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Very high morning blood sugar

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KatieCollis

New Member
Relationship to Diabetes
Type 1
Hello everyone

This is my first time posting on here so apologies if I get anything wrong..

I'm type 1 diabetic and every morning for about 2 years my blood sugar is above 20. I've tried splitting my levemir dose, increasing and decreasing, have been put on metformin.. everything!

My diabetic nurse thinks it's dawn phenomenon, but whenever I see my consultant he dismisses this as he says the increase is too high to be dawn phenomenon. The trouble is he doesn't suggest anything else and even proposed I was waking up and drinking sugary drinks in the night!!

Sometimes I find it can be a bit delayed so it's around 9 when I wake up, but by the time an hour or so has passed, it's gone very high again.

My libre sensor just shows a massive spike from about 4am onwards.

I otherwise have good control but I'm at a loss of what to do about this. Has anyone else experienced the same?
 
Sorry I hope someone can be of more help than me but has there never been a suggestion of trying a different basal? xx
 
I have the same problem and have been on every basal insulin out there, I'm now admitting defeat and going on a pump in May. I found as well as DP, I would also then spike again as soon as I got up, often ending up in the mid 20s before I'd even made it downstairs. I've been managing in the meantime by setting an alarm for 2am every night and bolusing 2 - 3 units depending on what my libre says I am, then bolusing again as soon as I wake up but obviously this isn't ideal (especially as I'm still typically waking up on anything between 12 - 19!). It is very frustrating. If you haven't tried different basals perhaps ask to try a new one (and also a new doctor! Lol). But honestly I am so relieved I am now going on to a pump because I haven't found anything that works for me. Good luck, I hope you find something that does the trick for you 🙂
 
I agree - pump it is (once you've tried different basal insulins since they all peak at different times after injecting and if you found one that matched what your body does better that would be good) but in the meantime - try doing what we'd say to anyone whose BG goes up between waking up and breakfast time - eat something! A little bit of anything except carb (although something small eg one cream cracker, buttered might be enough) eg a bit of cheese, half a slice of boiled ham - whatever's handy. It tricks the body into not dumping any more glucose out of your liver into your blood stream, even though it's not anywhere near enough to be a 'meal'.

Are there other consultants at your clinic you could ask to see instead of the totally unhelpful one you've been seeing? Sounds like he was trained about when the NHS started to me, cos that's the sort of attitude you saw people reporting when I was first diagnosed.
 
Hi everyone

Thank you all so much for replying and for your advice! I really would love to go on a pump, but it just feels like it's always a no when I ask.
How did you all find the process of asking for a pump?

I'm going to see my gp tonight to discuss seeing a different consultant as I'm not happy with how my current one is behaving.
Will let you know what happens, because I can't go on like this, the damage it might be causing is scary!
 
Hi Katie
When I was unhappy with one of my many consultants and I decided that I would try and find someone who specialised in my particular condition, my GP was very supportive and said she would refer me to any specialist of my choosing who specialised in that particular field. For the time being though I would make a request to my GP for a referral to a different consultant in your area. Your high bg levels need sorting out and as you say you need to be proactive to avoid possible later diabetes complications later in life.
 
Hi Davein,

Thank you that's really helpful to hear. I will ask tonight.
I'm really reluctant to go back to this consultant because alongside what he said about my blood sugars, he also said that my diagnosis by my gastro consultant of gastroparesis and ehler danlos syndrome were probably just the tests coming back incorrectly, which seemed ridiculous to me!
 
KatieCollis said:
Hi Davein,

Thank you that's really helpful to hear. I will ask tonight.
I'm really reluctant to go back to this consultant because alongside what he said about my blood sugars, he also said that my diagnosis by my gastro consultant of gastroparesis and ehler danlos syndrome were probably just the tests coming back incorrectly, which seemed ridiculous to me!
Click to expand...
Katie
Years ago I was given one piece of advice about my health which was if you get no joy from someone who read the book, then go to the person who wrote the book. In other words don't compromise your health. If your health problem isn't resolved by the local GP or Consultant, then try to see the person whom they learn from ie the top man in the field or at least one of his team. You can't put a price on your health- it's the most valuable asset you have and it's worth looking after. Your instincts tell you that your faith in your present medics isn't very high so ask for another opinion.
 
Personally (from a non medically trained viewpoint) I would be suspicious of a consultant who a) doesn't appear interested in BG levels that are potentially damaging, b) has the gall to suggest you are the cause by drinking something sweet 😱 and c) is unprofessional by casting aspersions over other another consultant's findings.
I would find a second opinion elsewhere & that hopefully that person will help to get your levels back within a safer margin.
Good luck
zx
 
Davein said:
Katie
Years ago I was given one piece of advice about my health which was if you get no joy from someone who read the book, then go to the person who wrote the book. In other words don't compromise your health. If your health problem isn't resolved by the local GP or Consultant, then try to see the person whom they learn from ie the top man in the field or at least one of his team. You can't put a price on your health- it's the most valuable asset you have and it's worth looking after. Your instincts tell you that your faith in your present medics isn't very high so ask for another opinion.
Click to expand...


