Blood sugar levels high in the morning any advice to get it down please?

[Ditsy daisy]

Hi I've been getting high levels in the morning for a very long time. I used to be on 2 injections in the beginning novomix30 then changed to 3 injections not sure what insulin that was. Now I've been doing 3 novorapid injections and 1 levemir at night for years now but I never seem to be able to get my sugars down in the morning. I mean it's improved alot I was getting 18 in the morning now it's more like 11-15 is the average in the morning. Sometimes very rarely I get 8 in the morning. The thing is I'm doing 38 levemir units in the night then I have a hypo in the night so I put it back down to 37 then it goes too high. I feel angry and depressed about it but I'm trying not to blame myself. I'm really depressed don't know what to do. Does anyone do something the night before or in the morning that helps bring the reading down for them? I know it's only advice but I'd like to know thanks ditsydaisy

 

[Inka]

Hi @Ditsy daisy Yes, it can so annoying and upsetting when you do everything right but your blood sugar messes about. Please don’t be depressed - diabetes is a hard thing to control and never stays the same.

Have you tried testing in the night to see what time you’re prone to hypos/dropping? Have you tried splitting your Levemir to see if that helps in any way? Have you tested to see when your blood sugar starts to rise?

There’s something called Dawn Phenomenon which can push sugars high in the morning even if they’ve been fine earlier. I get that but luckily have a pump which allows me to stop the rise. That’s the ultimate answer if other things don’t work. How’s your control overall?

 

[Bruce Stephens]

Most people (including me) find Levemir doesn't really cover 24 hours, so really it works better in two doses (which needn't be the same).

If you can get the doses right that might be good enough, but as @Inka notes, being a bit higher shortly after you wake up in the morning is entirely normal. That's really obvious if you use a Libre or similar: I can see that my blood glucose can be fine (6 or something) just before I wake up but then rise rapidly even though I've not had a chance to eat anything.

If I tried to correct that by increasing Levemir the previous evening I'd probably go hypo during the night which would just make things worse. So I just take 2 or 3 units of Novorapid more or less as I wake up.

 

[DaveB]

Hi. Can you tell us something about your diet and BMI? I wonder whether you have some insulin resistance which would mean insulin effects are less predictable. I would certainly start splitting your Levemir which I have started recently. BTW are you carb-counting your Novorapid i.e. adjusting it for each based on the carbs in the meal?

 

[Ditsy daisy]

Hi @Ditsy daisy Yes, it can so annoying and upsetting when you do everything right but your blood sugar messes about. Please don’t be depressed - diabetes is a hard thing to control and never stays the same.

Have you tried testing in the night to see what time you’re prone to hypos/dropping? Have you tried splitting your Levemir to see if that helps in any way? Have you tested to see when your blood sugar starts to rise?

There’s something called Dawn Phenomenon which can push sugars high in the morning even if they’ve been fine earlier. I get that but luckily have a pump which allows me to stop the rise. That’s the ultimate answer if other things don’t work. How’s your control overall?

Hi thanks for your kind reply. I'm getting varied readings in the day like I've had a few hypos that were around 3.3 and other high readings that were around 11-16 but I'm getting at least 1 good reading a day sometimes 2 good readings a day. By good readings I mean 5-8.7 which is what range I'm aiming for from my diabetes nurse. I suppose that's good for me but I'm just trying to improve the readings overall. It's not going in any sort of pattern except like I said it's good 1 or 2 times a day. I would have to ask my nurse if I can split the levemir into two but that means getting up at night and a fifth injection. Anyway its good you are positive about it. I'm trying but I have other issues and mental health issues aswell to deal with. Ifor I do have hypo in the night it's usually around 3 am to 6 am but I would wake up I'm sure as I always dream I'm having a hypo it warns me.

 

[Ditsy daisy]

Hi @Ditsy daisy Yes, it can so annoying and upsetting when you do everything right but your blood sugar messes about. Please don’t be depressed - diabetes is a hard thing to control and never stays the same.

Have you tried testing in the night to see what time you’re prone to hypos/dropping? Have you tried splitting your Levemir to see if that helps in any way? Have you tested to see when your blood sugar starts to rise?

There’s something called Dawn Phenomenon which can push sugars high in the morning even if they’ve been fine earlier. I get that but luckily have a pump which allows me to stop the rise. That’s the ultimate answer if other things don’t work. How’s your control overall?

Yes that's a good idea I could test it near the morning and see if it's going up thanks

 

[Ditsy daisy]

Most people (including me) find Levemir doesn't really cover 24 hours, so really it works better in two doses (which needn't be the same).

If you can get the doses right that might be good enough, but as @Inka notes, being a bit higher shortly after you wake up in the morning is entirely normal. That's really obvious if you use a Libre or similar: I can see that my blood glucose can be fine (6 or something) just before I wake up but then rise rapidly even though I've not had a chance to eat anything.

If I tried to correct that by increasing Levemir the previous evening I'd probably go hypo during the night which would just make things worse. So I just take 2 or 3 units of Novorapid more or less as I wake up.

That's a great idea I'll ask my nurse if I can try some novorapid before breakfast.

 

[Ditsy daisy]

Hi. Can you tell us something about your diet and BMI? I wonder whether you have some insulin resistance which would mean insulin effects are less predictable. I would certainly start splitting your Levemir which I have started recently. BTW are you carb-counting your Novorapid i.e. adjusting it for each based on the carbs in the meal?

