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Pre Bolusing In The Morning....sugars Still Rising!

I

Indy1282

Well-Known Member
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Hello. I've been type 1 since February ( diagnosed on my birthday! ) I'm doing ok and I pre bolus for all my meals which works well.
I am having a bit of trouble with morning rises though. I can be a good figure when I wake up but even when I pre bolus for say 20 mins before eating I'm rising right up in to double figures before i have dtarted eating! I've tried not eating breakfast as I don't really get hungry in the mornings but I'm still getting a rise ... Any tips or ideas? I eat natural yoghurt with nuts and 10g of granola every day which works out to be 20g of carb.
 
It sounds like a variation of the "dawn phenomenon". I have the same problem - bgs rise as soon as I wake & start moving around.
It sounds illogical but eating settles it down, so in my experience not eating breakfast doesn't work.
That was a rotten birthday present!
 
Hi @ Indy1282,
As @ DunePlodder suggests it could be theDawn effect or phenomenon.
With me in the early morning say from 4 am, my body produces 'wake-up' hormones, things like cortisol (steroids) which actually increase resistance to insulin.
If my basal (like long-acting insulin) is giving good waking BSLs, it means that I am at least countering the initial effects of the "Dawn' but I need a higher bolus (insulin per carbs) and taken earlier before breakfast compared to evening meal.
I am prescribed Novorapid, but there are short-acting insulin that work even more quickly).
It may also be that the honeymoon time, when after diagnosis one needs less insulin than later on, is passing for you, so that more insulin might be needed.
That is just a thought and that plus the thoughts above need to be discussed with your dsn and doctor to work out the best way forward.
Good Luck and may you succeed splendidly!!
 
I would say it is DP. It may be that you need more bolus than you think first thing. Ratios can vary throughout the day. At night your ratio may be a lot less. Continue to pre bolus preferably whilst sat in bed, as moving about exacerbates the problem and always eat because as @DunePlodder says eating helps.
 
Indy1282 said:
Hello. I've been type 1 since February ( diagnosed on my birthday! ) I'm doing ok and I pre bolus for all my meals which works well.
I am having a bit of trouble with morning rises though. I can be a good figure when I wake up but even when I pre bolus for say 20 mins before eating I'm rising right up in to double figures before i have dtarted eating! I've tried not eating breakfast as I don't really get hungry in the mornings but I'm still getting a rise ... Any tips or ideas? I eat natural yoghurt with nuts and 10g of granola every day which works out to be 20g of carb.
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It's called "feet on the floor" phenomenon, it's part of the dawn phenomenon where your liver starts dumping its glycogen stores the minute you start moving around to give you energy for the day. It's a throwback to the caveman days when humans needed energy to hunt I read somewhere. Either way, you need way more insulin than you normally would need in the morning, and pre-bolusing alone won't stop it. I take a unit the second I get out of bed, whether I'm eating or not, and even that isn't enough sometimes. What basal are you using and how do you take it? Lantus and Levemir don't really last 24 hours and probably won't match your higher basal needs in the morning the way a pump could be programmed to for example. Many people split Lantus or Levemir and take more at night to help cope with this.
 
DunePlodder said:
It sounds like a variation of the "dawn phenomenon". I have the same problem - bgs rise as soon as I wake & start moving around.
It sounds illogical but eating settles it down, so in my experience not eating breakfast doesn't work.
That was a rotten birthday present!
Click to expand...
Hi @DunePlodder,
I wonder if the finding of carbs helping to lessen the effect of Dawn effect is die to carbs + insulin?
 
Thanks for the replies ☺ I take Abaseaglar in the evening, at 10pm ish.

Interestingly I tried fruit and double cream for breakfast the last few days and not had crazy spikes at all!!
 
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