Morning highs

[CarlyB]

Hello all,

I'm currently honeymooning and my morning (fasting) sugars tend to be pretty erratic, ranging from 6.5-12.4mmol! I've been gradually increasing my Levemir and am currently on 17U at 10pm. I don't often notice the impact of the increased dosages on my morning (fasting) bloods but then it goes right down to between 5-7mmol post breakfast with the help of my Novorapid.

I think the following factors also impact my morning levels, would you agree?

- unhealthy snack after dinner the night before
- time of the month
- crying baby at 5am which stresses me out

The fact I'm honeymooning makes it very difficult to work out how much insulin I need and with trying to maintain tight control ready for family planning, it is getting frustrating. I've been on a mission to improve my diet again. It's going well but tweaks are still needed in the evenings.

Anyone else in the same boat? Anyone got any ideas on how I can control the overnight/morning fasting sugars? I know for starters I need to cut out the evening snack and/or replace it with a healthy equivalent.

Any further advice would be much appreciated.

Thanks

 

[catapillar]

Do you bolus for the evening snack? You blood sugar doesn't really care whether it's a healthy snack on not, just whether the snack is covered by an appropriate amount of insulin.

Have you done any basal testing?

Do you adjust you basal doses depending on where you are in your cycle?

If your looking to control overnight, you should probably start out with a basal test. It'll give you a better idea of what's going on overnight and should help with basal dosage and timing.

The other thing that would help with figuring out what your sugars are doing overnight would be a CGM or libre so that might be worth looking into.

 

[azure]

Hi @CarlyB

A disrupted night can affect your blood sugar. Have you kept a diary to see if there's any pattern to your highs?

A bedtime snack shouldn't affect your morning BS if you bolused correctly.

Could it be Dawn Phenomenon? If it is, a pump will help if you qualify for one.

 

[CarlyB]

Do you bolus for the evening snack? You blood sugar doesn't really care whether it's a healthy snack on not, just whether the snack is covered by an appropriate amount of insulin.

Have you done any basal testing?

Do you adjust you basal doses depending on where you are in your cycle?

If your looking to control overnight, you should probably start out with a basal test. It'll give you a better idea of what's going on overnight and should help with basal dosage and timing.

The other thing that would help with figuring out what your sugars are doing overnight would be a CGM or libre so that might be worth looking into.

Thanks this is really helpful. Yes I do bolus for the snack but I'm never sure if it's the right amount due to how unpredictable my bloods are. Plus I go to bed soon after so find it hard to test before bed.

But it's reassuring to know that it's not the snack causing the morning highs.

I've tested in the night before and it does go up gradually through the night.

I'll look into doing a basal test and will look into a libre in the future. Money is tight at the moment!

 

[CarlyB]

Hi @CarlyB

A disrupted night can affect your blood sugar. Have you kept a diary to see if there's any pattern to your highs?

A bedtime snack shouldn't affect your morning BS if you bolused correctly.

Could it be Dawn Phenomenon? If it is, a pump will help if you qualify for one.

Thanks for this. I looked into the dawn phenomenon and think this could be it. On the whole my diabetes is well controlled with my most recent HBa1c being 6.8% so I doubt I'd qualify for a pump?

 

[azure]

@CarlyB It does no harm to ask about a pump. INPUT has some good info:

http://www.inputdiabetes.org.uk/alt-insulin-pumps/is-it-provided-by-the-nhs/

I got a pump with a good HbA1C. Dawn Phenomenon can be a reason to have one for some people.

 

[mentat]

A pump is recommended if you want to get pregnant, so do look into it.

Also see if you can get a Libre or CGM on loan from your clinic. It is the best way to see what is going on during the night.

In addition to the things you said, the amount of exercise you get in a day can also have a big effect on what happens overnight. Consistency is very helpful.

Is your snack consistent from night to night? Remember that very sweet/carby things can vary in carbs quite substantially even if they look about the same size.

 

[CarlyB]

A pump is recommended if you want to get pregnant, so do look into it.

Also see if you can get a Libre or CGM on loan from your clinic. It is the best way to see what is going on during the night.

In addition to the things you said, the amount of exercise you get in a day can also have a big effect on what happens overnight. Consistency is very helpful.

Is your snack consistent from night to night? Remember that very sweet/carby things can vary in carbs quite substantially even if they look about the same size.

Ok I'll ask about the pump and the libre.

My snack does vary actually.

Thanks!