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high morning levels (Confused)

L

LWA

Well-Known Member
Messages
104
Location
Weston super mare
Type of diabetes
Type 1
Treatment type
Insulin
Dislikes
Society
I normally wake with perfect levels (between 4-6) and start work at 8am 'prior' to having insulin/breakfast at 9.30am. My problem is that 'before' i do my pre breakfast injection my blood will already have risen from anywhere between 8-10. As a result my mid morning levels remain high (Sometimes peaking at 16) prior to dropping to normal around mid-day. i use Novorapid and inject 20/30 mins before eating!

My observations/Theories are as follows but ANY HELP WOULD BE MOST USEFUL?:-
1) i've heard of liver dumps but can't accept this happens the same 'most' days?
2) Could 'stress' in first 1.5 hours at work be the cause.....if so i think i will quit work!!??
3) I use currently use 33units Levimir at night.....does anyone believe changing to lantus may help?
4) Could eating nearer to injection time possibly help?
5) Does insulin 'generally' absorb slower in the body at mornings rather than other periods of the day
For information i inject 10 units of Novorapid and only comsume 1no toast, poached egg and very small glass of natural orange juise so i cannot really accopt that i need to increase morning insulin?
 
Hi

Split your Levemir dose so that you inject it before bed and also in the morning. Tonight inject the 33 units like you do and then tomorrow morning inject 10 units and before bed inject 28. Do the changeover gradually and keep testing your bg levels. Keep adding to the morning 5 units at a time and deducting 5 units from the bedtime dose until you start to see a more balanced level in your bg levels. After a day or so you will then have to start altering your bolus doses as there will be a better level of background insulin. This should sort your problems out. It's difficult to say how much Levemir you will end up needing in the morning as this will depend on its effect with your bolus on your bg levels
 
HI,

Have you tried taking your insulin/breakfast first thing rather than waiting for an hour and a half?

The reason I ask is that I know without taking insulin my BG will rise if I'm up and active, even if I haven't eaten.
I used to think that if I don't eat then my BG won't rise, but that doesn't seem to be the case although I don't know the reason why.
 
Hi,

i recently did the DAFNE course and have a few suggestions.

Your rise in blood sugar could well be stress from work. some people (including one guy from the course i was on) was higher in the morning only a few hours after testing upon waking up. your body releases hormones and adrenalin preparing your body for a stressful day. thus pushing your sugars up!

it is also said that levimeir doesn't last the full 24 hours so splitting it apart would be a good idea. but please ask your diabetes specialist on doing this first as what works for one person may no work for another!


I use novorapid and i inject just slightly before or even after a meal so this is to personal preference. novorapid takes around 15-25 mins to start to work and leaves your system after about 2-5 hours again depending on the person.

you also dont mention what the rest of your blood glucose levels are through out the day but as you dont mention is i assume they may be okay.

in DAFNE and even before i've always be told to eat what i want (obviously in moderation applies to everyone with or without diabetes)

if i want orange juice i have orange juice!

Everybody's insulin requirements are different.

because i'm only 22 and still have 'raging hormones' according to my diabetes nurse i take a higher ratio than the guys i went on the DAFNE course that are six foot tall and weigh about 14 stone! (i'm 5''3 and weigh just under 9 stone!)

for example if i ate two slices of toast and 200ml of orange juice that would be around 5 carbohydrate portions and my ratio is 3:1 which means for every portion i would take 3 units. totally 15 units.

so everyone is different! dont worry about how much insulin you take as you need what you need.

ultimately i think you should give your diabetes specialist a call and see what they think.. after all thats why they are the specialists and not us :)

and if you are keen to go on the DAFNE course i would definately ask as it teaches you how to correct these sort of problems by yourself using the power of knowledge woo! :)

good luck!
 
Thankyou all for your comments
1)i think i will try splitting my levimer which i have never done before. As i use pre-filled cartridges i will need to inject twice as i cannot mix....assume this is ok?

2) CarbsRok i take your point about "not sussing out my insulin" however i am not new to diabetes and have been type 1 for over 20 yrs (i am 37now). My ratios have worked for a long time but i am finding it more challenging by the year and my insulin needs are increasing slightly....has anyone had experiances or cause to appreciate that this is normal?
3) i have always postponed eating for a longer while after injecting if BG are high before a meal as it seems natural to let insulin absorb to bring levels down....has anyone had personal experiance to suggest otherwise that it is better to inject Novorapid directly before eating as opposed to waiting 30mins....appreciate i will need to experiment on this one!!
 
CarbsRok said:
ebony321 said:
if i want orange juice i have orange juice!
Click to expand...

So what you are saying then is, it's ok to drink full fat coke.
Full fat coke has the same amount of carb as does unsweetened orange juice.
Drinking pure juice as well as full coke has always been a no no unless treating a hypo.
This basic rule applies whether or not you have done DAFINE. It's called common sense.
Click to expand...

.. yep i'm saying the whole point of DAFNE and the slogan is 'like what you eat, eat what you want'

i don't appreciate your sarcasm as i was giving someone else examples. i wasn't telling anyone to drink orange juice, you cant tell someone not to drink or eat something they can if they want to. if you dont want to drink orange juice then thats up to you. i drink orange juice when i want to, and i match it with insulin. i don't go sky high or fall low.

