Still no joy with morning readings!!

[nathansdiary]

Ok, I have been having trouble getting steady morning readings. I have tried all of the advice followed on here and really can't think what to do. If I go to bed with a nice normal BS of say 5.5 I wake up super high, might be going hypo so tried going to bed with a slightly higher sugar level (8) still woke up really high. I have tried splitting my lantus both ways (bulk at night and bulk in morning) and I am now getting very frustrated. Do I need to maybe talk to my doctor/nurse about maybe trying Levemir? I know many of you have found Lantus a problem and Levemir better. I am just fed up with this as it is making me feel like **** when I get up and is also going to have a bad effect on my hba1c that I had done on monday (I should get the results back today)

Thanks for any help you can offer. I am fed up of having to correct my blood sugars in the morning, which nearly always consists of super sized breakfast insulin shots.

 

[hanadr]

Sounds like a victim of the dreaded Dawn Phenomenon. there's no simple answer to it.
Research what's known about it and try. AWhat is your carb load like?

 

[nathansdiary]

My carb load is fairly low, Normal day is fruit or scrambled eggs for brekkie, soup + 1 slice bread for lunch, meat/fish and veg for dinner. snacks will be fruit, nuts, a little popcorn. I will only eat richer fruit for breakfast. later in the day I will stay with fairly plain fruit like apples.

I will be bringing it up with my diabetic nurse when I next see her, she's really cool so hopefully will be able to offer some advice. I will keep reading up on the Dawn thing....so so annoying as the rest of the day is so easy to control.

 

[Stuboy]

there's one option you can try mate to find out what's going on... i will be attempting this too on Monday at my appt...

Ask for a continuous blood glucose monitor for night time use. They can hook you up with a meter to use for a week or so that will monitor your blood over night and they then analyse the results when you go back. Over the course of a week or so you should be able to work out what's happening...

Im having a similar problem, i have zero consistancy (other than being inconsistant! lol) in my morning readings.

Dawn phenomenon is a good argument for a pump too i've heard!

 

[nathansdiary]

I have not thought about getting a continuous meter for night time, I will do my best to get one!! I have to be honest and say that I am completely unaware of insulin pumps, I have heard people mention them on here but that is as far as my knowledge goes. All I know is I just want to get this little problem sorted as the rest of it is all falling into place so well.

 

[efaitch]

Luckily, the Insulatard I'm taking is helping really well to keep my fasting levels low (below 5). However, when controlled on diet alone, my fasting levels can go up to about 8.

My diabetes consultant has told me that even the medical professionals don't really understand why this happens. However, he said that they think that it's to do with other metabolic hormones that don't contribute during the night (when sleeping..).

I also find that when diet controlled, my BS rises when I don't eat for a while too.

I think that asking for a monitor sounds like a good idea too.

 

[iHs]

Ok, I have been having trouble getting steady morning readings. I have tried all of the advice followed on here and really can't think what to do. If I go to bed with a nice normal BS of say 5.5 I wake up super high, might be going hypo so tried going to bed with a slightly higher sugar level (8) still woke up really high. I have tried splitting my lantus both ways (bulk at night and bulk in morning) and I am now getting very frustrated. Do I need to maybe talk to my doctor/nurse about maybe trying Levemir? I know many of you have found Lantus a problem and Levemir better. I am just fed up with this as it is making me feel like **** when I get up and is also going to have a bad effect on my hba1c that I had done on monday (I should get the results back today)

Thanks for any help you can offer. I am fed up of having to correct my blood sugars in the morning, which nearly always consists of super sized breakfast insulin shots.

Nathan

Have you tried eating a bit of carb before you go to bed with the Lantus? Sometimes, this is all that is needed to make this basal behave itself during the middle of the night.

 

[nathansdiary]

Ok, I have been having trouble getting steady morning readings. I have tried all of the advice followed on here and really can't think what to do. If I go to bed with a nice normal BS of say 5.5 I wake up super high, might be going hypo so tried going to bed with a slightly higher sugar level (8) still woke up really high. I have tried splitting my lantus both ways (bulk at night and bulk in morning) and I am now getting very frustrated. Do I need to maybe talk to my doctor/nurse about maybe trying Levemir? I know many of you have found Lantus a problem and Levemir better. I am just fed up with this as it is making me feel like **** when I get up and is also going to have a bad effect on my hba1c that I had done on monday (I should get the results back today)

Thanks for any help you can offer. I am fed up of having to correct my blood sugars in the morning, which nearly always consists of super sized breakfast insulin shots.

Nathan

Have you tried eating a bit of carb before you go to bed with the Lantus? Sometimes, this is all that is needed to make this basal behave itself during the middle of the night.

