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Increased basal = increased fasting sugars

A

Alan-58

Member
Messages
13
Type of diabetes
Type 1
Treatment type
Insulin
I'm no newcomer having been T1 for 44 years. Forcsone time (10 years-sh) I've had Dawn Phenomenon with frequent fasting sugars of between 10 and 15mmol. The obvious suggestion of increasing my basal (Toujeo) has unpredictable results. When I adjust I always wait 10 days before readjusting but am now finding that mostly my new basal readings dont change mych and are sometimes higher despite the insulin increase, but i aldo have maybe 1 of 10 that are around 3.6.

Any ideas what to do next
 
Have you tried taking a 'correction' dose first thing after you wake up? I believe some members here do that to combat dawn phenomena.
 
Hi @Alan-58 do you use a libre or other cgm? I would be very interested to know what is going on at night with those readings.

While dawn phenomena is one of those things that so many of us (me included) have to deal with, some people also go low at night and then have a morning rebound
my.clevelandclinic.org

The Somogyi Effect

Learn about one of the possible causes of high morning blood sugar in people with diabetes.
my.clevelandclinic.org my.clevelandclinic.org

I inject a correction dose when I wake to counteract the dawn phenomena, but I would recommend you talk to your clinic. With readings up to 15 they might think it makes you eligible for an insulin pump. (They did for me, though I didn't accept at that time, and as I am in New Zealand I don't know if UK clinics have the same criteria.) And even if they don't offer you a pump, it may be that a different insulin regime (basal) might help?
 
EllieM said:
Hi @Alan-58 do you use a libre or other cgm? I would be very interested to know what is going on at night with those readings.

While dawn phenomena is one of those things that so many of us (me included) have to deal with, some people also go low at night and then have a morning rebound
my.clevelandclinic.org

The Somogyi Effect

Learn about one of the possible causes of high morning blood sugar in people with diabetes.
my.clevelandclinic.org my.clevelandclinic.org

I inject a correction dose when I wake to counteract the dawn phenomena, but I would recommend you talk to your clinic. With readings up to 15 they might think it makes you eligible for an insulin pump. (They did for me, though I didn't accept at that time, and as I am in New Zealand I don't know if UK clinics have the same criteria.) And even if they don't offer you a pump, it may be that a different insulin regime (basal) might help?
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That's what happened to me years ago. I was waking with high BS and the obvious solution (before the time of cgm) was to increase my basal. Since I've been on a cgm I've found that I need absolute minimum insulin through night and my high readings were due to a kickback. If you can get a pump and sensor I would recommend it. Im now on a minimed 780 with the G4 sensor and my night-time hypos are down to a minimum and my waking BS are the best they've ever been.
 
Just to say as type 3c for 10+ years on insulin I am juggling using the Libre 2 readings with Toujeo ( and Fiasp) around a liver glucose dump at about 10.30 -11 am ( I get up late as have conditions inc fibromyalgia) when monitor shows rise of say 10 in less an hour or two without food. I meanwhile intermittent fast till 3 pm ish, and go swimming. I had been told to adjust Toujeo every 4 days, when it settles, but today when I was thinking of raising the dose just a little say 2 units fine tuning I had a previously unknown 2 hr long hypo instead…ie the Toujeo has not settled down as quickly as I had been informed. I never changed the Fiasp dose, and diabetic team were very reluctant to suggest using that to counteract dump even tho that rose BG more than most meals with the Fiasp.
 
i take 2 or 3 units of fast acting insulin as soon as i wake up in order to correct dawn phenomenon. Plus i skip breakfast.
Going for a walk or workout in the morning also helps to limit the dawn phenomenon. If i start the walk or workout my bg will rise further but when back in rest bg will drop.

Btw i also tried adjusting the long acting insulin dose, tried to split it in two (half mornjng half evening), tried to adjust the timing but it doesnt help. For the long acting insulin, i also just take it in the morning now, to avoid unexpected nightly hypos.
 
I usually take a rapid insulin dose when I first get up to counteract the dawn rise in my blood sugar I have been a type 1 diabetic for over 60 years.
 
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