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allowing DP to counter morning lows?

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Phil65

Well-Known Member
Relationship to Diabetes
Type 1
I know this is very debateable, just wondered what your thoughts were and indeed if anybody does this. Here's the situation: I always test my BS on waking and if I am below 5 will treat as normal for a hypo, I do suffer from DP though so.....If after getting out of bed without treating my hypo, my DP is probably going to sort my hypo. I know that some of you will think it reckless and I haven't tried it yet.....but I do intend to soon. I reckon that it will be safe to do so, my levels never drop after I have got up and at the moment if I treat a morning hypo my DP puts me even higher 15-30 mins later......thoughts? (don't shoot me down please!? 😉)
 
I wouldn't personally treat a waking low unless it was below 3.5 (which would mean I was probably a bit Shakin Stevens) as my levels inevitably rise once I am up. What's more, I inject as soon as I get up but then don't eat for 30-45 mins. I've proven to myself that this isn't a problem for me by testing at regular intervals, but of course it may differ from person to person, so the key is to be extra cautious 🙂
 
Hi Phil, I'd never shoot anyone down! There are surely lots of strategies 🙂

As you are pumping, why don't you think about increasing your basal at that time of the morning to combat the rise in BGs that you experience? And while you're doing that, if you are consistently waking hypo, you could look at decreasing your basal a couple of hours before this happens. Btw, we always think of a level below 4 as being hypo, do you treat anything under 5? 5 should be an ideal waking level.....
 
Hi Phil, I'd never shoot anyone down! There are surely lots of strategies 🙂

As you are pumping, why don't you think about increasing your basal at that time of the morning to combat the rise in BGs that you experience? And while you're doing that, if you are consistently waking hypo, you could look at decreasing your basal a couple of hours before this happens. Btw, we always think of a level below 4 as being hypo, do you treat anything under 5? 5 should be an ideal waking level.....

I only treat under 5 if driving or obviously if I still have 'active' insulin, If I wake to 4 I'm happy with that. I could increase my basal more to counter my DP....I already take 3.5 units per hour between 4-8 am.....but if I need to increase.... I need to increase!
 
So is your basal rates not already adjusted to eliminate/hide the effects of the DP...?

Also, do you eat when you get up? Giving your stomach something to digest should turn off the livers dump and therefore not giving you higher results if and when you do wake lower than you would like.....
 
So is your basal rates not already adjusted to eliminate/hide the effects of the DP...?

Also, do you eat when you get up? Giving your stomach something to digest should turn off the livers dump and therefore not giving you higher results if and when you do wake lower than you would like.....

yes, my basal rate is adjusted, it is just that my DP can vary from one morning to the next so it is tricky. I think I do need to turn my basal up from 5 am to coincide my rising at 7/8 am though.
I always eat about 30 mins of getting up.
 
I think that it needs more trial and error, but I think most would agree that allowing your hypo to be self treated by the liver is something to avoid....

I have felt hypo a few times on the train going home from work, didn't confirm with a test but I definitely felt it. I waited it out and allowed my liver to respond. I have done this successfully several times. Not good practice though.

🙂
 
I think that it needs more trial and error, but I think most would agree that allowing your hypo to be self treated by the liver is something to avoid....

I have felt hypo a few times on the train going home from work, didn't confirm with a test but I definitely felt it. I waited it out and allowed my liver to respond. I have done this successfully several times. Not good practice though.

🙂

I wouldn't either...... and haven't yet. And the ONLY time i would consider it is between waking and breakfast, just wanted people's opinions and already there are different answers. A DSN would ALWAYS say to treat the hypo even if in the high 3s, no matter what time of day and prevelence of DP.
 
I never treat a hypo on waking as I know my levels will rise anyway so I do my usual routine and then have breakfast as normal. I wouldn't do it at any other time either but in the mornings I know that my levels will rise and not fall so it is safe to do so (in my case anyway).
 
It depends what your reading is.

A reading between 4 and 5 shouldn't require treating, particularly if you know you're already going to suffer from DP. After all, your blood sugar SHOULD be between 4 and 5 on waking anyway.

If you had a reading below 4, then you'll need to be pragmatic about it. I would personally leave it if it was in the high 3s but anything lower, I would treat, even if I knew my blood sugar would be rising anyway. This is because every minute your body puts up with low BGs, the more hypo-unaware you become. If I was say, 3.2 on waking and knew that my DP would punt me up in an hour's time, I'd still treat because otherwise I'd still be spending an hour in hypo territory, making my body see this as 'normal' and thus storing up problems for the future.
 
I'm not sure if this helps but if I have hypo symptoms, even if I'm 4.5 then I will treat it as a hypo. Touch wood this means that I have been hypo aware for 42 years🙂. I sometimes, but not always, suffer from DP and then I correct accordingly once it has gone up. But I would always treat the hypo with jelly babies or Lucozade.
 
I never treat hypos on waking unless i'm below about 3.5 or if I have symptoms. I have raging DP and normally within 30 mins it's sorted itself out. If I felt hypo I'd just have breakfast sooner (can't usually stomach eating first thing and normally skip breakfast altogether!) I use it as an excuse to eat either frosties or cocopops :D I bolus the amount I normally would do to.
 
It depends what your reading is.

A reading between 4 and 5 shouldn't require treating, particularly if you know you're already going to suffer from DP. After all, your blood sugar SHOULD be between 4 and 5 on waking anyway.

If you had a reading below 4, then you'll need to be pragmatic about it. I would personally leave it if it was in the high 3s but anything lower, I would treat, even if I knew my blood sugar would be rising anyway. This is because every minute your body puts up with low BGs, the more hypo-unaware you become. If I was say, 3.2 on waking and knew that my DP would punt me up in an hour's time, I'd still treat because otherwise I'd still be spending an hour in hypo territory, making my body see this as 'normal' and thus storing up problems for the future.


Thanks Deus, good point ....hadn't thought of that.
 
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