog for meals

 

[becca59]

Hi Tony, for me walking or exercising is not helping don’t know why...thank you

Doesn’t help me either. Levels rise during exercise!

 

[mike@work]

Hi again, I use Levemir 30u before bed Plus 20 u in the morning and Humalog for meals

Hello Ali and all around here!
I'm sorry for answering really late...

OK - we have some small details here still. When you say Humalog for meals, I suppose this also means together with some kind of breakfast?
Remember, that we can only give some suggestions here. If you feel you have a need to change dosages, you should discuss that with a doctor, or someone with equivalent profession.
If you take Humalog some time before breakfast, together with your long acting insulin, the resulting action profile of the insulins should, in my opinion, not give too much of a BSL rise. Levemir, has its peak-action after about 8 hours, but it should start acting after about 1-3 hours. Humalog is active up to 4,5 - 6 hours, so there should be some overlapping.
One explanation to your problems could be, that your Levemir, is not acting long enough. The second problem, and solution could be, that your Humalog and Levemir together, gives an aggregated peak after about 4 hours, and this peak is enough to give hypos. If this is the case, I could maybe recommend to time your insulins and breakfast a bit differently.
If you start with high levels, do you also compensate, with more fast-acting insulin, than what you would usually use?

My thoughts above, are only reflections of what I think I know about your situation this far. I would suggest, that you check your BSLs directly as you get up, and then follow the BSL-trends a few hour onwards. If nothing else, at least your GP, could give some good suggestions based on facts.