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Morning Highs

Melissa 2

Member
Messages
9
Type of diabetes
Type 1
Treatment type
Insulin
Hi im looking for some help im type 1 and am struggling with morning highs i am just wondering if it is because i am up two to three times plus settling my one year old to sleep so my body is preparing for the day etc even though im going back to sleep has anyone experienced this advice please
 
I am sure caring for a one year old, getting up multiple times throughout the night will be impacting your morning BG.
I know @Mel dCP has techniques for reducing morning highs (I think she takes a pre-rise bolus but I am sure she will provide more details).

Another thought is an insulin pump. Is this an option for you?
One of the great things with a pump is the ability to adjust basal by the hour (or less) to address different needs throughout the day such as your morning high.
 
TE="helensaramay, post: 1834206, member: 181361"]I am sure caring for a one year old, getting up multiple times throughout the night will be impacting your morning BG.
I know @Mel dCP has techniques for reducing morning highs (I think she takes a pre-rise bolus but I am sure she will provide more details).

Another thought is an insulin pump. Is this an option for you?
One of the great things with a pump is the ability to adjust basal by the hour (or less) to address different needs throughout the day such as your morning high.[/QUOTE]
Than
 
Than you for the recomendation ill get in touch with mel ive never really considered a pump not sure why maybe im just to used to injecting for the past 23 years
 
Hi @Melissa 2,
Every time you are woken your body has to wake up and move, which causes adrenaline to rise as part of the arousal.. Your little one is crying, naturally this is an emergency of sorts. Adrenaline causes release of stored glucose in the liver.
You are likely to be on insulin injections which are not specifically designed to easily deal with random adrenaline surges through the night.!!!
After nights of this not only is adrenaline surging periodically but the chronic stress also sets up an increase in cortisol levels, according to my doctors when treating me for another medical condition which affects sleep.
Cortisol, another hormone, makes insulin work less well so more insulin is needed to keep BSLS controlled.
Because your little one needs you you cannot chose to ignore her in any way, so as helensaramay points out insulin pumps can program insulin to be delivered in hourly (some even 1/2 hourly) squirts to better try to provide insulin to meet your BSL rises.
Also there is thing called the Dawn Phenomenon (DP) where our bodies prepare us for a normal waking ( normal for all but mothers and some husband/fathers of little ones, that is!!). This DP starts somewhere around/from/after 4 am onward for some hours, cortisol starts preparing the body to awaken in several hours time and our bsls might rise and again the liver is involved ( not everyone diabetic has trouble with DP).
This is on top of the effect of your periodic/random wakening through the night, not that people automatically wake at 4 am etc but the bsls can rise from about then. Some diabetics have to wake (alarms set) to take a small dose of short-acting insulin at 4amish , others have a pump that has a programmed increase of insulin going in around that time for ? several hours., other wise their morning BSLs before breakfast may be high.
If you have your partner/parents/in laws that could help you have a break from interrupted sleep that could also help .
You will really, really enjoy sleep once your little one sleeps through the night !!!! Fingers crossed that that is soon.
 
Hi @Melissa 2 - I’ve been T1 for 20 years myself, and had a baby since diagnosis, he’s fifteen now. I don’t recall much about rises in the night like you describe, as I wasn’t taking especially good care of myself, so you’re doing great compared to that!

Couple of questions, what’s your insulin schedule at the moment? What basal are you on, and when do you take it? I was having horrendous DP, 5/7 days, and was woken up between 3 and 5 am by a jolt of cortisol and then the glucose dump kicked in, sending me through the roof. So I worked out a sort of sliding scale, and took some Novorapid when I woke at horrible o’clock according to what my BG level was. I was taking a morning dose of Tresiba at the time. I’ve since split my dose, in order to try and squash it a bit - so I take just over half in the morning, and the rest at night, which has reduced how many nights I get woken by it. I’m now finding I go really high late afternoon, and I’m trying to work that one out. I’m hoping for a pump.

However, none of this is particularly useful once you’ve thrown a one year old into the mix! Of course when littlun wakes up, you’ll get a dollop of adrenaline, which will release glucose... you know how it goes. It’s basically your liver trying to be helpful, and for we T1s it makes it triply hard to go back to sleep. Are you in sole care of your baby, or do you have a partner? If you’re not alone at night, maybe try a small dose of quick acting when you get woken and your levels start to rise? Do you have a Libre so you can monitor it? It’ll take some trial and error, and more than a few glucose tablets to get it right, but you may be able to keep on top of it that way. However, it seems like a pump really would be best, even if it’s temporary until you’re getting a full night’s sleep again.
 
Hi my basal is humalin s 13 units in morning and 14 at bedtime i did try giving a correction dose of may bolus humalin i @5 am when i went in to settle little one adlnd noticed my sugars were not great when i woke up for the day but where in single figures which is a start i guess ill have to keep tweaking things and hope she learns to sleep through soon xx
 
Hi my basal is humalin s 13 units in morning and 14 at bedtime i did try giving a correction dose of may bolus humalin i @5 am when i went in to settle little one adlnd noticed my sugars were not great when i woke up for the day but where in single figures which is a start i guess ill have to keep tweaking things and hope she learns to sleep through soon xx
This insulin regime is outdated. Very. I used to be on premixed insulin but not anymore. I use Lantus (soon Tresiba) amd Humalog and after the switch it solved my Dawn phenomenon. Hope this helps. If you don't feel like using a pump, try Lantus plus a bolus (Humlog Novolog Novorapid etc..) and give it some time to settle down then consider a pump. After all, if you want to use a pump, you will be using Novorapid or those bolus insulins.
 
This insulin regime is outdated. Very. I used to be on premixed insulin but not anymore. I use Lantus (soon Tresiba) amd Humalog and after the switch it solved my Dawn phenomenon. Hope this helps. If you don't feel like using a pump, try Lantus plus a bolus (Humlog Novolog Novorapid etc..) and give it some time to settle down then consider a pump. After all, if you want to use a pump, you will be using Novorapid or those bolus insulins.
I agree its outdated but ive had priblems with ceratin types of insulin over the years and the only way its ever been settled is on my current regime obviously minus the dawn phenomenon which i suspect after researching more is due to my constant wakeling in night to settle child on next hba1 check i will ask for more info on pump as it does seem to have so many pros x
 
Hi @Melissa 2,
Thank you for clarifying your insulin type and dosages.
I am uncertain whether humalin S can be used in a pump so you would need to check with your doctor.
 
I will definitely be looking into it
Apologies: diabetesmanagment.com - Insulin pumps - 2014 talks about the various insulins used in pumps and some patients apparently use Regular insulin which is equivalent I think to humalin S. Your doctor will be the one to confirm this.
As you might see in the Pump forum, pumps are not handed out readily. There are some ideas there on how the apply and what may sway the powers that be to accept your application. The two I can think of are: 1) the high bsls which make you unwell and more prone to infection 2) the risk in trying to manage the adrenaline surges with correction doses of your short-acting insulin AFTER the surge has started, can risk you developing hypos, which are a risk to you AND baby.
Best Wishes and LUCK.
 
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