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Suggestions for morning blood sugar spike?

Discussion in 'Type 1 Diabetes' started by hannahkat, Sep 22, 2020.

  1. hannahkat

    hannahkat · Newbie

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    Hi all,
    Probably been posted many a time but can anyone give me some ideas why my blood sugar spikes so high in the mornings having not eaten anything?

    For example, today I woke up about 8am and my blood sugar was 10.1 mmol/l, it has just gone 11am and I haven't eaten/drank anything and yet I've skyrocketed to 18.7mmol/l.
    I'm regularly experiencing this type of spike regardless of what I've eaten the night before. I usually don't eat until 2pm ish the next day.
    I'm T1 on MDI (Tresiba and Novorapid).
    Usually eat last meal quite late (9pm-10pm) due to work etc. but eat earlier if out or visiting parents (ate about 6:30pm last night at partner's parents) and same spike happens.
    I have my Tresiba around 8-10am (21 units) every day, I have tested upping this dose but just end up with low blood sugar. I've tried adjusting ratios and going carb free for base line but I just end up with low blood sugar when messing with dosages so I don't think that is the problem.
    I'm on 1:1 ratio all day.

    Any ideas? Is the answer staring me right in the face?

    Many thanks :)
     
  2. hannahkat

    hannahkat · Newbie

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    I know everyone is different but any rough guesses appreciated :)
     
  3. ert

    ert Type 1 · Well-Known Member

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    I don't eat until 3 pm as I'm intermittant fasting. I take Levemir twice a day and correction of 2 units of fast-acting on rising to cover my coffee and cream (not that coffee should need covering so it could be the morning spike too which is what you're finding.)
     
  4. Antje77

    Antje77 LADA · Moderator
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    Sounds like 'foot on the floor effect' to me.
    Many of us experience this, some of us in a very predictable way, others only some days.

    Upon waking your friendly liver thinks it's being helpful by giving you a boost of energy to get you going for the day. Liver does this by dumping glucose in your bloodstream.
    Being a T1, you cannot use this glucose for energy without insulin, so it's pretty useless. But your liver doesn't know that.

    Some people find it helps to eat something, others prefer injecting for it. People on a pump can adjust their basal rate for this time of day I believe.
     
  5. MarkMunday

    MarkMunday Type 1 · Well-Known Member

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    Tresiba is good for providing flat basal insulin action over the 24 hour cycle. But if insulin requirements increase in the morning, which is not unusual, there will be a spike. A shorter acting insulin like Levemir injected twice a day may help deal with this. It provides more flexibility in catering for changing basal insulin action needs over the 24 hour cycle. Supplementing Tresiba with an early morning bolus of fast or rapid acting insulin may also do the trick. I use Lantus and Actrapid first thing in the morning for this reason.
     
  6. ROE100

    ROE100 · Member

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    I sometimes have foot on the floor so i test when I wake and test again when fully up and moving if on the rise and not planning to eat breakdfast then i will give myself a unit or two depending on how quickly I am rising. But everyone is different including yourself as i don't always get foot on the floor. However this normallly brings me back to normal and flatish line on blood testing so agree with MarkMunday - also on Tresiba, but testing is the key if you opt to give yourself a unit.
     
    • Agree Agree x 1
  7. SueJB

    SueJB Type 1 · Well-Known Member

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    Hi @hannahkat this phenomenon was the first thing I noticed after diagnosis. It happens to me every single day without fail. I have my evening meal around 7 and don't eat lunch until around 12.30 the following day. I correct with a bolus.
     
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