Insulin And Morning Highs

[claudetteholmes]

I have started on the 13 th of June on insulin slowly building up doses. My BG is finally in normal range after 4 months of hell. My nurse is lovely but very out of depth with my low carb diet.
I am now on 28 units of Levemir and on Novorapid ( 4-6) before meals. My fasting sugars is better but still between 8.4 - 11.4 on waking I have a coffee with coconut milk while getting kids ready, showering in the hour or so till I inject/ eat sugars just rocket to 10- 12. It drops down in normal range for rest of the day to 4.8 to higest 8.2 after meals. My problem is I just cant eat first thing - before insulin I just used to fast. I need to get it down as the headache just puts a halt to my day till it eases.
My nurse pulled her shoulders up and was told to ajust a little at a time?
I have figured out my fast acting insulin for meals to correct high sugars and cover the carbs.( Lots of research)
I currently on 15 or less carbs a day and have cut out milk and nuts because my weight started to go up. I test 10 a day.
Can anyone give me some advice?

 

[kitedoc]

Welcome @claudetteholmes to the forum.
I am sorry to hear you have been through hell and back with your insulin.
You mention being on Levemir but it is unclear from your post whether you take this once per day or twice per day.
Most people say they take their prescribed Levemir as split doses, i.e. twice daily because they find that Levemir does not last 24 days but nearer 12 hours.
Could you clarify when you take Levemir in case it has some bearing on things like your fasting BSLs.
Best Wishes.

 

[EllieM]

Could you try just giving yourself a couple of units the minute you wake up? There's an issue called dawn phenomenon where the liver pumps out extra glucose as you wake so as to provide energy for the day, so you have to inject even if you aren't eating.

I agree with @kitedoc that if you're splitting your levemir you might be able to adjust things so that you get a bit of extra insulin whoomph at the beginning of the day. (Which has got to be better than yet another insulin injection).

How are you going with hypos?

 

[Antje77]

Could you try just giving yourself a couple of units the minute you wake up? There's an issue called dawn phenomenon where the liver pumps out extra glucose as you wake so as to provide energy for the day, so you have to inject even if you aren't eating.

This is what I do, and I don't do breakfast usually. Be very careful when experimenting! It's called feet on the floor effect, because it happens as soon as you get out of bed.

 

[claudetteholmes]

This is what I do, and I don't do breakfast usually. Be very careful when experimenting! It's called feet on the floor effect, because it happens as soon as you get out of bed.

Thank you so much for the advice. I am on forum for about 3 years, how I learned everything about lchf. The hell wasn't with insulin but with my medication and convincing doctors that it isnt my diet it took a lot of appointments and proof of diet and graphs of my sugars. We now know my pancreas stopped working ( huge family history) my sugars at the end was between 11 and 21 I was sick all the time. I only started on Insulin on 13 th June. I inject my Levemir at night 28 units. My sugars have always been good but mornings always higer in past. I have only ever had one hypo 3 years ago when I started on medication. I am very prepared as I drive a lot we live in country side and can not afford to loose my licence.
I think I will start experimenting with 1 unit and then maybe 2 till I feel like eating. I hate eating when not hungry. My sugars for rest of the day is perfect 4.6 - 7.5 sometimes a 8.5 after meals but drops straight down.
If I want to split my dose for Levemir do I do them 12 hours apart?

 

[claudetteholmes]

Welcome @claudetteholmes to the forum.
I am sorry to hear you have been through hell and back with your insulin.
You mention being on Levemir but it is unclear from your post whether you take this once per day or twice per day.
Most people say they take their prescribed Levemir as split doses, i.e. twice daily because they find that Levemir does not last 24 days but nearer 12 hours.
Could you clarify when you take Levemir in case it has some bearing on things like your fasting BSLs.
Best Wishes.

Thank you so much for taking the time to reply. I take my 28 units at about 10 pm at night I get up between 5 and 6. Take bg immediately. So next measurement is 7.30 before I inject with Novorapid before reluctantly trying to eat something

 

[kitedoc]

Thank you so much for taking the time to reply. I take my 28 units at about 10 pm at night I get up between 5 and 6. Take bg immediately. So next measurement is 7.30 before I inject with Novorapid before reluctantly trying to eat something

Thank you @claudetteholmes for that information.
Not sure if splitting your Levemir dose would work for your morning hypers. If you google 'insulin profile pictures - Levemir you will see that Levemir is fairly even in its blood sugar lowering effect through its duration of effect. So if there were an upswing of blood sugar say, at 4 am, Levemir may not have the ompph to settle it. You would need to discuss with your doctor.
Also to discuss with him/her what to do: ? Novorapid at 4 am (yes, groan!!), Novorapid on waking followed by ? more just before breakfast.
If you google insulin profile pictures - Novorapid, it shows a graph of the insulin-lowering effect ( peak = greatest effect) of Novorapid, which is ? 2 to 3 hours after injection. If say, your blood glucose is highest about 2 hours after a meal, Novorapid may or may not be working at its peak effect. Some people, I am one, inject Novorapid an hour before breakfast to better 'catch' the blood sugar spike after breakfast.
Lots to think about and discuss but a solution is in there somewhere! Best Wishes!!

 

[claudetteholmes]

Thank you @claudetteholmes for that information.
Not sure if splitting your Levemir dose would work for your morning hypers. If you google 'insulin profile pictures - Levemir you will see that Levemir is fairly even in its blood sugar lowering effect through its duration of effect. So if there were an upswing of blood sugar say, at 4 am, Levemir may not have the ompph to settle it. You would need to discuss with your doctor.
Also to discuss with him/her what to do: ? Novorapid at 4 am (yes, groan!!), Novorapid on waking followed by ? more just before breakfast.
If you google insulin profile pictures - Novorapid, it shows a graph of the insulin-lowering effect ( peak = greatest effect) of Novorapid, which is ? 2 to 3 hours after injection. If say, your blood glucose is highest about 2 hours after a meal, Novorapid may or may not be working at its peak effect. Some people, I am one, inject Novorapid an hour before breakfast to better 'catch' the blood sugar spike after breakfast.
Lots to think about and discuss but a solution is in there somewhere! Best Wishes!!

Thank you for all the info... I think you right might take my insulin an hour before food especially evening meals was it bit high last night 10.4 after meal with 6 units my meal was only 4 carbs. Before meal I was 6.7.

 

[claudetteholmes]

This is what I do, and I don't do breakfast usually. Be very careful when experimenting! It's called feet on the floor effect, because it happens as soon as you get out of bed.

Morning you are my hero !!!( wish I get this advice from my diabetic team) I woke at 6 am BG at 8.2 injected 2 units and at 8:33 7.7. No headache no nausea...lots of energy!!! Best thing I dont need to force myself to eat!!! What a difference from the high readings this time of the day! Thank you again. Bit OCD testing every 30 min so it wont drop to quickly - new feeling to get used to xxx

 

[kitedoc]

Thank you for all the info... I think you right might take my insulin an hour before food especially evening meals was it bit high last night 10.4 after meal with 6 units my meal was only 4 carbs. Before meal I was 6.7.

Great. Run it by your doctor and see how it goes. Fingers crossed.

 

[Antje77]

Morning you are my hero !!!( wish I get this advice from my diabetic team)

Wow, thanks! I like being a hero . The most likely reason your diabetic team didn't give you this advice is simply that they didn't know. My nurse thought I'm crazy for doing this as she's learned you shouldn't take insulin without food unless correcting a high. I explained to her that I AM correcting a high, only before it's there, just like when I eat. She reluctantly agreed, after seeing my numbers .