New to the site - not so new to diabetes

[meeshathecat]

Hello there can someone help me! I am a type one diabetice and I am having major problems with my sugars in the morning, it doesn't seem to matter what I do with my insulin regime, I am waking up high and its doing my head in! Has amyone else had expeirience of this? For example last night before bed I took an extra 5 units of lantus and 5 of rapid, my bloods were at 11 but I woke up at 18 . I have always been one of those people who fell over night but now that doesn't seem the case. I've also started having hypo fits and my blood has been 1.6, 1.4, 1.6, 1.8 at various times this week - too be honest Im just worried and my diabetes team don't seem to have any answers

Any advice you could give me would be massively appreciated

 

[fergus]

Hi meeshathecat,

It sounds like you're having a really rough time of it there. Has any other aspect of your routine changed in any way; your exercise, diet, stress levels, work, illness etc.? The highs and lows you describe can become something of a 'negative feedback loop' when one thing goes awry, extra insulin chases down the high blood sugar and you can end up chasing your tail.
Can you think about anything which might be contributing to the cycle?

All the best,

fergus

 

[hanadr]

That all sounds quite maddening.
I have no personal experiences like this. I'm a T2,
But I do get BG going up overnight. I can't stop it either.
The only thing I know that helps wildly changing BGs is to follow "Dr. Bernstein's complete Diabetes Solution" and his " doctrine of small Numbers".
Have you read it?
If you Do try that route, it can't hurt you, but might just help

 

[meeshathecat]

That's low carb isn't it?

 

[hanadr]

Yes Bernstein is pretty low carb, but he has a lot of experience with loads of patients over decades, so It has been well tested. He does show insulin users how to work out the right dose.
Have you had a problem with low carb?

 

[meeshathecat]

yes i have but then to be honest Ive had a whole host of food problems

 

[meeshathecat]

Do you think it could be to do with the fact that I tend to exercise later in the evening?

 

[fergus]

Ah, I think you could be onto something there.
Exercise can raise blood sugar through the release of stress hormones. It also wakes up insulin receptors on the cell membranes which is why blood sugar can drop quite a bit later on.
So, if you have exercised and your bs has gone up, then taken extra insulin but found your bs falling very low much later, this might be a part of the problem.
Just like an episode of 'House' here!

All the best,

fergus

 

[meeshathecat]

Ok so - I didn't do any exercise yesterday evening and despite shooting 2 units of rapid I still woke up higher than I went to bed, I also checked my blood around 4 am and it was on the increase not decrease!! I changed my vial this morning to see if maybe it's a faulty batch of Lantus - here's hoping that's what it is - Any other suggestions?

 

[fergus]

Hmmm, does sound like a Lantus issue, doesn't it?
A new vial might do the trick, otherwise perhaps you need to adjust your dose. Do you take your Lantus in one single dose, or split it into 2 separate ones, out of interest?

All the best,

fergus

 

[meeshathecat]

I take in one dose in the morning - this thought had occured to me however and a few days I gave myself a little extra lantus at bed and it was higher than ever - woke up at 33 :cry: which is the worst result Ive ever had.

 

[LittleSue]

I take in one dose in the morning - this thought had occured to me however and a few days I gave myself a little extra lantus at bed and it was higher than ever - woke up at 33 :cry: which is the worst result Ive ever had.

Sounds to me like you've slept through a hypo, and your liver has dumped glucose as a result. They always say you'd wake up if hypo at night, but I'm living proof that some don't. When this happens it affects daytime control too. If this is happening,increasing the dose will start a vicious spiral.

You don't say what your actual doses are, but 5 extra Lantus and 5 rapid seems a big change in one go. If you weren't going hypo before, the extra could make you do so.

You could ask for a continuous glucose monitor for a few days, otherwise just take your normal dose, set an alarm and test your bs every 1.5-2 hours through a night to see the trends. Not much fun but educational!

Some find it best to split the dose into two (not extra at bedtime, but start with roughly half current dose in the morning and half at bedtime, then adjust each as needed). You may need one dose quite a bit higher than the other.

Very annoying I know, this happens to me sometimes, but I've learned its best to test rather than assume what's happening when I'm asleep.

 

[fergus]

I think the split dose suggestion could be a good one for you. I've seen it reported that Lantus can have an action as short as 18 hours for some people. It certainly doesn't work for 24 hours for me, or many others.
This might be the most obvious explanation for your toboggan ride. Your morning dose is lowering your bs during the day, but by early the following morning, it has run its course. No basal insulin equals high bs numbers.
I would guess that if you split your dose between morning and bedtime, the peaks and troughs will even out quite a bit. Then it'll be down to fine tuning the doses to get things sorted.
Worth a try?

All the best,

fergus

 

[meeshathecat]

Yeah definitely will try and speak to my team today to see if they OK that. I have also just found out today that I have hypothyroidism so maybe thats got something to do with everything.