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Type 1 Diabetes - High Blood Sugar In The Morning

H

horcruxer

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I'm wondering if anyone can help me. I've had type 1 diabetes for over seven years now and it's been well controlled with good HbA1c results. However, over the past few months, I've been getting high blood sugar in the morning. Nearly every morning it's anything between 10 and 15 mmol/L.

I had my regular check-up and found out my latest HbA1c was the highest it's ever been at 73 mmol/mol, which is quite high. I told the nurse I've been getting high blood sugar readings in the mornings and she put me on a new type of background insulin. According to her, I'm doing everything I should be doing for my diabetes management and my HbA1c should be a lot lower. She also recommended I trial the new patch that monitors your blood sugar levels 24/7, which I'm going to do in the next month or so.

Last night, I checked my blood sugar before bed and it was 8 mmol/L. I injected one unit of Insulatard to bring it down a little bit. I l also injected the required units of the new background insulin I'd been put on. I hadn't eaten since tea time.

However, this morning I woke up and tested straight away: my blood sugar had gone up to 16 mmol/L. It had been around 8 before bedtime, so it's clearly risen while I've been asleep. This is just one of many examples of my blood sugar rising overnight.

So, is there anything I can do to solve this? Like I said, I'm doing everything I can to manage my diabetes well. I check regularly, count carbs, inject accordingly - on paper, I should have steady blood sugar results, but for some reason it rises overnight and this is affecting my HbA1c, which I obviously want to get down.

Has anyone with Type 1 Diabetes experienced something similar? Any possible solutions would be much appreciated.

James
 
Hello James,

I may not be the right person to advise, but having been a type 1 diabetic for 35 years, has helped me to assess certain situations. The issue here could be the bolus insulin as well. When did you check the blood sugar after meals? Do you take insulatard twice? Else you may need to take lente as replacement once. But these are best done under supervision of your diabetic doctor or health professional.

Thanks and regards,
K Ramaswamy
 
Hi,

Thanks for replying! I usually take the bolus insulin right after eating and I weigh food/look at the packet so I'm 99% certain I'm injecting the right amount. It's usually 3-4 hours before I test at bedtime. I take Insulatard twice a day (morning and evening).

James
 
Just out of curiosity which insulins are you on?

The rise overnight could be Dawn Phenomenon - it's when the liver decides to be helpful and gives you extra sugar to get you up in the morning - of course as a T1 this can be extremely unhelpful.

I know for myself when I get Dawn Phenomenon my sugar level starts to raise at about 3am - and yesterday morning was upto 18 by the time I woke up at 6:30! - I have only been able to tell this because I am using a CGM (I self-fund the libre) so I can see whats going on, it doesn't normally get that high so my liver was obviously having a real go at it (stupid liver).
 
Yes as advised above sounds a lot like dawn phenomenon, i also get this however mine is more late onset dawn phenomenon, mines tend to rise from about 8 am, an hour after i get up. My however does drop back and by lunchtime it back to normal.

I see that you take Insulatard, have not seen that for years, i think i was on this about 20 years ago. There are different Basal insulins, which may be more beneficial. I find the best one i have had so far was Levemir, which is taken twice daily. Maybe worthwhile have a conversation with your DSN
 
I've just been advised to switch to Levemir, so I'll see how that goes. So with the Dawn Phenomenon, is there anything that can stop it? And what causes it - is it something that just happens naturally in some people, or is there some underlying cause?
 
horcruxer said:
So with the Dawn Phenomenon, is there anything that can stop it? And what causes it - is it something that just happens naturally in some people, or is there some underlying cause?
Click to expand...
The Dawn Phenomenon is totally normal. It happens to most people regardless of whether they have diabetes or not.
It is our body giving us glucose to get going in the morning. Without diabetes, the pancreas will release insulin to convert this to energy.
There are lots and lots and lots and lots of threads about it. Some people have techniques that reduce the impact for them.
Just search "Dawn Phenomenon" and take a read.
 
So your BS was at 8 mml before you went to bed. Then you took one extra unit of Insulatard, then the new insulin your DSN has given you which you haven't told us the name of and your BS rose to 16 mml overnight. How long have you been taking the new insulin in addition to the Insulatard twice a day ? What effect does it normally have ?
 
horcruxer said:
Last night, I checked my blood sugar before bed and it was 8 mmol/L. I injected one unit of Insulatard to bring it down a little bit. I l also injected the required units of the new background insulin I'd been put on. I hadn't eaten since tea time.
Click to expand...
I'm curious why you took both the Insulatard and the new insulin (Levemir I think you mentioned) as they are both long-acting (basal) insulins, or was that a mistype?
 
I'm in exactly the same boat as you. I wear the Libre and my blood sugar starts to rise from about 3am to 10 or 11 by 6am rise. It is very frustrating as my normal levels are between 4 and 6. I take Lantus and Novarapid. I'm trying different injection times to solve this but not found a solution yet.
 
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