high blood sugar at mornings

blacknjr

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Hello guys i hope everyone is having a good day!
my problem is when I check my blood sugar before bed it’s always normal and perfect ( 5.5 - 6.4 ) but when i wake up in the morning it’s suddenly so freaking high and I don’t if i should make my lantus higher i’m so sad about it :(
whats your suggestion/ solutions ?
 

MeiChanski

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Hello, it might be a difficult one, have you discussed it with your team? You could be experiencing, 1 dawn phenomenon where the liver does it’s sugar dump to get you started for the morning, 2 your lantus might be running out or doesn’t quite last 24 hours, so some people have to split dose but that would be something to discuss with your team and 3 you can do a basal test to determine if your lantus needs more or less by fasting (eating protein or low carb) either morning until lunch or stop eating after dinner. Of course if you hypo, do treat it. And 4 you might consider another basal insulin to try. So a bit of research and discussion with your team.
 

EllieM

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Have you talked to your clinic about this? Some possible reasons for the higher blood sugar
1) Too little lantus - do some basal testing to see how much you need.
2) dawn phenomenon - your liver dumps sugar first thing in the morning to hekp you get up and go and it doesn't realise you don't produce the insulin to process it.
3) You're actually going low in the night and this is a rebound because your liver dumped sugar to combat the hypo.
4) Lots of fat in your evening meal (I love cheese but I have to be very careful with it) and it's slowed down the processing of the meal's carbs so that they are hitting in the middle of the night
5) You take lantus in the morning and it doesn't quite last 24 hours.

Last time I had this issue my clinic lent me a cgm for a week and I kept a food/insulin diary. They were able to adjust my doses and ratios accordingly and I actually ended up reducing my lantus!
 

MeiChanski

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Another thing to consider is your dinner during the evening, certain foods with higher fat or take longer to break down like pasta could send blood sugars quite high after the bolus time frame, it is advised to split dose for it.
 

ert

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Of course, you need to contact your diabetes team for advice.

First, 'It's suddenly high'? Does this mean it's normal on waking then suddenly goes higher? If so we call that 'feet on the floor' or 'the dawn phenomenon'. As the Lantus runs out overnight and it takes four hours for the new injection of long-acting Latus to work then you can see a rise in blood sugars. If it's this, then I cover it with 1-1.5 unit of quick-acting insulin before starting my day.

Second, if it's high on waking? Are you on a split dose Lantus - morning and night? Do you take it on going to bed (rather than at dinner time) and on rising? If not, the timings are the first thing to change before the dosage. You may be asked to skip dinner, take your basal as normal, to see what you base line looks like or set an alarm for 3 am. If you make an increase in your (in this case bedtime) basal according to DAFNE, it should be 10 to 20%.