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High BG before breakfast?

Discussion in 'Type 1 Diabetes' started by birchy66, Jul 31, 2021.

  1. birchy66

    birchy66 Type 1 · Well-Known Member

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    Can anybody help please. I often have a high BG reading first thing in the morning before breakfast, like this morning it is 11.7. It has been like this for quite a few weeks but not always high. I take Lantus at 10pm every day and bolus after meals three times per day. My control is good with HbA1c usually 51 or 52.
    I manage to get my reading down to acceptable levels during the day but this involves a walk first thing or other exercise. I have noticed that as I get older my insulin need has increased and I currently take 30 units of Lantus and around 55 units of Novorapid over three meals.
     
  2. In Response

    In Response Type 1 · Well-Known Member

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    This sounds like Dawn Phenomenon.
    Most people experience it but those with a healthy pancreas have the insulin to manage it.
    This a common topic so you can search for "Dawn Phenomenon" using the field on the top right if the page.
     
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  3. Jaylee

    Jaylee Type 1 · Moderator
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    Hi,

    What are your BGs retiring to bed?
    How long after you wake do you test? I find my BG can shift up a gear from a "foot to the floor liver dump by 3mmol just from running about getting ready for work? (I don't do breakfast.)
    (Teaching gran to suck eggs time, sorry.) injection sites, are they reasonably rotated?

    Now, I use Lantus. & have noticed for me now & again it can lose potency about halfway down the cartridge?
    Changing the cartridge for the following day resolves the issue.

    You could try basal testing, if only to check your Novorapid isn't pulling the Lantus's weight the rest of the day??
     
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  4. EllieM

    EllieM Type 1 · Moderator
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    I have similar issues, such that my consultant even offered to put me on a pump for it. (I have allergy issues so turned this down and am currently managing OK). Can you get access to a cgm for a couple of weeks so that you can see when the rise is happening? For some people it is literally foot on the floor, others start rising from 3am. And there is always the (slim?) possibility that you are going too low at night and are getting a rebound from a helpful liver dump.

    My diabetic team were really helpful to me about this (actually ended up suggesting I lower my lantus and I still don't understand why that helped) but they did hand out a temporary cgm so they and I could better work out my ratios. But honestly, in my personal experience, getting the basal dose right is crucial. And if you've been unwittingly overusing a particular injection site then finding a new one can help enormously as well.

    As for the increasing insulin needs (insulin resistance?) do you have any T2 in your family and has your weight crept up at the same time? Again, this is just my personal experience and may well not apply to you, but I have a T2 dad (and a T1 mum, what can you do:)) and I've noticed both weight and IR go up over the last decade. I stalled both increases by eating lower carb, but suspect that the IR is why dawn phenomena can be such an issue for me.
     
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  5. birchy66

    birchy66 Type 1 · Well-Known Member

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    Thanks for your reply I will check this out. My fasting BG this morning was 6.2 which I am happy with.
     
  6. birchy66

    birchy66 Type 1 · Well-Known Member

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    Thanks Jaylee for your reply. My readings at bedtime vary but usually within my range and below 9 mmol. Last night I was 10.1mmol and took two units of Novorapid and this morning I was 6.2 which is great.
    I always test within 15-20 minutes on waking but have experienced a higher reading if I shower first and then test (as you allude to above). My injection sites are good.
    I will look into my basal testing too.
     
  7. birchy66

    birchy66 Type 1 · Well-Known Member

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    Thanks for your reply EllieM very helpful. I'll look into the CGM. I did think about a possible liver dump as you suggest, so a CGM would be useful.

    I was wondering if after having had T1 for eight years now that perhaps my pancreas has finally given up the ghost and not producing any or much less insulin. This might account for the higher dosage as my weight is pretty steady.

    Diabetes can be complicated and very frustrating at times. I have dug out "Think Like a Pancreas" by Gary Scheiner and will read it again. It's an excellent read.
     
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