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Morning highs please help!

M

mon

Active Member
Hi there I'm looking for advice on how to deal with morning highs. This am it was 21!!i regularly find its in the high teens when I wake up. I always try to take my levemir at the same time each day : 10pm and 7 am 8 and 9 units. And I if I'm high before bed I take a correction dose. Please help i feel it's out of control now

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hey mon, if ur diabetes is high at night u need to take the insulin wake up at midnight check urself n then if its high inject ur self n hve a fruit
 
If you go to bed at a 'normal' level and wake up at 20 you may be having night hypo's, with a liver dump causing the high. Have you tried a 2am test?


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The likely cause is your basal insulin is too low and needs increasing, if you go to bed with your bg readings in range and regularly wake up to readings of 21 then you need to carry out some night-time basal tests, to do this set your alarm 2 hourly and test your bg, if your bg is gradually increasing throughout the early hours then you need to increase your basal insulin.

I'm sorry but can't advise on the split levemir doses so hopefully someone else will help you out there.
 
I can usualllly tel if I'm having a night hypo as wake up sweating etc but now I'm worried I could be sleeping through and not knowing is that possible?


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mon said:
I can usualllly tel if I'm having a night hypo as wake up sweating etc but now I'm worried I could be sleeping through and not knowing is that possible?


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That is why you need to test your bg 2 hourly to rule out any other cause.

In answer to your other question about injecting through the night then the answer is No, if your basal insulin is set right there's no need to take corrective doses of insulin during the night, sleeping with QA insulin on board with no food isn't a good idea IMHO.
 
Mmmm - definitely the middle of the night wake up - bolusing to correct a high before bed will increase your chances of hypos - as due to the hormones when you sleep most people tend to need less insulin to bring them down as you are more sensitive to insulin generally when asleep (again that is only most people!) and then you have this 4 hour quick acting on top of you levemir - and it is just really risky.

The other chance is that you have that old dawn phenomenon…which can happen as you get to wake up point too - so, basically there are a few things that could be going on. If you still can't get it to work with the testing at night ask your hospital if they have a continuous glucose monitor that you could wear for a few nights and that should help you really get to the bottom of it - whether you need more basal or whether you are hypoing and need less! If it is the dawn phenomenon too and you have that early morning rise then I think it is only pumps that can help you with that. I wear a cgm and sometimes (not everyday as that would be too easy) I have a dawn phenomenon just as I wake up, so I once I see my sugar arrow go on the increase I get up, inject straight away and then eat about 10-15min later so that I don't have a really high peak with breakfast and my dawn phenomenon.
 
Tested before going to sleep: was at 13 so took 2 units novo rapid
Woke up at 2am and tested was at 17!! So took 3 units

Woke up at 4 am was down to 11
This morning was back up to 17!!!??
I can't explain what's going on... Is it possible the levemir is just not working or has gone off?


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Not done DAFNE…and might just be me…but consultants and diabetic nurses have always told me never to bolus before bed! (I did a week ago - just cos of the security of being on a continuous glucose monitor and it did make me hypo!) Levemir can go off - you are meant to change it monthly. To me it sounds like you are not having enough at night - do you inject the levemir around 10pm or earlier? How close to going to sleep to you eat? What did you eat?

This is just me, but it might be of use in all your thought - I try and eat fairly early - so that I know at the latest all the novorapid will have cleared my system by midnight 'cos if you are eating at 8, checking at 10 then your sugar level could still be high from the food you ate and still be moving around because of that - also I have noticed that high fat foods can keep my sugar elevated for longer. I also know that my sometimes (not everyday) my sugars will rise fairly quickly in the morning before I get up - but the night has been fine!)

Those are my ramblings anyway!
 


It's your basal insulin that is too low that is causing your night-time highs, despite the correction doses you still managed to wake with a bg of 17 which is extremely high.

I would speak with your diabetes team and get them to advise you on adjusting your basal insulin, if things don't improve then ask them if you can switch to lantus, in my experience lantus gives a better 24 hour coverage and in most cases there's no need to split the dose.
 
As you took 2 correction units before bed and still ended up at 17 its clear your basal is too low, so in this case the 8 units at 10 pm.......

I personally would stick 2 units on that and repeat the test overnight.........consult with your team is you don't normally change your own dose....

As far as the split dose is concerned, for individuals who have fairly active lifestyles a split is ideal as you can drop or increase each separate dose for things like, exercise, long days of activity, illness, alcohol........so I would say its good to stay on a split........

Once you have got a dose overnight that holds you steady till at least 3 am then you can start testing for the Dawn Phenomenon.....

 
i have much the same problem so far with no solution no mater what i do i end up high at night. ive had more insulin less insulin smaller dinners nothing seems to help. it is the only part of my day that i end up that high and it can be pretty upsetting. my Doc doesnt seem to bothered about it. but it anoys me a fair amount because ive to take a lot more insulin in the morning than id really want to, to deal with it.
 


So are you saying your increased your dose and your blood sugar didn't come down at night?

what insulin's are you on?
 
novorapidboi26 said:
So are you saying your increased your dose and your blood sugar didn't come down at night?

what insulin's are you on?
Click to expand...
Yep Tried most things.

im on Levimir/Novo Rapid. using a split dose for the Levmir. uping the dose before bed didn't really seem to change my over night BS but caused me some Hypos around 10/11am. my Doctor has suggested the Dawn phenomenon, which leads me to getting up a few hours before i have to testing and injecting some Novorapid so im not too high for breakfast.

i was put on a CGM for a week before Christmas (didnt get given a receiver so im still waiting for the results) to see exactly whats going on
 
when you say it didn't really seem to change your blood sugar overnight, what does that mean.......?

Did you continue to increase your dose until you had a hypo either overnight or in the morning.......?

lows at 10/11 would also have some contribution from your morning dose of Levemir.........

so initially you should only focus on the bedtime Levemir holding you steady from before bed till you wake.........if your suffering from dawn phenomenon you would be looking to achieve a steady blood sugar till 3 am at least.....

I suffered and still do from the dawn phenomenon, it is a pain and hard to beat if it all, so I sympathize.......

when you say there was no receiver with the CGM, does that mean nothing was recorded.....?
 


Thanks from what i can tell from waking up and testing my bloods seem to hold fine till around 4/5 in the morning then just spike.

i increased it in small increments of 2/3 units over a period of about 3 weeks during this time i was setting alarms to wake up during the night to test. i seen a trend of lower blood sugar before 4/5am which resulted in a slightly less bad spike but it was causing me to sit around 4.3/4.4 at 2/3am which i didnt feel conferrable sleeping with as every few weeks or so ill get a day without a morning spike so i dialed it back again.

i just had a recorder attached to me that recorded my levels i had no access to what it was testing at all and im waiting for the hospital to tell me and advise.
 
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