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insulin before bed

H

hismom

Well-Known Member
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114
Hi,
my son has been having some weird morning readings . I wondered if anyone can help me. His levels before bed will be around 10 which is normal for him to wake with levels in the 6's. he is normally hungry being 14 and growing for england so he has some supper along with insulin to cover it. When he wakes the next morning his levels will be in the 10's. This makes me believe that the insulin doesnt work while asleep. Is this correct?
 
Could be Dawn phenomenon, where your body releases adrenaline and glucose in the early morning in prehistoric preparation for running around harpooning your breakfast mammoth. Unfortunately I can't help on how to avoid it, as I'm currently having a huge problem with it and nothing I do heps. I think there are a number of threads about it if you search on here though :-)

What kind of insulin regime is he using?
 
No, you are thinking of the Somogyi effect! (I think!) the Dawn Phenomenon is exactly what badmedisin says, it's the weird fact that your body pushes out extra glucose to help you meet the day. If you travel to another time zone you will find that the Dawn Phenomenon often continues on your original time zone's body clock, which is disconcerting.
However, it sounds to me simply as though your son just isn't taking enough insulin to cover his night time snack. Insulin does work while you sleep, but don't forget that when you are lying down in bed you are not doing any exercise at all, so you probably need a bit more insulin to cover the same carbs.
Try adding a unit at a time and make sure he has something at the ready in case it goes too far the other way and he gets a night hypo.

Badmedisin - have you tried increasing your night time/long acting insulin? What long acting one are you on? I'm on Lantus and that seems to be quite good for coping with the Dawn wotsit. I had similar probs to you before when I was on Protophane.
 
thanks for the advice. To be honest I didnt know there was two types . My son has only been diabetic since october so we are still learning. he hadnt had this problem before but he is 14 and going through puberty so it would make sense.
 
i think it's his levels you need to be looking at before bed.

if your background insulin is accurate then you should wake up with the same levels that you went to bed with...

so if he's going to bed around ten then he should be waking up around ten like your post says. so this isn't current with the dawn phenomenon. your background insulin is supposed to keep you level throughout the day then your fast acting insulin covers your food. so if your going to bed with 10 and waking with 6, that's a very big drop and is likely your background insulin is too high.

i would suggest a small snack before bed (which should please him as he sounds a typical hungry teenage boy!)

according to his levels before he has insulin to cover this take one unit of insulin to make his BG's lower by 3mmols... so if he';s around 10 when he goes to bed, one unit of insulin should bring him down to arouns seven, which is a great figure to go to bed with. if he wakes up with an extreme difference in BG's then start to think about the dawn phenomenon.
 
hi,
what normally happens it that he goes to bed with a reading of around 10 and will wake up with a reading of around 6 to 7. The hospital have set his base level and he is monitored every 6 to 10 weeks. they have said that it is working properly. if we lower the base his readings are high all day.
 
Hi, are you carb counting and using ratios etc? or I should say, is your son?! It could be his late snack/supper needs more insulin? or it could be all the other things already mentioned, it can be tricky to know even when it's not such early days.......my advice would be to stop the snack (or use a zero carb snack, ham or cheese perhaps to stop him chewing on the pillow case in his sleep!) and see if he still wakes higher than he should be. Also, if he can bare it, try waking him up at 2am and 4am etc for some BG checks, see if you can pin down when the rise is happening, I hope this is what your DN would suggest you do anyway........good luck :D
 
hi,
it happens sometimeseven if he doesnt eat late. We do carb count and in general he has good levels. his hb1ac was 5.4 then last time did go up a bit to just over 6 as he had been ill and had exam stress. It has just changed now. I might try more insulin with an evening snack normally we use 1 for 15 grams of carbs which works. maybe 1 for 10 or 12.
 
Lol you don't have to wake him up to do 2am tests! When I was in hospital I was rather put out when I found out this nurse had been sneakily testing me 3 times a night for the past week and I'd never noticed. Made me wonder what else they'd been up to...

I think your son's insulin requirements will change a lot as he grows, and also his hormones will probably make things unpredictable. So don't worry too much, his HbA1c sounds pretty good, especially for a teenager.
 
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