Morning High, but what to do?

[mbudzi]

I could do with some ideas/views from anyone who has been doing this longer than me.

I'm currently just taking Novarapid which has BGs pretty well under control during the day. A couple of months ago, I started getting high BG in the morning. I've tested overnight and things are fairly stable (usually around 5-6) until I wake up. Initially I am usually around 6, then over the next couple of hours the sugars go up to 8/9.

Diabetic Nurse has suggested starting on a night-time dose of basal Humulin I. However as things are normal all night and only shoot up when I start to wake up, I'm concerned this will result in hypos at night and actually may not still be working by the morning as I am only going to need a small dose (2units suggested).

My current coping strategy is to wake up and immediately take 2 units of Novarapid so that by the time I'm up and about, I can actually have breakfast without getting myself above 10.

Many thanks for any suggestions as to how to progress.

 

[Sheffield27]

Hi,

If you are 6 when you wake up then thats obviously great!

What do you have for breakfast?Might be something hidden it thats raising... You might need more than 2 units? or any other hidden things like tea with sugar?

Cheers

 

[Sanober]

Hi there

this has troubled me also in the last few months. I started insulin in December.

My levels are steady until 4/5am then it edges up a little, then when I actually wake up and out of bed, I'm in the 8s/9s plus before breakfast.

Do you take your background/basal insulin in the morning or night?

I'm on Lantus (and Novorapid) I take it in the morning and I'm finding that if I delay even by half an hour (like today) then this is what causes me the morning high problems. Even a 2 hour delay never used to be a problem until 3 months ago.

I know that different background/basals have differing lifespans too. Lantus has a life span of 24 hours but some folk use it up in 18 hours, so technically if I inject at 6.30am then technically that should do me until 6.30am then next day but I wonder if it's perhaps running out maybe 4-5am instead and therefore with the liver dump the background insulin isn't there to steady things? What do the more experienced T1s think?

I read in a book that when you inject Lantus it can take about 6 hours to settle into the body, so perhaps this is why I keep going higher in the mornings.

I too have to take a correctional unit and delay breakfast which isn't ideal if I'm 9 plus. I read somewhere on this forum that Metaformin can help to switch off the liver dumping extra glucose in the mornings but I know that Diabetes staff don't give this to Type1s as standard.

I'm going to ask my support team about Metaformin, for some folk splitting the background/basal is a better idea but I don't think it's affective for all basal insulin - you're best to ask your Diabetes team about alternatives if you're worried about night hypos - which shouldn't be an issue if you're confident your basal level is set ok and your bed time reading isn't too low before you go to sleep (and you've not been drinking alcohol or exessive exercise).

Either that or I start running early before I have breakfast :***:

 

[kellyrae]

Hi, I recently went on to a pump, prior to this i was suffering exactly the same on insulin injections and trying to get it right.
Its called "the dawn phenomenom" i believe, or so i was informed by my diabetic nurse.....hope this helps....this id from wikipedia

The "dawn phenomenon," sometimes called the "dawn effect," is the term used to describe an abnormal early-morning increase in blood sugar (glucose)(usually between 2 a.m. and 8 a.m.), usually in people with diabetes. It is different from Chronic Somogyi rebound in that dawn phenomenon is not associated with nocturnal hypoglycemia.

It is possible that dawn phenomenon is caused by the release of counterregulatory hormones such as cortisol, glucagon, or epinephrine, all of which can signal the liver to release glucose. Other causes may include insufficient insulin administration the night before, incorrect medication dosages, or eating carbohydrate snacks at bedtime.

Dawn phenomenon can be managed in many patients by avoiding carbohydrate intake at bedtime, adjusting the dosage of medication or insulin, switching to a different medication, or by using an insulin pump to administer extra insulin during early-morning hours. In most of the cases, there is no need to change insulin dosing of patients who encounter dawn phenomenon.

 

[hails]

I have the same problem but if I wake up on a single number it is at least doubled in 2 hours! I have been prescribed metforim but I find the novorapid when I wake up sorts it. This only happens on weekends for me as I eat breakfast in the week so the insulin starves the rise