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Morning highs.

E

EddyB

Newbie
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4
Hi All,

I am a 29 year old male type 1 diabetic of 15 years. I have for the last two days running woken up with very high bm readings, even though my pre-bed test results have been within range. Specifically 6.4mmol/l at 11.40pm to 18.8mmol/l at 7.15am. And 5.4mmol/l 11.30pm to 15.6mmol/l 7.00am.

I had eaten around 7.30 - 8pm both evenings, around 70g carbs in pasta with bolognese (yes both evenings!) but the pre bed test show that my bm should have stabilised by then (at least 3 hours later). I can't figure out why my morning bm would have been so high. I don't have any illnesses or infections (that im aware of), I hadn't changed my exercise habits, I'm pretty sure I dont sleep walk (and no food was missing from my cupboards) .... no idea!

Has any one else experienced this? Or could anyone offer an explanation?

Many thanks in advance,

Ed
 
Hi Ed and welcome to the forum!

One potential issue is a Somogyi rebound, where you go hypo without feeling it (or in this case, without waking up) and your body's adrenaline response kicks your sugar up quite high. If it keeps happening you can try setting an alarm once or twice in the middle of the night and testing your sugar.

Another possible issue is that your long-acting insulin has gone bad (e.g. froze in the fridge or was left in the sun or is just too old) so it doesn't work properly. Or perhaps you've injected into a fatty lump which means the insulin does not deliver at the normal rate. You can always try a new insulin pen to check.

Seeing as you ate the same thing both nights, MAYBE there are some hidden carbs in the bolognese? Or its fat content is delaying digestion so that you are still digesting the meal well after your rapid has worn off?

Or, you may never find out. Diabetes can be affected by all sorts of things and sometimes we never work out why. My diabetes has a mind of its own, and I adjust my dosages constantly to follow what my body needs as best I can. My Lantus dose was 10 three weeks ago, then due to lows in the morning I reduced it over and over until it got to 3, and since then I've had to take it back up to 6. I think it's either hormones or some sputtering residual insulin production. Hopefully in your case it'll either get back to normal or you'll find the cause, but if not, don't let it worry you, just adjust to it.
 
Thanks mentat.

The same thing happened this morning so I really do need to figure it out. I have always been fairly sensitive to hypos and wake up when ones is coming on (weirdly I dream about food just before I wake up!), but maybe my sensitivity has gone, or I'm sleeping more heavily?! I will check my bm in the middle of the night tonight and see if that is having an effect. I was wondering about the lantus so I will change that this evening too.

Thanks for the advice, and I'll let you know if I find the answer!
 
Hi. Is it possible that your Basal units are a bit low? I realise this appears to be a new problem but I'm wondering whether your Basal needs have been creeping up anyway? What is you target for Basal fasting reading? My nurse suggests between 5 & 7 mmol.
 
Hi Daibell,

I'm not sure what you mean by basal fasting reading? You may be right about the lantus dose though as I am not hypo-ing nearly as much as I did a few months ago. This may be because I've had to cut back on exercising due to a back injury. My current dose is 20units of lantus a day.

Cheers
 
Yes, I meant the Lantus dose. It's not for me to suggest you change your units but if, in the morning test you aren't typically between 5 & 7 mmol you might want to discuss a change with the DN?
 
The change in exercise could definitely be contributing. Your level of exercise has an impact on your metabolism which can have significant impact on your sugars. The injury itself may also be having an effect (BG may be higher due to tissue repair, or stress caused by pain, etc.).

I take Lantus at night and always adjust my Lantus dose based on my fasting (morning) reading. It works pretty well for me. But be aware that:
-Lantus is not a strictly 24-hour insulin. It actually gradually declines over about 3 days. So if you increase your Lantus it may take a few days to see the full effect. Handle with care. I usually find that if I increase my Lantus from say 6 to 9 over a couple of days, it will then need to come back to 8 or 7 the next day.
-Since Lantus acts all day, your bolus dosages may need to be adjusted too. When increasing Lantus, do extra tests after meals to help prevent hypos.

One final word - the ideal (though not necessarily achievable) Lantus dose is basically one that keeps your sugar flat for most of the night (most people's sugar rises in the morning, but there's not much you can do about that without a pump). This way you can get maybe 6 or 8 hours of good sugars with almost no effort, which is great for your HbA1c. Keep that in mind if you're getting up to test your sugars in the middle of the night.
 
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