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Morning Highs?

T

toastlover

Active Member
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Hi everyone, I'm having a real problem with high morning sugars and don't really have a clue why it's happening!

For the last couple of nights I've been around the 7 mark before bed which is normal for me but then in the morning my bg has been almost double that!

I'm T1 and take a split dose of Lantus - 16 morning and night, then Novorapid with food.

I'm not eating before bed so it isn't that. Any ideas?

Thanks

Tina


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I suppose it's the liver rush. If you don't eat for 5 or 6 hours the liver provides sugar. I am a T2 and am not initiated into using injected insulin but I guess that something is making your body think that it is hungry and causing it to supply its own sugar.

This liver rush does not occur if you have a hangover until the liver is finished dealing with the alcohol. This causes some people to take the wrong amount of insulin.

Well, at least we know you are sober.
 
Sound like your Lantus needs increasing to me. If your overnight levels change by more than 1.6 mmol/l then you need to change your Lantus by 10%.

Could be that your levels are dropping in the night and your liver is producing glucogen to counteract this. So best to rule that out before increasing your Lantus. Do a couple of tests in the night, say at 1AM and 3AM to make sure you are not going hypo.

My money is on the Lantus dose though.

Its a bit of a myth that basal insulin (Lantus) doses are static. I change mine all the time according to when I last did exercise. Others change it with the seasons.
 
Hello

Do the 3am test as suggested above at least 3 nights in a row
It may be you are affected by the dawn phenomenon where your blood sugars rises in the morning. I definitely suffer from it. Read in this website about it, at least it could be something to rule out
 
Hi, I am currently battling the same at the moment although having no luck with fixing it. I also get affect by the dawn phenomenon, doing test between 1am and 3am like said above will help to let you know this too.


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Dawn phenomenon is a real curse. The problem with Landis and levemir is that they were developed with flat action. They can't cope with a spike in BG at 4am. I have had no end of consultants agree this is my problem. Unfortunately, they have all said I need to wake up during the night and take novorapid! The latest one agrees a pump might fix it. I am crossing my fingers...

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Hi Kangoo there are other ways to help with the dawn phenomenon. I stopped with the lantus and now take humalin I have done for 3 years as this has a peak in it the problem with it is that it needs too be take later at night but it was working for me taken it at half 10. Just does seem to be helping me at the moment.

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So I tested at 3am this morning and my bg was at 6.2. At 7.30am it was 10.4

So, I'm guessing this is dawn phenomenon?

Do you recommend I try and get a slot with my DSN to discuss changing basal? I'm certainly not prepared to wake at 3am every day to take Novorapid!


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I was given a different basal insulin to try, insulatard I think? Problem was the peak action gave me night hypos before my dawn phenomenon kicked in. I was taking it between 11-12pm.

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Sounds like the Dawn Phenomenon to me. In Gary Scheiner's Think Like a Pancreas book, he talks about a medium-acting insulin that can be used for this kind of think. Maybe Insulatard is this as mentioned by Kangoo. The other alternative is to have a pump so that it can be programmed to increase basal rate when the DP kicks in.
 
 
Try setting your alarm for say 2.30 and test your blood , this may tell you if you are having a hypo through the night , you might have to eat before going to bed!
 
Hi, I'm with SamJB, I also suffered DP for a long time as well as many night hypos and comas. I'm now use a pump and results are much better. You may need to battle for a pump though, but you must ask for one and insist. It will make the world of difference. Eating before bed might help if you are hypo during the night, but it won't help with the DP. Go see your doctor and ask about a pump. Good luck and let us know how you get on. :thumbup:
 
Glad you tried the night time test. What I do at the minute to try and stop the continual increase is take a couple of units of my fast acting once i get up even if its in target range. My DSN said this was fine and it works for me especially if not having breakfast. I can wake up at about 7.2 and half and hour later be 15!!! Pain in the behind!!!


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Hi toastlover,

I've been battling the exact same curse that is dawn phenomena for the past few weeks. The past two days though I think I've finally cracked it. I've been on an insulin pump for a year now and it takes a while before you can get all basal rates exactly how you need them.

Last year I had the privilege of trying a CGM for two weeks. What I determined was at around 4am my blood sugar would rise, leading to a reading above 10 in the morning. In the past when I was on injections I found increasing my lantus injection only caused me problems with low readings at 1/2am (and seizures). Now on pump I've finally managed to get a perfect setup of basal rates.

I now have 0.375units from 12am to 4am and then this is increased to 0.775units, until 7am when its back to 0.375. The past few days I've went to bed with a BG of 6/7, then woke at 4am with the same reading and then at 7am near enough the same.

I really think you should try and get an insulin pump, I find it gives me much more freedom in my life. I'm on Twitter if you need to chat, I've been posting my BG readings pre-sleep and pre-breakfast.
 
Dawn phenomenon is the issue - I only cracked it when I went on a pump.

Prior to pump if I pushed my long lasting up enough to stop the morning high I went too low at 1-2am and had night time hypo's.

Another option that some use is the split the nighttime long lasting and use a shorter one that kicks in just before you wake up - around 4am but its hard to manage with splits like that - I tried but it also didn't work for me.

Chas
 
This is brilliant (sorry folks) I also have ridiculously high BG most mornings, it settles by lunch and is generally fine for the rest of the day but it worries me, on the rare occasion I get up and have a "good" reading I am positively jubilant, I have done the 3am tests and all is well, my DSN tells me not to increase my levemir as she thinks I take too much as it is, has anyone had this phenomin and solved it? Would love to hear how
 
Yep remember it well, and its very true a high % of even non diabetics body's liver produces glucose naturally in the morning to kick start the day. I personally had the opposite problem as when drinking at night and my lantus working for 24hrs-basically I hypod when sleeping. The answer was INSULIN PUMP and never looked back.
 
So, I went to see my DSN and basically it is DP and bar getting a pump (which might be an option) there's little I can do except take some rapid insulin on waking which is what I have been doing anyway.

With 3am levels around 6 there isn't much margin for increasing my evening Lantus dose -I already split my dose.

So, maybe a pump is an option for me. Not sure how I feel about a pump.


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So, I went to see my DSN and basically it is DP and bar getting a pump (which might be an option) there's little I can do except take some rapid insulin on waking which is what I have been doing anyway.

With 3am levels around 6 there isn't much margin for increasing my evening Lantus dose -I already split my dose.

So, maybe a pump is an option for me. Not sure how I feel about a pump.


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