DAFNE is to give people the tools to better manage their diabetes. to not be restricted by saying 'you can't have this or that'

jelly babies biscuits mars bars are all good treatments for hypo's and i suspect i'm not the only one eating them when i want. because i have the knowledge and common sense to know how to match my insulin with what i eat.

it's a shame your missing out.
 
Hi Ebony 321
i don't think sarcasm is meant, maybe poiniant but constructive none the less......after all he is like your good self giving advice from experiance which is generally valuable.
Personally i have been drinking fresh unsweetened orange juice or similar and incorporate into my daily allowance and have done for the past 22 years without a problem, but we all differ.

CarbsRok
i have never split levimir into 2 doses and my query was not the amount rather the fact i use flex pens which cannot be mixed so i would inject twice in morning....once using novorapid and once with levimir....i was assuming that this is ok and that they didn't have to be mixed as i have seen before?

As for basal testing i have not heard this before so any advice is welcome?

My tests throughout the day are good it is just the mid morning as previously noted that i am currently experiancing problems
 
Could all members please remember that this is a discussion board and not a place to trade personal insults.

Sometimes what is meant in a post does not come over very well in text form. Please try and ensure that the language used is clear and it's meaning is unambiguous.

Mod 3.
 
CarbsRok
Could you give me a brief summary of carbs you consume in a basic day? i am intrigued to hear your comment to suggest that your 'daily' intake of novorapid is approx 10?.....i can only asssume that you are on a very low carb diet, which of course has it's benefits but an indication of you carb intake may prove helpful?
Also how much Levimir do you take?
 
It is more likely that you are having the Dawn Phenomenon effect which is different to an Liver Dump, a Liver Dump is the body dumping the contents of the Glucogen store into the system in reaction to low glucose levels... Dawn P is a natural raise of the amount the liver is dribbling into your systems, the amount being delivered can ebb at different times of the day, the lowest ebb is normally around the 2-3am in the morning...

I have yet to meet a diabetic who hasn’t had to change their tactics over the years, this is quite natural as many things change in our lives over time and changes are required to our diabetic control are required to adapt to these... I’ve had several changes so has my T1 husband, if we didn’t change our tactics as needed we would lose control over our diabetes...
I’m always surprised how literary some people can’t take ‘phrases’ and not look at with common sense in mind... Yes DAFNE does in some ways promote eat what you want, but it’s not quite literary as common sense still needs to be used when you are eating, DAFNE does teach you how to adjust your insulin’s to your food intake and what factors to take into consideration when you need to make changes to your diabetic control...

The animal insulin that CarbRok uses is done in the same theory but with a ½ hour time delay, I also use an insulin pump and how I work my pump is very similar to how CarbRoks uses hers.. We have some different tactics but this would be the same if we both used the same insulin
 
Help needed on liver dumps!?

We have had some computer gremlins this morning and part of this post was lost. The question was about Liver Dump's.
cugila
Forum Monitor

1) Do they tend to occur at similar times of the day for the individual in question?
No. They can occur at any time day or night. It is just a biological process, prompted by low blood sugar levels. In the early hours it is termed Dawn Phenomenon, later on it is known as a liver dump. Exactly the same process, increasing your Bg levels.

2) Can anything be done to reduce or avoid them?
Tight control of Bg levels will help. If levels drop too far during the night then it kicks in, raisng the Bg levels. Now if the person doesn't eat straight away after waking then that can trigger a liver dump, not enough Insulin pre meals and maybe not enough carbs can also trigger it.

3) Can stress/tension cause onset
Stress and tension usually causes Bg levels to rise which would negate the need for a liver dump. Same as when ill.

4) Does anything (such as alchohol) cause onset (As associated with liver)?
Alcohol can lower the Bg levels so may have some effect.

5) Are they generally 'common' with diabetes......or rare?
Anybody, even non-Diabetic's can liver dump. It is a natural biological process. The body's own defence mechanism coming to the rescue !

6) Is there any way to confirm if i AM experiancing liver dumps or NOT?
Testing. Fasting, waking, pre and post meals and throughout the day. Comparing the reults. Seeing how you actually feel.



There is also the little matter of the Somogyi effect, which you might like to read up on ? It is discussed on the Forum somewhere, if you do a search. Get's very complicated. :wink:

cugila
slight hiccup here....had to answer in your post. Trying to get it sorted....... :oops:
 
LWA

Dawn phenomenon and a liver dump are two completely different things...

Dawn phenomenon (of which I suffer) is regulated by an natural cycle hence you get it every morning, everybody's hormone activity raises and falls over a 24 hour period the lowest Ebb is around 2-3am in the morning, then the activity increases, in most individuals this won't be a large increase but for a few individuals I amoungst them this increase will be quite large indeed...It also happens every morning with similar raise in blood glucose levels..

A liver dump is a response to the blood sugar hitting the hypo range, beta cells then tell the liver to dump it's store.. With the diabetic this will cause a large increase in blood glucose as there isn't enough insulin to deal with this... A liver dump can happen at any point of the day or night but mainly over-night in response to an hypo that the diabetic has slept through.. It doesn't happen every-night (unless of cause you have an hypo every night of the week)

Suffering DP I do know when I've experienced a liver dump due to a hypo slept through, as I feel like I've been on a massive drinking binge, BG is sky high and my vision is effected it's as though I am looking through very thick heavy net curtains...

Somogyi effect is Dawn Phenomenon basically
 
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