Morning Highs - what to do?

[slbarron23]

Every morning when I wake up my blood sugars are fine, almost exactly what they were when I went to bed. I had 10units of levemir on a night and 5 when I first wake up.

I tend to get up around 5-6am most days and don't have breakfast until 10ish. When I go to test at 10 my blood sugars have always gone up by at least 3.

I tried having a little bit of carbs when I first wake up as I read this can 'trick' your body into not dumping a lot of insulin first thing on a morning as you have eaten. However this didn't work.

I then this morning tried having my full breakfast when I got up and was even higher come 10am! I'm only on a 0.5:1 ratio on a morning compared to a 1:1 ratio with tea.

Not sure what to try next - whether to up my background on a night (I never really wake up lower than 8) or on a morning (not sure if this is even working fully between 6 and 10)

Or whether to always have breakfast when I first get up and increase ratio to 1:1?

Any ideas would be helpful!

 

[novorapidboi26]

I would confirm your background dose of 10 is sufficient........but as you have said, you wake up with your BG almost the same as they were before bed..........a variation of up to 2 mmol can be viewed as successful.........some may try to tighten that if they choose......so it looks like your background dose of 10 is OK............

The reason for the BG rising after you wake could be down to several things:

1. The Dawn Phenomenon [Liver Dump]
2. Your Insulin/Carb Ratio
3. Your Background Dose

1. You have tried to take on carbs when you wake in order to let the liver know that food is digesting and its help is no longer needed, that's good. It hasn't worked so far, so you may need to look at one of the other options.

2. You mentioned taking on carbs to alert the liver, this would have had a dose of insulin to accompany it and the ratio may not have been enough. Everyone is different but the majority of folk need a higher ratio in the morning as the Dawn Phenomenon also produces insulin resisting hormones along side a glucose dump from the liver. So your insulin/carb ratio definitely needs looking at I would think.

3. Your dose of 5 may need looked at too. You would expect to see higher levels from lunchtime on wards as well though if this was the case, do you?

lots to think about..............


I would start off by testing your before bed background dose of 10...........if it need adjusting do so.......[i'm assuming you know how to do his ]

then, provided your levels are OK the rest of the day which may rule out the 5 Levemir, you should increase and test a larger ratio of 1:1.....

ideally you would want to be adjusting your background before the bolus insulin...........so at some point it will be worth testing the 5 units of Levemir in the morning.......

talk to your healthcare professionals............