Morning blood sugar rises

[Momo2021]

Hi all, only been diagnosed a few weeks ago and I’m worried about my morning blood sugars, all my others reading are within target range but my morning blood sugars are confusing me, on waking they are normally around 5.0 then an hour after waking they have jumped up normally by about 2.0mmol! This is before doing any excercise or eating. I don’t normally eat breakfast as I fast though till lunch time, what could be causing this? What can I do to stop it? Would eating breakfast help or is there something else I can do? As I’d rather not eat breakfast as fasting is helping with weight loss plus I’ve never really been fussed about breakfast and my meds are really making me loose my appetite but if needs must!
thanks

 

[Ivostas66]

It could be 'dawn phenomenon' or 'foot on the floor'. When you wake, or just prior to waking your body tends to kick out a bit of glucose/ adrenaline to prepare your body for the day. I'm type 1, not type 2, but pretty sure it affects just about everyone and is perfectly natural. My BG was a steady 6ish throughout the night, but just after 4am it climbed and when I woke this morning it was 7.4.

 

[EllsBells]

Hi all, only been diagnosed a few weeks ago and I’m worried about my morning blood sugars, all my others reading are within target range but my morning blood sugars are confusing me, on waking they are normally around 5.0 then an hour after waking they have jumped up normally by about 2.0mmol! This is before doing any excercise or eating. I don’t normally eat breakfast as I fast though till lunch time, what could be causing this? What can I do to stop it? Would eating breakfast help or is there something else I can do? As I’d rather not eat breakfast as fasting is helping with weight loss plus I’ve never really been fussed about breakfast and my meds are really making me loose my appetite but if needs must!
thanks

Sounds like foot on tbe floor. If your other readings are 5s, which is really good, then don't worry about it. As long as they're dropping again later so don't change your normal eating time.

 

[goodybags]

Hi @Momo2021 yes that can happen as @Ivostas66 was describing

 

[RirisR]

Mine where 7.2 this morning they will probably drop later after my
walk etc my morning tests are usually between 6 and 7.5 love it
to be 5 one can hope xx

 

[KS76]

I seem to have this problem too. From waking and getting out of bed my BS rise a lot within an hour!! Usually they double. Then over 2 - 3 hours in the morning they keep rising. I don't eat breakfast. The DSN told me to try taking my Levemir later in the evening so I'm trying that although its only been 2 nights so not sure if I should be seeing a difference yet. The DSN said its not dawn phenomenon as its only rising from about 7.30am and not 3am or 4am. Is there something else I should be trying?

 

[Inka]

@KS76 It might not be Dawn Phenomenon but it definitely sounds like Feet on the Floor (FOTF).
Missing breakfast is probably not helping either because your body will pump out even more glucose in the absence of food.

What blood sugar do you wake up on? And how high does it go? Do you correct it?

I’m presuming you’re taking Levemir twice a day?

 

[rebrascora]

@KS76 I usually inject 1.5-2 units of Quick Acting (QA) insulin to cover FOTF as soon as I get up plus my breakfast bolus if I am having breakfast straight away. If I am going straight out to feed and muck out horses, I don't inject any because the exercise will take care of most of the FOTF rise to keep me roughly in range but I may need a correction unit later with my breakfast/brunch. It depends on my waking reading and how hard I have to work at the stables.
If you decide to try this strategy of injecting QA insulin to cover it, do keep a close eye on your levels afterwards....it really helps if you have Freestyle Libre for this sort of thing.
Good luck finding a strategy that works for you.

 

[Maca44]

Agree that it is important to have breakfast you need to feed your body or your liver will feed it pumping out glucose thinking the body needs energy, which it does so by skipping breakfast you might be making things worse.

 

[KS76]

When I wake say about 7.30am I will be about 6-7mmol. By 9am I will be 12. Then about 11am I will be 16, by midday as high as 18. I have tried correcting by giving QA at 9am, I've even done QA at 7.30am knowing it rises. It never brings it down. I have lunch say about 12.30pm with Novorapid I will give couple of units extra with my food as still very high. By mid afternoon im down to 12 then 5pm back between 4 - 5. This is a daily occurrence.
I take levermir twice a day and I'm on the libre 2. I'm also on a waiting list to get a pump.

 

[rebrascora]

When I wake say about 7.30am I will be about 6-7mmol. By 9am I will be 12. Then about 11am I will be 16, by midday as high as 18. I have tried correcting by giving QA at 9am, I've even done QA at 7.30am knowing it rises. It never brings it down. I have lunch say about 12.30pm with Novorapid I will give couple of units extra with my food as still very high. By mid afternoon im down to 12 then 5pm back between 4 - 5. This is a daily occurrence.
I take levermir twice a day and I'm on the libre 2. I'm also on a waiting list to get a pump.

How is your Levemir dose split? It sounds like you are not getting enough in the morning with levels rising that much right through to lunchtime. Timing of it can be quite critical too.
I have had to adjust mine recently back to a single dose of Levemir first thing in the morning and none at night as I was getting repeated nocturnal hypos. It seems like a constant challenge to keep things balanced. Good that you are on the list for a pump. Sounds like you need it!

