What!??

[Stuboy]

This is a typical issue i keep having...

I haven't had anything to eat since last night at about 9 (when i finished eating).

This morning i wake up at 6.8.
45 minutes later after a doctors appt. im 8.3.
I take 1unit of insulin after that test to correct. If it had been coming down i wouldn't have corrected. but it was going up.
1 hour later test again, 9.2!!

Still haven't had anything to eat at this point!

making no sense to me...

 

[bonerp]

morning phenomenome (sp)?

 

[TROUBR]

I have this problem - about 5 during the night - get up and about 7.5 by the time I get to work and eat breakfast I am 8.5 (If I exercise before breakfast then it will be 10 or 11 before I eat. I mentioned this to my dietician yesterday and she said as SarahQ has that my liver is dumping glucose. She suggested that I have something small before the gym (banana / low fat yohurt) and 1 unit of insulin. This should stop my liver jumping to the rescue. I might also try having something when I first get up on non gym days.

Louise

 

[Pattidevans]

It could be liver dump as others have said, but it could also be inadequate basal coverage. The test to see if your basal is working correctly is to miss a meal, in doing so, your BGs should remain completely steady. If they rise, then it's inadequate basal coverage, if they drop, then it's too much basal. This is, I may add, a very simplified explanation.

 

[bonerp]

inadequate basal coverage occurs when the liver dumps this glucose. Your levemir or lantus cannot solve this as you need more over a limited period - between 4-6am for example. These background insulins are designed to give even coverage over 24/36 hours.

As Sarah said the pump solves this as you can programme it to give extra between any 24 hour period you like. Mine doubles the rate between 4-6 am and solves the problem.

Paul

 

[timo2]

Hello Stuboy,

The link below gives an idea of what exactly dawn phenomenon is and, more importantly,
how to overcome the problem.

:arrow: Wake up to Dawn Phenomenon

You'll notice that the term "liver dump" is actually more closely associated with the
Somogyi effect(hypo followed by rebound hyperglycemia), rather than true dawn phenomenon(although the hormones involved are pretty much the same).

Regards,
timo.

 

[iHs]

This is a typical issue i keep having...

I haven't had anything to eat since last night at about 9 (when i finished eating).

This morning i wake up at 6.8.
45 minutes later after a doctors appt. im 8.3.
I take 1unit of insulin after that test to correct. If it had been coming down i wouldn't have corrected. but it was going up.
1 hour later test again, 9.2!!

Still haven't had anything to eat at this point!

making no sense to me...

Hello Stu

Judging by your message are you using Levemir once or twice per day?

If its just once, then by not having any bolus or carb in the morning, you will find your bg go up and up and up. Simply because you have nothing active as insulin. I have also been in similar situation to yourself through going into hospital to have op done as a daycase. I have woken up with low bg, got to hospital and by time Ive had my op done my bg has been through the roof so have needed to do large correction bolus to get them down again and eat some carb.

For me 1 unit of bolus would do virtually nothing for me so would need to do correction of a larger amount and eat some carb to activate the insulin.

 

[Stuboy]

i take my Levemir twice a day, 12 hours apart.

1 unit of insulin used to take be from 11mmol/L into hypo range, so i tend to be causious when correcting sinse then. I thought about taking two but talked myself out of it.

it came down to 7.3 after a 20 minute walk to Greggs for lunch, then 2 hours after lunch back down to 6.4... perfect.

Then another hour later, 4.8... ok not bad.
another hour later, 3.8... doh I've avoided eating anything to fix the 3.8 though, i have a feeling that's bottomed out there and will go up on it's own accord. ill test again at 5pm and see.

this is a stupid diesease...

 

[manxangel]

this is a stupid diesease...

TOO RIGHT!!