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My morning hypers - Help?!!

pennyjwills

pennyjwills

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Hi,

I'm in the UK and Type 1 and I eat a healthy diet of plenty of veg and protein and I limit bread, potatoes, pasta and rice.

For some reason I keep waking up with blood sugars of 14 or more and its perplexed the diabetes doctor as I inject 5 times a day... 2 big long acting and 3 small short acting and I don't even drink fruit juice. I use soya instead of dairy and always pick unsweetened.

I cant seem to control the morning sugar, its erratic!

Help and advice please?

Thanks

Pen
 
Hi Penny, sounds like your not having enough long lasting insulin to me. If you have a difference of more than 1.6 between before bed and before breakfast glucose readings then change your long acting by 10%.
 
Hi there, I'm not a doctor however this advice is based on info given to me by numerous healthcare pros.
It is possible that your high am BGs are because you have gone hypo during the night and your liver has produced life saving glucose as a result, meaning you wake up high.
It will be wise before making any changes to your insulin to do a check at 3am for a few nights- a bore - I know, and see what's happening.
Please don't increase anything - night time hypos can be very serious - the last thing you want to do is increase your insulin if this is what's happening. :thumbup:
 
I'd second what kt has said. It's always a good idea to test in the night when things aren't right. The affect that kt is refering to is known as the Somogyi Phenomenon. Symptoms of this include:

- Night time sweating
- Cool body temperature
- Restlessness
- Headache/hangover-like symptoms
- Rapid heartbeat upon wakening
- Strange dreams
- Not feeling well rested in the morning

(Taken from Gary Scheiner's Think Like a Pancreas book)
 
Hi Penny!

I agree with KT and Sam. I was finding I was going to bed in the 5s and waking with BG at 8ish. Then I realised if I went to bed in the 6s I was waking with BG in the 5s. 2.30am testing gave me a real shock - 2 nights running my BGs had fallen into the low 3s. I was absolutely convinced that my BGs were rising due to the protein content of my evening meal (I low-carb to around 50g carb a day), but that was clearly not the case - at least not on those two nights. So I'm now planning to do a lot more night time testing. The night time testing is a total pain, but essential before you start adjusting basal doses.

Smidge
 
Thank you! I will try testing in the early hours. A year ago the consultant split my determir to do 40 units at night and 40 in the morning to try and limit the morning hypers. I take between 8-12 units of Novorapid with meals. x
 
Hello, I had the same thing and it was diagnosed as Dawn Phenomenon (Liver Dump) http://www.diabetes.co.uk/blood-glucose/dawn-phenomenon.html I went on to 10 units of Lantus before bed for a few months and it seemed to resolve the problem. I sympathise as it can be frustrating and upsetting having to chase your sugars all day. I hope you get to the bottom of it soon.
 
SamJB said:
I'd second what kt has said. It's always a good idea to test in the night when things aren't right. The affect that kt is refering to is known as the Somogyi Phenomenon. Symptoms of this include:

- Night time sweating
- Cool body temperature
- Restlessness
- Headache/hangover-like symptoms
- Rapid heartbeat upon wakening
- Strange dreams
- Not feeling well rested in the morning

(Taken from Gary Scheiner's Think Like a Pancreas book)
Click to expand...

I am a type 2 and have all these syptoms except the hangover but I ache all over when I get up! I have seen the Doctor because of the rapid heartbeat and the flushes (not hot but pins and needles) and have spent hours in the Cardeology Unit of the local hospital. I test my blood (at my own expense, as a type 2 I have to pay for the strips and prickers in Somerset) and have been told that I manage my diabetes very well. The cardiologist says that my heartbeat, blood pressure etc. is exceptionaly good. Could this be Somogyi Phenomenon that you have described here, as knowing something about it would put my mind at rest.
Sorry for hijacking your discussion.

Many thanks

Tony
 
Definately do a test at 3am ido every night on consultants orders i suffer from severe early morning hypos if ive been training { weight lifting } the day before,i dont believe what kt says is quite right the liver only releases a very small amount of glucose the same ammount as if you were invloved in an accident or shock hence the old saying have a sweet cup of tea after a shock to replenish the liver again,,,,,,,,,,,,,"The insulin continues to move the glucose into the body’s cells. The liver doesn't start releasing stored glucose (remember, it only does this when it senses your insulin levels are low). So, your blood glucose level keeps going down and can soon be dangerously low. The liver does not correct your low glucose."
Humaject type1 44 years
 
Hi humaject (and Penny!)

My concern for the post originator, Penny, was that she may be having nocturnal hypos she isn't aware of. The liver will release stored glucose - up to 40 grams because of this. It can save your life but also results in a 'false high'.

Dawn phenomenon is thought to increase the blood sugar by around 10% at most - according to the latest Canadian research (quite a lot less than was originally thought). This is a glucose boost due to the sun-rising that we inherit from cavemen, and is designed to give us the ability to go and chase our dinner!

They are two similar but different phenomenon with two varying effects.

It is also worth remembering that if your liver has produced a larger amount of glucose as a result of hypoglycaemia / glucagon that at some point, your liver will take that glucose back so you may experience another hypo.

If Penny's BG is reaching 14 on waking, (provided it was below around 12 .8 when she went to sleep) I think it is possible this may be caused by hypoglycaemia that she has slept through.