 

[Inka]

When I wake say about 7.30am I will be about 6-7mmol. By 9am I will be 12. Then about 11am I will be 16, by midday as high as 18. I have tried correcting by giving QA at 9am, I've even done QA at 7.30am knowing it rises. It never brings it down. I have lunch say about 12.30pm with Novorapid I will give couple of units extra with my food as still very high. By mid afternoon im down to 12 then 5pm back between 4 - 5. This is a daily occurrence.
I take levermir twice a day and I'm on the libre 2. I'm also on a waiting list to get a pump.

That does sound very, very annoying. What time do you take your Levemir in the evening and morning?

Have you tried eating breakfast pretty much after getting up? It doesn’t have to be a big one.

 

[trophywench]

I've never in my adult life enjoyed breakfast except on holiday when someone else cooks it and does the washing up!

On MDI - I eventually caved and it was easier to have ONE Weetabix with milk - cos I was at work and I had too much to do than spend ages experimenting with this that and the other. My Lev (14 or 15u) was injected asap when I got up and the second dose at approx 9.30 ish at night - NOT bedtime (11-ish in those days) and 4/5u.

Then I needed more Lev adjustment so told the consultant I was fed up of having to fiddle with dosing and it still not being right so could I please have a pump? - I'm on my 3rd pump by now.

It's far more 'fiddling' - but it's so much more precise, it makes the fiddling worthwhile!

What does the full 24 hours look like - you have done a full 24 hr basal test recently I presume? If not - read this and then do it to see exactly when your peaks and troughs happen throughout the day and night - plus it helps greatly being able to follow the Levemir graph of how it releases into the body.

Basal testing

Basal insulins « Diabetes Support Information Exchange

www.diabetes-support.org.uk

Levemir

Levemir – detail « Diabetes Support Information Exchange

www.diabetes-support.org.uk

 

[KS76]

That does sound very, very annoying. What time do you take your Levemir in the evening and morning?

Have you tried eating breakfast pretty much after getting up? It doesn’t have to be a big one.

That does sound very, very annoying. What time do you take your Levemir in the evening and morning?

Have you tried eating breakfast pretty much after getting up? It doesn’t have to be a big one.

I take 3u at about 10pm and 15u about 9am. I was taking them at 9am and 9pm but DSN just recently told me to take the evening one an hour later. I was having nocturnal hypos so only take 3u now but still getting the high sugars during the morning. Maybe I need to try breakfast, but do I take extra units with food to correct for the high sugars?

 

[Inka]

You’ll need to experiment to find the right ratio for your breakfast. I’d eat it as soon as possible ie bolus for it when you get up, then eat it after waiting for your bolus to get working. I find I need to bolus more in advance for breakfast than other meals, so bear that in mind too.

If it was me, I’d choose my breakfast food and keep it exactly the same for all the days it took me to experiment with insulin amount, bolus timing, etc

 

[rebrascora]

I would be inclined to take your morning Levemir earlier as well as taking the evening one later. I take mine when I wake up at 7am (currently 20 units) and I was taking a couple of units at night when I went to bed at 11pm ish but I don't need any overnight now and my levels still slowly decline whilst I sleep, so I usually have to go to bed with a reading near 10 to wake up about 5 or 6, but the 20 units plus 1.5-2 units of QA when I wake up pretty much tames my FOTF and keeps me in range.

 

[KS76]

You’ll need to experiment to find the right ratio for your breakfast. I’d eat it as soon as possible ie bolus for it when you get up, then eat it after waiting for your bolus to get working. I find I need to bolus more in advance for breakfast than other meals, so bear that in mind too.

If it was me, I’d choose my breakfast food and keep it exactly the same for all the days it took me to experiment with insulin amount, bolus timing, etc

Thanks i will try that.

 

[KS76]

I would be inclined to take your morning Levemir earlier as well as taking the evening one later. I take mine when I wake up at 7am (currently 20 units) and I was taking a couple of units at night when I went to bed at 11pm ish but I don't need any overnight now and my levels still slowly decline whilst I sleep, so I usually have to go to bed with a reading near 10 to wake up about 5 or 6, but the 20 units plus 1.5-2 units of QA when I wake up pretty much tames my FOTF and keeps me in range.

Thanks for your comments i will try the morning Levemir earlier like you said. Can't harm to give it a go and see what happens.

 

[rebrascora]

I know it is recommended to take the Levemir at 12 hour intervals but I have been finding bedtime and waking up worked better for me until recently when I had to gradually reduce the bedtime dose until I wasn't injecting any but increase the morning dose.
I love the fact that Levemir gives me the flexibility to fiddle about with the doses and timings to get a best fit for my body, but sometimes it seems like no 2 days are the same at the moment or certainly every few days I need to tweak things again. I know it is partly due to the time of year with the changing seasons and partly my ever changing routine!

 

[Drummer]

I don't need medication, but back when I was taking Metformin etc I fasted until lunchtime and took them then. Once I gave up the tablets in despair, the side effects were dreadful, I stuck to the same routine, but realised my morning results were way higher than for the rest of the day and into the evening.
By experimenting, I found that eating at 12 hour intervals my levels were a lot less erratic, not dropping so low and so fast I went wobbly, not going as high before eating.
When I thought to weight myself, as my clothes were falling off, I had lost almost 50lb that I knew of - I had stopped weighing some time earlier when being encouraged to eat carbs - as they are so healthy. Fasting doesn't help me to lose weight.