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Reducing morning Help

Discussion in 'Type 1 Diabetes' started by philly1991, Sep 7, 2019.

  1. philly1991

    philly1991 Type 1 · Active Member

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    Hi guys, I was just wondering if anybody has any tips or suggestions on how to reduce before breakfast BG.
    I usually wake somewhere between 6mmol-9mmol but my consultant would like to see lower numbers with a target of 5mmol-6mmol. He has suggested increasing my basal slightly (Tresiba) but I have a strange relationship with my medication and lots of issues around this and an increase always feels like I'm failing somehow so I'd like to explore other options first.
    Could I have a longer fasting period to do this where I eat earlier in the evening? Are there certain foods to avoid later in the day, would this help? What kind of levels do people aim to go to bed at?
    Any advice welcomed :)
    Hope you're all well!
     
  2. karen8967

    karen8967 Type 1 · Expert

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    hi @philly1991 i aim to go to bed between 6/8mmol and like to wake up round the sameim very sensitve to insulin so even an increaase of half a unit of tresiba would see me hypo my consultant said for me to aim between 6/8 for my levels .
     
  3. CathP

    CathP Type 1 · Well-Known Member

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    If you’re aiming to get morning blood sugars of 5-6 mmol then you need to be going to bed between 5-6 mmol, presuming that your basal is set correctly to keep you stable. If you’re rising throughout the night and waking up higher than you wish then upping the tresiba is the answer. It depends what level you’re going to bed at really, as if you’re going to bed at a higher range then you don’t want to up the tresiba and use it to pull you down overnight, as that’s not it’s job. It should keep you stable.
     
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  4. EllieM

    EllieM Type 1 · Well-Known Member

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    And if you increase your basal you'll probably have to decrease your bolus at some point to compensate, so it's not necessarily an increase of insulin.

    But I agree with the others, if the basal is right then your morning reading should be the same as your bedtime one....

    For me, the only way to decrease basal is to either lose weight and/or take significantly more exercise.
     
  5. Kim Possible

    Kim Possible Type 1 · Expert

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    Do you know if your BG is slowly rising through the night or whether it is rising just before you wake?
    If it is a constant rise, I would agree that you need to increase your basal. This is not a bad thing. High BG is a bad thing. The only definition of too much insulin is if you have lots of hypos. There are many things which affect our insulin needs and taking more than someone else is not a failure.
    If it is a rise before you wake, this is Dawn Phenomenon (DP). Again, it is not a mistake you are making with your insulin or your food. It is a very natural thing which happens to most of us (including those who do not have diabetes). Our liver releases glucose to give us the energy to start the day. A healthy pancreas will release insulin naturally to manage the glucose.
    The way to tell is either via a CGM or Libre or to set an alarm in the middle of the night to measure your BG. If you have to set an alarm, I recommend doing it a few times to double check.

    Once, you know what is happening during the night, you can look at sorting it out. Without this information, you risk going hypo during the night if the high is DP.
    If you can rule out DP, this may sound blunt but, you need to realise increasing insulin dose is not a failure and do as you have been told.
    DP is harder to deal with on injections (it is a common reason for using an insulin pump). Some people will set an alarm a few hours earlier than they usually wake up to take a small bolus and then go back to sleep. I recommend getting a Libre sensor so you can see when the rise happens to time that extra bolus if you decide you need to go down this route.
     
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