You're completely right. I am definitely going to pursue seeing someone else and someone better! Thanks for your help and encouragement, I really really appreciate it 🙂
 
zx10pilot said:
Personally (from a non medically trained viewpoint) I would be suspicious of a consultant who a) doesn't appear interested in BG levels that are potentially damaging, b) has the gall to suggest you are the cause by drinking something sweet 😱 and c) is unprofessional by casting aspersions over other another consultant's findings.
I would find a second opinion elsewhere & that hopefully that person will help to get your levels back within a safer margin.
Good luck
zx
Click to expand...

You're completely right, the way he behaved was so unprofessional. It's nice to hear that you agree with me as I was a bit worried I was just being over sensitive for a moment!
I'm definitely going to get a second opinion!
Thanks for your advice 🙂
 
Welcome to the forum, Katie 🙂

I've also had problems with diabetes consultants belittling my other condition (I have Myalgic Encephalomyelitis, which, so far as clashing with diabetes is concerned, has a lot in common with EDS) and its consultant. I stood my ground, but it was very distressing, so you have my sympathy. I hope you are able to find someone else who is more understanding and more knowledgeable.

I have very high blood sugar in the mornings too - not quite as bad as yours, but bad enough. I find the things which help are:
1) test first thing, before doing anything else (when my levels are typically 7-10 - if I wait until after I've used the bathroom and am ready for breakfast they could be well into the teens), and inject immediately
2) delay eating breakfast for 30-40 minutes so the insulin has a chance to get going before I eat
3) go straight back to bed after breakfast and rest. I'm aware not everyone can do this, but if I don't my levels invariably get to about 15-16, whatever I've eaten - and even if I haven't eaten anything.

I'm on the list for a pump, but this is mainly because I have far too many hypos. I think the other criteria were that I knew how to carb count, understood the principle of pre-bolusing, things like that (just knowing how to manage my diabetes). It's definitely worth asking about. Your diabetes nurse might be able to get you onto the waiting list for one and bypass the consultant.
 
In my case it was my consultant who told the nurse - but who knows how it works with your dinosaur one?

Another thing that would be useful if you're thinking of moving your care to another hospital is to contact INPUT because they keep a list of 'pump friendly' clinics and if you can specify where you want to be seen and where you don't that should be helpful.

http://www.inputdiabetes.org.uk/
 
Just a thought - you might also try setting your alarm an hour earlier for a bit and see if that makes any difference (obviously not a long-term solution, and with your spike starting in the middle of the night it may not make enough difference to be worth it, but you could see). I was woken up by someone delivering a parcel an hour earlier than I'd normally get up today - wasn't worth going back to bed so I did my before-everything-else bgl test and my blood sugar was 5.1 o_O
 
One thing that helped me slightly was to move my last levemir dose to bedtime (had previoulsy been injecting 7am and 7pm) and that helped a bit, but ultimately I had the same problem as you and couldn't solve it with MDI. The team were reluctant to give me a pump as my HBA1c was good, so I played the game a bit by:
1. Asking them for help
2. Seeing a DSN and dietician with a food diary for a week and a BG diary and Libre Trace
3. Increasing my evening levemir to get rid of a morning high and showing that this caused a 2am low
4. Pointing out a 2am low every day was not good for me, neither was waking to a level of 16 and this was affecting my quality of life
5. Throwing in that I wanted to start a family but didn't feel I could do this at present because my good A1c was made up of peaks and troughs.

Think it was actually 5 that did it in the end. I got rejected by the pump panel first time round then asked the consultant to write to the CCG for funding on the grounds of quality of life. Then she retired and the new consultant went back to the pump panel and they said yes. I was probably talking about it and jumping through these hoops for over a year before they said yes, so stick at it!

I did find the INPUT website very useful, have a read, particularly this page : http://www.inputdiabetes.org.uk/education/better-clinic-appointments/ about how to make your appointments more productive.

Hope you make some progress soon, I remember how horrible it felt waking up that high!
 
KatieCollis said:
Hi everyone

Thanks so so much for your help with this. I just wanted to update you all, I saw a new consultant this week and within 5 minutes he put me on the list for a pump. He said it was the only way to tackle dawn phenomenon.

I'm so pleased and relieved.

Thanks again for all your help 🙂
Click to expand...
Brilliant news, what a huge relief for you. At last a sensible consutant.
 
KatieCollis said:
Hi everyone

Thanks so so much for your help with this. I just wanted to update you all, I saw a new consultant this week and within 5 minutes he put me on the list for a pump. He said it was the only way to tackle dawn phenomenon.

I'm so pleased and relieved.

Thanks again for all your help 🙂
Click to expand...

Fantastic, glad to hear it! I am now on a pump and honestly it's made a world of difference. I'm still not a morning person but I'm not the miserable cow I once was upon getting out of bed either :D lol. Good luck, really pleased for you!
 
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