I have tried eating both a carb and non carb snack before bed....I even tried eating a couple of sweets before bed one night out of desperate curiosity. I think I am going to set a few alarms through the night and get a few snapshots of what is happening. I can then take these figures to my nurse and try and use them as bargaining power to try and get a continuous meter to do a more detailed analysis of throughout the night. Over the last week my fasting sugars when I wake up have been between 13-17 apart from one morning where I got a 9.1. This is taking quite a bit of work to correct and most mornings is just leaving me feeling like ****. Lets face it, no-one really likes getting out of bed at the best of times let alone with a sugar level of 17 and all the symptoms that go with it (apart from the huge urge to pee which is probably the only thing that gets me up on days like that ha ha ha!)

 

[DiabeticSkater]

Mornings have been a constant problem for me. I've tried everything....

 

[nathansdiary]

Well this morning is no different....14.4!!!!

 

[hanadr]

One theory for the Dawn Phenomneon that I have read and which makes sense is that it's a survivaal mechanism. The liver dumps glucose into your blood as your sleep gets lighter towards morning, so that even if you haven't eaten, you have the energy to escape predators.
I have no evidencew, but suspec it's why many species,( including us0 are mostt likely to give birt in the early hours of the morning.
That's all interestingf, but doesn't help deal with it.
I think David Mendosa has some stuff on it on his Brilliant web site. Bernstein is bound to have something too.
I suffer from it myself and the only way to counter it ( for me a T2) is to delay my last Metformin until just before bedtime. Which is working! ( morning range 4.4 - 5.4)
You might try asking your care team if you might try having a Metformin at bedtime. this would work for a T1 too as far as I can figure out. It wouldn't do any damage anyway, but could reduce your insulin requirements.

 

[TROUBR]

Hi

Sorry but I have the same problem and have too tried various things. Took night time readings - don't seem to be going hypo but I still then get what I assume to a be a liver dump in early hours - 4 ish and I don't settle until a couple of hours after breakfast.

Please, please let us know what your doctor suggests if you do see them, I will try anything (well within reason!) to sort this!

 

[chocoholic]

That's interesting because for three nights running I woke up feeling hypo at exactly 4 o'clock and each time my reading was in the 9's, so assumed I wasn't hypo. (I thought perhaps I was just overhot but no heating on and hubby was cold!) Last night I made the decision to finally split the Lantus before bed and didn't wake up in the night. My readings have been creeping up every day, so I'm hoping splitting the Lantus will sort this over the next few days. I had no idea changing to basal/bolus would be so tricky.

 

[chocoholic]

Well, I've now had 24 hours since splitting the Lantus and this morning's reading is back to 5.8. It's such a relief. iHs's tip about having a tiny amount of carb. seems a good one too. I had 2 ultra thin oatcakes last night with a smear of cheese spread and a fasting reading of 5.8 will suit me fine. Wish all you others luck with getting that morning reading right. I know how frustrating it is but hopefully you'll hit upon what is right for you very soon.

 

[nathansdiary]

well I had no joy over the weekend so I will be phoning to make an appointment for my diabetic nurse and see what she has to say on the matter. I will report back as soon as I have any news or info. In the meantime it looks like its just a case of carrying on and trying to get it back to normal asap in the mornings.

 

[iHs]

Nathan

Have you tried yet increasing your Lantus up a bit more before going to bed and eating a small snack like 1/2 slice of bread with some cheddar cheese in it? I nearly always do my basal jab about 10pm but I eat the above snack about 9.30pm upon doing a bg test.

None of these basal type insulins are perfect. They can cause problems for people as well as solve them. It can take quite a few days with fiddling about with doseages and carb to get things right.

If you decide to inject Lantus twice a day, then it will take a day or so for your body to adjust to the Lantus so you will most likely have to increase your morning bolus on the first day but after that you will then have to decrease the morning bolus as the Lantus will then be covering you more evenly.

 

[eddiemac]

Hi Nathan

Have you tried changing the time of your evening Lantus? I do 34 Levimir @11pm and 22 at 8 in the morning. I was having exactly the same problem as yourself when I was doing Levimir at 12 hour intervals (7.30/8.00). Seems my body is more reactive to the insulin during the day. I actually ended up increasing my dose from 30 to 40 at night over a 5 day period and that sorted it out.

Heres my average sugars from July to August and then last month! Spot the difference!



I also noticed that when I started rugby training again after a long summer break things started to even out and am now back down to 34 (less when I'm training during the week)

3am blood tests were also suggested but waking me is like trying to wake the dead!!

 

[nathansdiary]

This mornings reading..........

.....5.7!!!!!!!!!!

I don't know how so it is probably just a fluke but I was in shock.

 

[eddiemac]

So Nathan

Think back to yesterday and did you do anything different? Literally could be something as small as using a different injection site!

Think boy think! lol

Ed

 

[nathansdiary]

I had the usual meals....usual amount of exercise.....same injection sites.....same doses.....arrrrghh......I am happy with the reading but I want to know what I did to get it lol. Who knows...only time will tell, hopefully tomorrow will follow suit.