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Type 1 Hypers in the morning

Tom.thomas61

Tom.thomas61

Active Member
Messages
38
Type of diabetes
Type 1
my ratios have always been 3:1 which after doing dafne figured was really high compared to other people. I have a freestyle libre so can monitor my levels easily, but i have a recurring pattern of my morning bg being anything above 14.
despite being below 8 before bed, 5 hours after tea and with no snacks or sugar drinks,
1. what is the cause (slow carb release? sleep hypo, glycagon>liver relese, insufficient bi)
2. what is the solution? (more bi? not splitting, justevening)

My libre is showing that I have hypos in the night.
I am on humalog kwikpen and split dose of levemir flexpen.
If anybody can explain it would be much appreciated.

Thanks.
 
Hi @Tom.thomas61
A few thoughts/comments
- your morning highs sound like classic Dawn Phenomenon. This is a common topic on the forum so use the Search and take a look around.
- Libre is renowned for reporting low when pressure is applied. For example, when you lie on it during sleep. Therefore, those nighttime hypos should be checked with a finger prick. Annoyingly, this probably means setting yourself a middle of the night alarm to wake yourself up.
- have you thought about or discussed an insulin pump with your diabetes team? If your bg is having a roller-coaster ride during the night as the Libre suggests, your basal needs are not constant as the basal bolus insulin regime assumes. The great advantage of a pump is you can set varying basal doses every 30 minutes to match your body's needs.
 
Tom.thomas61 said:
my ratios have always been 3:1 which after doing dafne figured was really high compared to other people. I have a freestyle libre so can monitor my levels easily, but i have a recurring pattern of my morning bg being anything above 14.
despite being below 8 before bed, 5 hours after tea and with no snacks or sugar drinks,
1. what is the cause (slow carb release? sleep hypo, glycagon>liver relese, insufficient bi)
2. what is the solution? (more bi? not splitting, justevening)

My libre is showing that I have hypos in the night.
I am on humalog kwikpen and split dose of levemir flexpen.
If anybody can explain it would be much appreciated.

Thanks.
Click to expand...

I have been taking a break from Libre but when I'm using it I don't trust it implicitly and I use finger prick tests a couple of times each day and especially when readings are not what I expect.

The Libre often seems to give extreme results at the top and bottom end of the scale so your overnight hypo's may not be real. It also gives low readings if you've been laying on the patch, causing pressure to be applied to that area.

As for being high in the morning, I have been having similar problems and I'm on the same insulin combination as you. I have tried various ways of splitting Levemir doses and am currently taking equal amounts every 12hrs.

This gives the best result I have achieved with Levemir and have woken up with BG around 6's and 7's this past week but this morning I was over 10 again and I don't know why.

I do get better results if my evening meal does not involve carbs like pasta and rice, even though (like yourself) I am in range before bedtime.

So you can change the timing of your basal, and the way you split the quantity to see what works best. It might be that you need to try a different basal.
 
I will have a search for dawn phenomenon
Also I'm guessing during the night I must be applying pressure on it. As for finger prick testing, mine are nearly always the same as the libre
 
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