I just didn't want her to take more insulin - this could be very dangerous indeed! :D
 
Hi, thank you all for your help and suggestions! I've spent 2 days of testing and I reduced my night time insulin from 40 units to 30 units and this morning I woke with a 6.6! :P I also took my night insulin earlier at 8pm instead of 10pm.

I tend to sleep very deeply for 7-8 hours every night but the last couple of nights I managed to wake myself up to test. On Monday evening I tested before bed 9pm and I was at 7.4 and when I tested at 1.30am yesterday morning it has already risen to 10 then I tested again at 6.30am it was up to 15.

Today is a good sugars day today! :) It's so hard to control sugars through the day when you wake with stupidly high tests! :?

I've been type 1 since my teens and I'm in my mid 30's now so I was afraid it was earlier than expected hormonal changes that us women all dread. I already have PCOS so I didn't want more problems!

:)

x
 
Penny - I sent you a PM (Just thought I'd mention as I'm new to this forum too and am not sure if you would have noticed. Of course, no worries if you don't have time to reply - that's cool!) :wave:
 
Thank you all! I've been testing all day and will do the same tomorrow. Managed to stay under 9 all day! Yay! Will try to test in the early hours to see if theres further change. Xxx
 
I've been googling and apparently the way I eat is the Okinowan way... The Rainbow Diet with only colourful veg, lean veggie protein and soya :) so diet wise I do everything right and if I can suss the night hypos and dawn phenomenoms with changing my insulin then I will be sorted! :)
 
I've been googling and apparently the way I eat is the Okinowan way... The Rainbow Diet with only colourful veg, lean veggie protein and soya :) so diet wise I do everything right and if I can suss the night hypos and dawn phenomenoms with changing my insulin then I will be sorted! :)
 
Hi Penny

I'm with KT on this, I have found over the years that my liver does a heck of a dump of glucose when I have had night time hypo's, thank goodness. I had loads of these when I was on Lantus. Since my change to Levemir they are a thing of the past.

I do know from experience that a liver dump is MUCH harder to get rid of ( ie to get BG back under control) than a rise from food. I used to find, like you have mentioned that my control the next day was erratic because of the amount of extra insulin I needed to counteract the liver dump, this was confirmed to be common by my DSN too, so my correction dose ratio's were nil and void when it came to high morning glucose levels due to night time hypo's. And like you I roller coasted the next day.

it really is a must to test throughout the night, as not only do we get the liver dump possibly because of going low, we all have different strength DP's , Some Diabetics get a big Cortisol dump along with the glucose so get very high morning sugars without ever going low.

I did weeks of testing 4/5 times a night for a whole month, basically throughout my Cycle to see what was really going on, a pain but vital for me. I could have got hooked up to a CGM but could only have it for a week and I wanted to see BG fluctuations throughout my Cycle, as Hormone fluctuations change things so much for us Ladies who still ovulate. Well some of us.

You have the double whammy with the PCOS ,so it can't be easy as I'm sure you will have a good degree of insulin resistance. Its not easy at time's with Type 1 and even harder being a chick with it! hormones eh :roll:

hope it all settles for you .
 
Yep hormone imbalances aren't good. Kept sugars to under 9 today too :)

Think I've sussed it for now but I bet my hba1c will be rubbish in december.

I reduced night dose to 30 and took it earlier and made sure my novorapid only brought my post dinner sugars to between 7-9 instead of 6-7.
 
Hi, I am having a simular problem.

I am struggling to keep my levels right, below is a typical day to give you an idea.

I have done the DAFNE course and have carb related insulin doses for each meal, 1:1 at lunch and dinner and 1:1.5 at breakfast (correction doses are 1 unit of insulin to bring reading down by 2) I have 2 background insulin doses of 14 units at 10:45 am & pm

Before bed: 8.3
Before breakfast: 14.7
Breakfast of 6 carb points and 9 units of insulin with a correction dose of 4, should bring me down to 7 ish
10.45am: 22.3, background dose of 14 units and corrections dose of 7 should bring me down to 8 ish
Before lunch: 8.3
Lunch of 6 carb points and 6 units of insulin
Before Dinner: 9.7
Dinner of 14 carb points and 14 units of insulin without correction as sometimes I drop overnight
Before Bed: Background insulin of 14 and reading of 9.8

Typically this would suggest that my PM background insulin needs increasing but when I tried this I had hypo’s overnight or in the morning.

I am at a loss now as everything I have tried (short of extra doses) does not work.

It also seems that if I do a correction dose at the same time as one for food it does not work. I have to do them separately. Anyone know why this is?

I'm also very tired all the time (so maybe night hypo's, will check if I can wake myself up) but more so at 2pm everyday, I literally cannot keep my eyes open at this time and on my days off all I do is sleep.
 
Hi Zoe, sounds like you're having the same issues as me and have been trying to control the morning highs with rapid insulin.

I woke with a flukey 12.1 this morning despite having same readings and insulin for last couple of days when I kept it under 9.

I'm doing regular testing now and I'm going to plot it, my insulin units and carbs onto a chart to take to my consultant in december as these erratic sugars are killing my health and social life as I too am so tired all the time, all I do lately is work and sleep.

Pen
 
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