My morning hypers - Help?!!

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

Enjoy your time in the UK and if you have time let us know how it goes!

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!

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:

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 .

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.