That Old Chestnut - DP vs Somogyi Effect

[Paulaah]

Good Morning all,

(I'm Type 1 newbie diagnosed Feb this year, aged 39. Taking Apidra and Lantus and trying low carb approach.Eating around 80g carbs a day. HBA1c 3 months after diagnosis - 8.1. Was 12.3 when diagnosed)

I've been reading previous threads regarding my question to try and help myself, but wondered if anyone could help me out any further.

I've been very stable over last few weeks after tweaking background insulin, and I do about 2 carb free test mornings each week to make sure it's still doing its job. All seems well on this front, making my short acting easier to predict in conjunction with a low carb diet. Bedtime and waking readings are all pretty steady as a result.

Last night I went to bed on 6.7, and this morning I woke up on 10.3. So, my theories are as follows:

1) Somogyi effect. Did I hypo in middle of night without knowing. Is it even possible to have a hypo without knowing? - They've woken me up before. Don't feel ill etc this morning. Would I do if I'd had a hypo? I woke up in the early hours to go to the loo (too much info, lol!!!) but I didn't feel shaky or hot / cold etc or I would have tested.

2) Does anyone have a view on what number to go to bed on? I must say, I prefer something with a 7 or 8 in the title as it makes me feel a little more secure. (I think NHS literature says between 5 and 10) - but what are your views? Experience gives me a better idea than a leaflet!!!

3) How many (if any) mmol should there be difference upon waking to going to bed? I've read previous threads on the subject and think it might be 2 up or down. Is this correct?

4) Or is it not hypo territory at all, but the dreaded DP?

I sometimes find I suffer from this if I get up and test on waking and am on say 7.1, but after 1 hour before I actually eat my breakfast, I test again and could be 8.5.

So, is it possible that this unexpected high reading is a DP episode, but it's just happened before I got out of bed?

I'd read a lady on a previous thread saying her daughter has this issue, but found the raise corrected itself after about 30 mins of rising, so they started testing a little after she had got up and it sorted itself out and they recorded ok range readings. Has anyone got any similar experiences to this?

I might be way off the mark with all of the above, so experience and a bit of guidance would be appreciated.

Thanks in anticipation

Paula

 

[sugar2]

Hi Paula,
Sounds like are doing a great job.

I am not sure what to suggest about the rise to 10.3. It could be any of the things that you have suggested, and without douing a bit more detective work, it is difficult to say.

I guess what you are looking for is a pattern..when does this happen? Was this theonly time it happened? Could it be that you injected earlier, later than normal ( I know that Sundays for me are a little different from the est of theweek).

It could be linked to time of the month etc as well.

I think what I am saying, is monitor it for a few days...if tonight , you go to bed with a 6 somthing...set the alarm and do a test at 3am, and see what that tells you.
Good luck!

 

[Paulaah]

Thanks Sugar2.

I think you are right. I think i probably slightly overreacted after just one episode. I'm just so anxious to do everything right. Did the 3 am test overnight. All was fine.

Thanks for your reply.

Paula

 

[jopar]

If you've only just been diagnosed then it's likely that you are still in the Honeymoon period, and durning this period your body will still be producing some insulin, this tends to keep BG's more stable at the begining then you find after 6-12months than the pancreas gives up, and BGs can become more irratic, and control changes..

Somgyi effect normally produces quite a difference in BG levels, because it's a rebound high and generally if you've slept through a night hypo you do get some symptoms in the morning, such as an hang over feeling or another symptom that would suggest an night-time hypo..

DP's

Most people will see a raise durning the morning, a 7.1 to 8.5 aren't even of a raise in hour to suggest DP, your baseline basal can flutuate +/- 2mmol/l over an hour period if your basal insulin is correct, yours is well within this limit... With DP you generallly find that the bg will double or more in an hour periods..

What you need to do is look at what you ate the day before starting with supper and tea, if this was based aroud a high fat/protien type of food, it probably more to do with the adsorbtion rate of this has high fat/protien meals can impact take a very long time to work through the system So if you are low carbing you need to be aware of this, keeping it in mind when you working with your data..

 

[Paulaah]

Thanks Jopar,

Your reply has really helped clarify a couple of things that I really didn't understand properly.

I had a BBQ on Sunday evening - plenty of protein coupled with salad and a little carb, so even examining my meal has made some sense of it to me.

I really am still learning. I've just received "How to think like a pancreas" from Amazon after someone's suggestion on the forum, so my family won't get a peep out of me for a day or two until I've read it!!! I might be a bit better clued up on some practical issues then.

Thanks for your time.

Paula

 

[squishee]

Hi,

Not sure if this is helpful or not, but in my own experience if I have had a night hypo and not woken up (which is rare - I nearly always wake up & devour the contents of the kitchen in my sleepy state!) I tend to get the following:
Raging headache, something akin to a hangover-type headache, that pills don't even touch
Weird taste in my mouth & extremely bad breath
BS result around double what my normal morning reading is
Just feel generally kind of "meh" (if that makes sense?)

I don't tend to suffer from the dawn phenomenon if I have little to no carbs after about 5pm the previous day - case in point, last night I went to bed at 7.6, this morning I woke up at 7.5
I think, when you get used to everything, you should be able to tell if it's night hypo or DP giving you a higher morning reading, just by how you feel.

(sometimes, of course, a high morning reading is niether - I just overindulged the night before lol)