How does my blood glucose jump during the night

Is there a possibility that you might be going hypo during the night and not waking up? In these circumstances the liver takes over and pumps out glucose, often leaving levels high by morning. I'm only speaking from my own experiences in the past; but perhaps a possibility for you to consider.

Hi cupcake 32. I had this problem every day. I used to wake each day and could be as high as 22. Yes unfortunately it can make u this high and I definitely was not having hypos although I know that can be the cause too. I was put on the pump about a month ago. It is still early days yet but it has made such a difference to this problem. I hope you get on ok. Please let us know.

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Yes, this sounds very like my experiences of dawn phenomenon. I can be 6.0 at bedtime and 23 in the morning, even though my levemir was increased to 50 units at night.

Have had a loan of a continuous sensor from the DSN, so we know it is not caused by hypos. It's difficult to address with larger doses, since bigger injections can have less efficient absorption.

I was left to my own devices for 2 years and ended up on 80 units on Lantus that still didn't fix the problem. I'm getting a pump next month, hoping that will allow me to fix my morning highs.

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Cupcaake32 said:

Annoyinly my blood is low thos morning 2.5 and i have done evertying this same i may change it to 17 if its low tomoro flipping dawn phenononomemeneon

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Fingers crossed that you've got your answer and that the insulin adjustment helps. I remember thinking my DN was insane dropping my dose for morning highs, and to my shock it actually worked. :wink:

Sorry to hear that. I was advised when making changes to long lasting insulin, to give it three days before changing the dose again.
Hope you get sorted out soon.


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The liver throws sugar out at night most times

Hey Cupcake32, do you mind me asking what are your eating habits from about 6 o'clock onwards? Like, what are you eating during that time? It might be affecting you in some way. I know that I can't have starchy foods like potatoes for dinner because it causes me to spike . What you're eating could be dumping into your blood in the middle of the night.

I find personally that I have a BG rise in the morning at certain times of the month. I need to increase my lantus just after my period by two units as otherwise I can have highs of 14 mmol/L, maybe even 15, and then it tends to have a domino effect, as in, I will be continually high until 3 p.m at the latest.

Keep trucking, Cupcake, there's always a way!

Izzy.

I am getting a pump to try and get over this problem, I am extremely insulin resistant in the mornings for example at 03:30 this morning my level was 5.8 by 06:30 it had jumped to 17.9! Every morning I have to take 20 units of bolus when I awake then another dose at 8am to cover my breakfast. God forbid I ever have a lie in then it is in the high 20's! Liver dumping has been ruled out and the consultant is hopeful that the pump will solve the problem. I have stage 4 CKD so it is important that my levels are kept in control.

Lorna

For a few nights set you alarm for 3 am or 4 am and just see what is happening. If you are going low then special K is very low and used to help stabilise my sugars at night.
I have had my pump for 6 months and have lovely stable sugars now but find that my basal needs to vary through the month as post menstrual i am low and pre i am high. Have you considered this also? Not sure what gender you are.

Hi Cupcake32,

I would suggest keeping a diary of these results and having a chat with your diabetes team. It can be depressing to keep a diary when your results are all over the place (I can attest to that) but in the long term it's good because sometimes you can even see yourself all of a sudden something little you might be doing wrong. There are times indeed when I believe I'm doing everything right and by the book but then I realise that a little mistake (such as not taking that extra unit of insulin, or not eating that extra biscuit before a walk) caused an unruly chain of highs/lows.

But to have massive highs in the morning, after not eating after six? And then, bizarrely, having a low in the morning? Perhaps it's an irrelevant question, but have you checked your injection sites for lumps? I had a dreadful experience with that once. Not only did I inject in pretty much the same spot the whole time but I injected through clothes and didn't always change the needle :O. After a weekend of being in the 20s I went in a mad dash to my clinic where they figured out what was wrong very quickly . Never, ever again!

Keep testing and see what happens,

Izzy.

Hey, just wanted to chip in since I often have the same problem with high morning bg.
As far as I can tell there are two possibilities which have both been mentioned:

- Dropping low during the night, which a lot of Levemir (or equal profile Insulin) will do sooner or later.
- Eating slow-metabolizing starch (rye bread or wholegrain food fx.) late which spikes your bg after bedtime.

I've found that if you need a lot of fast-acting Insulin (Rapid) to knock it down to a reasonable level then it's most likely a glyco-release from your liver to counter low bg during the night. Somehow the reserves from the liver are more "heavy-duty" than carbs from a meal, which makes sense since it essentially saves your hide in these situations.

In your case i'm betting its your slow-absorbant Insulin that bites you sometime during the night. If I were your i'd try halfing your dosage over a week and see where that gets you. My guess is a lot more stable in the morning and less "bombed out".

In general I think many take way too much slow-absorbant Insulin which of course allows you to think on bg less, but can also force you to eat/drink much more than you actually need.
Remember, adjust your Insulin based on how much you eat and not the other way around. :thumbup:

I often take a fasting stab when I get up and it reads 14. Always confused me. I have a couple of Weetabix and within an hour I'm down around seven.

Yeah I've started doing the same. Get up 30min earlier, and if too high take what I assess is needed to knock it down and then snooze for 30 min more.
If I get up and start out with breakfast with a bg of say 14 and its from the liver reserve, it will just keep climbing almost regardless of how much Rapid I take. It works best to knock down the bg first and then wait a bit with eating breakfast.