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High morning readings..every morning. Any ideas?

Mathoo

Mathoo

Newbie
Messages
4
Type of diabetes
Type 1
Treatment type
Insulin
Hi everybody,

My first post. Yay

I've been diagnosed in 2008 and for a while I managed to control it really well.
However, since last summer or so I've been waking up with glucose over 12.5 (up to 17) every morning (6:30 am)! And it won't come down until about 11am.
my last HbA1c was quite bad - 65 , which worries me.

I wake up with a headache and my eyes are sore every morning. I can't figure out why this happens or how to fix it.

I check it before I go to sleep and it's fine. Tried waking up several times throughout the night to check and it's usually fine up until about 4 am when it shoots up.
Nurses and gps are not helpful at all. I have an appointment with a specialist next Wednesday so will see what they say.

I inject 12 units of Lantus before bed and nurse suggested that I might be getting hypos at night and my body tries to correct it. But that's not it. I experienced hypos at night several times and I always woke up(luckily) in panic with glucose at around 2.8. And I don't believe that I'm getting hypos every single night.

So my latest solution is to inject 9 units of novorapid as soon as I get up (6:15). Then have some light breakfast at 7am and inject more novorapid for that. Then I go to work and check it at around 10 by which time it comes down to about 9!

Once it gets to normal levels I can keep it there for the rest of the day.

Just to add I have a very physical job now which requires me to snack a lot after I finally got it down. I drink 2+ litres of water while at work as well if that makes any difference. We usually have dinner at around 7pm and I also like to snack afterwards but my reading is usually ok before bed (11pm). And then I wake up with a reading of 14+

Oh and I also tried to get up at 4 and inject like 5 units of novorapid but I'm worried I might go hypo. And also find it hard to get up at 4 every night haha

Any idea what to do?

Thanks!
Matt
 
Welcome to the Forum Matt.

I would say that your Basal insulin is slightly out and should maybe be put up by a couple of units. Plenty of people need more insulin in the morning but you do seem to just be fighting it if you are effectively taking a 9 unit correction every morning. It might be best to wait until you see the specialist next week.

Are you in contact with a DSN, they may be able to help you further but I would be fairly confident in adding a couple of extra Lantus units in and see if that makes a difference.
 
dtennant9 said:
Welcome to the Forum Matt.

I would say that your Basal insulin is slightly out and should maybe be put up by a couple of units. Plenty of people need more insulin in the morning but you do seem to just be fighting it if you are effectively taking a 9 unit correction every morning. It might be best to wait until you see the specialist next week.

Are you in contact with a DSN, they may be able to help you further but I would be fairly confident in adding a couple of extra Lantus units in and see if that makes a difference.
Click to expand...

Thanks dtennant9,

I already added 2 units to my Lantus but that made no difference. Maybe 2units weren't enough. I used to inject lantus in the morning (I kept forgetting to inject at night so I did it before bfast) but once this started happening I changed it to evenings hoping it would help.

Sadly no help.
Will see what they say next week but to be honest for my experience DSN and even local specialist aren't very helpful. It almost feels like I only go there for them to add some more info into their database so they can learn from me. Not much help. Haha
And since diagnosed I visited many diabetes nurses and 3 different specialists (Colchester, bury St edmunds and now going to see chester one for the first time)

Its just annoying and I'm fed up with this headache and sore eyes every morning..
 
The first thing to do is see if your Lantus is correct, and if not, how much it needs to be varied. The idea of long acting (basal) insulin such as Lantus, is to keep your blood sugars steady with no outside influence (food to raise them, exercise to lower them). So the best way to check your dose is to choose a day when you are not going to be moving about, and fast for that day. If the idea of not eating all day fills you with dread, you could cut out breakfast one day, lunch on another and dinner on another, monitoring your blood sugars for that time. If you do this, make sure to have a fast acting source of glucose to hand, in case of a hypo.
Your blood sugars are rising in the morning anyway, due to something called the dawn phenomenon. When you go to sleep, so does your liver, so it stops releasing glucagon (kind of the opposite of insulin, and makes your blood sugars rise). When you wake up, it can try to over compensate and makes your blood sugars rise a lot more than at other times of day. I combat this myself with a couple of units of fast acting insulin at around 1.30am. If you decide to try this, wake up and test throughout the night to ensure you don't hypo, and keep doing this until you are completely happy with your levels. Set multiple alarms for every 1-2 hours to be safe. As before, it's probably best to do this when you can rest the next day!
 
