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Sudden Rise in BG on waking

Discussion in 'Type 1 Diabetes' started by LionChild, Apr 9, 2022.

  1. LionChild

    LionChild LADA · Well-Known Member

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    I was diagnosed with type 1 in May 2019.
    Recently, my waking up BG according to Libre has been very high. This morning, breaking all records it was 10.5. It seems from finger pricking that this high reading from LIBRE is probably about 1 mmol higher than the finger prick results. Since I have had nothing to eat or drink since 18.30 yesterday, to wake to such a high BG (with libre or with FP), can only be to do with the Glucose being thrown out by my Liver? Is that correct? Does anyone know why this might suddenly be happening at such a high rate now? I am assuming this is not the end of the so called Honeymoon Period, since it does not seem that the rise in average glucose is to do with the need for more insulin for food intake, only to do with the glucose being shoved out by my Liver. I usually take 5 units of Levemir on waking up, and for most meals which are salady stuff, (usually with animal protein)I take between 1-2 units of Novorapid.
    My last A1C was two months ago, and was a happy 41, but I suspect that will be higher when it is is taken next time.
    Does anyone have any ideas why I am experiencing this sudden rise in BG on waking in particular?
     
    #1 LionChild, Apr 9, 2022 at 6:58 AM
    Last edited: Apr 9, 2022
  2. Rokaab

    Rokaab Type 1 · Well-Known Member

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    I believe many of us suffer from some kind of dawn phenomenon or foot-on-the-floor problem, I know I suffer from DP, mine could go upto about 14-16 by the time I woke up (and I could see the rise started at 3am on the libre - before that time in the morning it was normally heading very slightly downwards).

    And yes it was just my liver being "helpful" and preparing me for the day.(some preparation that was lol)
     
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  3. In Response

    In Response Type 1 · Well-Known Member

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    Do your levels rise gradually through the night or start rising early morning?
    The great thing about Libre is that the graphs will tell you (if you exclude compression lows).
    If yo see a gradual rise, it is likely that you do not have enough basal insulin.
    If they start to rise from early morning, it is more likely to be Dawn Phenomenon.

    i find my DP is less pronounced i& I exercised in the last 48 hours.
     
  4. LionChild

    LionChild LADA · Well-Known Member

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    Hi In Response,
    BG seems to rise just before or at about 3 am....So maybe 5 units of Levemir in the morning are not enough? bg eigth and ninth april 2022.jpg
     
  5. In Response

    In Response Type 1 · Well-Known Member

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    That looks like a continuous rise from 9pm until 7am.
    I don’t see a sharp rise at 3am. The trend does not get any steeper.
    Dawn Phenomen would be very prominent
     
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  6. LionChild

    LionChild LADA · Well-Known Member

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    So in your view I need more basal insulin, or maybe to split it?
     
  7. derivadow

    derivadow Type 1 · Well-Known Member

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    @LionChild if you haven’t already you might benefit from running a few fasting BG tests to check your basal dose is correct and correct at different times of day.
     
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  8. LionChild

    LionChild LADA · Well-Known Member

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    Well, I never eat breakfast but BG continues to rise often beyond midday when I have had nothing to eat and nothing to drink at all....!
     
  9. derivadow

    derivadow Type 1 · Well-Known Member

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    It sounds like your basal insulin needs tweaking. Looking at what your fasting BG is doing at other times of day will help you work out what to do.

    Also worth remembering that extended periods of fasting can also affect your BG.
     
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  10. becca59

    becca59 Type 1 · Well-Known Member

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    Try eating something. I have a spoon of full fat yoghurt to help trick that pesky liver on the days I swim and eat breakfast later. A spoon of yoghurt and a unit of insulin helps keep me level until I get my breakfast. This is the problem with type 1, just because we don’t eat, it doesn’t mean we are not going to have a rise. It is far more complex than just food.
     
  11. Jaylee

    Jaylee Type 1 · Moderator
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    Hi @LionChild ,

    what time do you usually do your basal in the morning?
     
  12. LionChild

    LionChild LADA · Well-Known Member

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    Hi jaylee, I inject the basal somewhere between 7 - 8.30 am..
     
  13. ealingr

    ealingr Type 1 · Well-Known Member

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    It has been a while since I was on basal bolus, but I seem to remember experiencing something similar. What I think helped was changing the time of my basal injection from morning to evening. Have you considered giving that a try?
     
  14. ert

    ert Type 1 · Well-Known Member

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    I take Levemir and it does not last 24 hours which is supported by my Diabetes Specialist. I take Levemir in a split dose ie twice a day - waking and bedtime. If I did not take my night time dose, my blood sugars rise overnight. Discuss this issue with your specialist team.
     
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    #14 ert, Apr 16, 2022 at 8:02 AM
    Last edited: Apr 16, 2022
  15. Chas C

    Chas C Type 1 · Well-Known Member

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    This as others have mentioned is called the Dawn Phenomenon and is very common. You can try splitting your long lasting into two 12 hour does - something like 8am and 8pm with 50% of current dose for each, then adjusting to see if the balance is right to reduce the morning highs, but see your dose is pretty small at 5 units so that might not be so easy. I had this and the only working solution for me was to move to a pump, after maybe 30 yrs trying to fix it.
     
  16. StewM

    StewM Type 1 · Well-Known Member

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    This was exactly my experience with Levimir also.
     
  17. JustLucky

    JustLucky Type 1 · Well-Known Member

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    I have the same experience, my night time glucose numbers are much better after exercise. Even longer than 48hrs
     
  18. LionChild

    LionChild LADA · Well-Known Member

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    So, thank you for all those who responded to my query about high BG in the morning. (often in the 9s). I adjusted my Levemir up by .5, and then the BG levelled out and was more like 8 mmoles than 9, on waking up.

    But another odd thing that has only happened in the last few days is that my BG now starts off at a reasonable 8, or thereabouts, and then actually goes up until around 2 pm! (that is with 5.5 Levemir, and 1 unit of Novorapied - I do not eat anything or drink anything for breakfast ..except water).

    It then starts dropping, but means that I eat lunch much later than I would like to...

    This is really quite a surprise as in the past, BG has always flattened out quite nicely in time for lunch at around 12.30. Now, why would that be happening suddenly?!
     
  19. StewM

    StewM Type 1 · Well-Known Member

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    Well it certainly sounds you need more Basal as you’re essentially using Novorapid as a Basal replacement, if you’re still taking it when you don’t eat. If your Basal dose was sufficient you wouldn’t need Novorapid in the absence of food.
     
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  20. Hertfordshiremum

    Hertfordshiremum · Well-Known Member

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    Hello
    Firstly I found and still find patterns change quite often, I am 4 years in. Secondly Levemir does not last 24hrs, more like 18 hrs so a lot of people split the dose, morning and evening to keep you steady all day. Are you doing this? If not ask your diabetic nurse. Lastly eating nothing until lunch may encourage your liver to try and ‘help’ by kicking out glucose so try a carb free breakfast maybe scrambled egg or a couple of spoons of plain yogurt and see if that improves things?
     
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