typical behaviour of the dawn phenomenon, bg all good until about 4am............

unfortunately there is nothing you can do to stop this process but you can manage it slightly...........

the first thing to do is split your background dose so you can get as much basal in overnight as is possible without hypo.........

it also helps to take a basal dose before bed, then in the morning, this gives an uneven coverage but also gives an overlap in the morning to help with the higher blood sugars......

some also eat a slow acting carb or fat like cheese or peanut butter before bed, this will help with the livers response to an empty stomach and should either delay the liver dump or decrease it effect.............

lots of things to try really......
 
As @Charles Robin says it may be better for you to do a basal test to see what is going on but it is likely to be the Dawn Phenomenon.
 
Thanks guys,
I have tried waking up and checking a few times before but it didn't seem to make any sense at times. ie. Let's say I went to bed with 6.. One night I would wake up at 2am with 5,6 and another night with 12. I need to do it more often to figure it out..just find it hard with my current job. Need my sleep so I can function all day.

I read about this dawn phenomenon and mentioned it to my dsn however she didn't have a clue what I was going on about. I will need to get up at night and check more often.. Already go through 200 test strips in 3 weeks so my gp will not be happy if I ask for more! Ha
Might need to get that new Freestyle Libre...
 
a test at 3 am only should reveal whether the dawn phenomenon is giving you problems..............do this for 3 days to discount any anomalous readings [which happen all the time] and then go from there..........

if you hold steady right up till 3 am then your basal dose is correct........:)
 
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Mathoo said:
Thanks guys,
I have tried waking up and checking a few times before but it didn't seem to make any sense at times. ie. Let's say I went to bed with 6.. One night I would wake up at 2am with 5,6 and another night with 12. I need to do it more often to figure it out..just find it hard with my current job. Need my sleep so I can function all day.

I read about this dawn phenomenon and mentioned it to my dsn however she didn't have a clue what I was going on about. I will need to get up at night and check more often.. Already go through 200 test strips in 3 weeks so my gp will not be happy if I ask for more! Ha
Might need to get that new Freestyle Libre...
Click to expand...
If you want a thorough understanding of your blood sugars, it may be worth speaking with your diabetes team about a short term continuous blood glucose monitor. I'm not sure how widespread this is, but my diabetes team (At The RUH in Bath) have a monitoring system in place. Basically they attach a sensor to you for a week, which takes a blood sugar reading every 5 minutes. It doesn't show you any data, but your diabetes team will take back the sensor at the end, and then discuss the results with you a couple of weeks later. They ask you to fill out a comprehensive diary for the week. It should contain all insulin doses, food intake (usually carbohydrate levels, although for me I also included protein as I eat a very low carbohydrate diet), and exercise. They also ask you to record your blood glucose results, so that they can verify that the sensor is working properly. If it isn't available everywhere it should be, it gives a wonderfully comprehensive picture of your control, so you can see what times you typically get highs and lows, and what caused it.
 
Hi guys, me again. I've been trying to test at night. Wake up at random times. And it's a mixed bag really.
For example, Monday night- bed time reading was 10 so i injected 2. Woke up at 1am and it was 13 so I injected 3. Woke up at 6am n it was 6.
last nights readings: 9pm - 10, 10:20pm - 6, 11:00pm - 6, midnight - 5.8, 5:40am - 17.8. I mean, ***?
I spoke to my local diabetes specialist doctor and nurse. They told me to put my Lantus up from 16 to 20 saying that it will level it out n help with my day reading. But I feel that it made it even worse tbh. I don't struggle with day readings. It's just my night/morning readings that suck.....
 
Quick question, you couldn't be going low during the night and then seeing the rebound in the high readings? I only ask with you saying you wake up with headaches...? Could always set an alarm for 3am ish (maybe at the weekend?) and do a check then...

Matt
 
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