No I'm not carb counting because I can't cope with it in my circumstances I have mental health issues and am very stressed with it. My nurse tells me i can't do it yet because its too difficult. I'm eating less than usual carb wise as I'm trying to lose weight and my weight is just staying the same which is annoying me I'm 12 stone 2lb and 5 foot 2. Also have issues like ibs and mental health issues I take medications for all my issues which maybe isn't helping but I rely on it.

 

[AJLang]

You don’t need to get up in the night to split your Levemir. I used to do mine around 8am and 8pm.

 

[Ditsy daisy]

Ah that's cool. That's interesting good to know I don't have to wake in the night to do it. Thankyou so much ☺

 

[Ditsy daisy]

Thanks everybody for your kind messages and I really appreciate you giving your advice I'm working on it ☺ and so far had 2 good readings out of 3 today we will see how I do later. going well so far.

 

[Bruce Stephens]

That's interesting good to know I don't have to wake in the night to do it

I take mine about 12 hours apart (9pm, 9am), but not always exactly at those times. While Levemir doesn't really last 24 hours, it does last more than 12 hours so it doesn't have to be precise. I think most who split it take one dose in the evening and one in the morning (so one dose is for the night, one for the day).

 

[trophywench]

Hi DD - I would strongly suggest you spend a few days testing where your basal insulin is lacking or a bit too much, like this https://www.diabetes-support.org.uk/info/?page_id=120

Levemir very very rarely (if ever?) works well by single dose for ordinary T1s and was always, originally, meant to be delivered via 2 split doses, which actually put quite a lot of T1s - me included - off it to begin with, why have another jab when I'm OK with 4? But having tried and tried and tried ad infinitum with Lantus to get it right for me and failed I thought different and that when you're having 4 jabs a day anyway, one more is hardly onerous and if you can benefit by getting better BG control, then it's worth at least trying, isn't it? You aren't burning your boats after all - do it when you still have at least one full pen in the fridge (or one whole new cartridge if using a refillable Lantus pen) cos then if you do happen not to get on with it OK, you can just revert NP.

I always found it, from the start, more 'biddable' - ie easier to get it to do, what I wanted it to do - within the limited parameters of what insulin CAN do, of course!

 

[Amity Island]

No I'm not carb counting because I can't cope with it in my circumstances I have mental health issues and am very stressed with it. My nurse tells me i can't do it yet because its too difficult. I'm eating less than usual carb wise as I'm trying to lose weight and my weight is just staying the same which is annoying me I'm 12 stone 2lb and 5 foot 2. Also have issues like ibs and mental health issues I take medications for all my issues which maybe isn't helping but I rely on it.

Hi Ditsy,
I understand, it is difficult managing diabetes, it requires full time care.

You said you don't want to carb count as it's too difficult. Just till you get sorted, could you try a week eating same meals? same times of day, same carb amounts? This would greatly simplify things for you and take away any worry as you can stick with same routine. With some testing you'd soon spot where its not working and can increase / reduce insulin the following day. You could then introduce a different meal the next week for lunch and so on.

btw you may end up taking an extra unit (correction) with breakfast to counter that morning rise or may need to take bolus insulin a bit earlier to prevent a spike.

I know this is opposite of how diabetes management is taught today with the DAFNE principles, but there is nothing wrong with having a routine, if you don't mind same meals.

 

[everydayupsanddowns]

Hope you manage to get split doses of Levemir to work well for you @Ditsy daisy

Hopefully it will be a big piece of the puzzle for you. Erratic BGs, and
frequent out of range numbers are really draining

 

[billyblue]

Hi I've been getting high levels in the morning for a very long time. I used to be on 2 injections in the beginning novomix30 then changed to 3 injections not sure what insulin that was. Now I've been doing 3 novorapid injections and 1 levemir at night for years now but I never seem to be able to get my sugars down in the morning. I mean it's improved alot I was getting 18 in the morning now it's more like 11-15 is the average in the morning. Sometimes very rarely I get 8 in the morning. The thing is I'm doing 38 levemir units in the night then I have a hypo in the night so I put it back down to 37 then it goes too high. I feel angry and depressed about it but I'm trying not to blame myself. I'm really depressed don't know what to do. Does anyone do something the night before or in the morning that helps bring the reading down for them? I know it's only advice but I'd like to know thanks ditsydaisy

@Ditsy daisy It is soooo annoying, I have been in the same situation for 2 years and yes I agree with whatever @Inka mentioned, I found 2 ways to get rid of the Dawn Phenomenon after lots of researches and reading lots of theories, BUT DO NOT FOLLOW ANY OF THEM BEFORE CONSULTING YOUR DR, I have asked my GP and tried both.
1-option 1: (that's what i am following now) Before bedtime and before I get my basal dose ( i use Tresiba as basal) I check my BG and i take a small dose of Novorapid which can last up 3 to 4 hours and this small dose helped my morning readings a lot.
- Option 2: split your levemir dose into 2, the first at bedtime and second at 3-4 am, I didn't follow this one since i hate waking up and sleeping again.

ASK YOUR DR. and i hope you will find a solution

stay safe

 

[Ditsy daisy]

Thankyou for everyones comments it's been helpful having your suggestions. I'm still waiting to discuss the different things I could do with my diabetes nurse. Don't know where she is but she hasn't rung back I've left 2 voice messages. I'm getting frustrated because it's all over the place my sugars lately and the heat of the weather is giving me hypos too in the night. guess I'll have to wait for my nurse to ring hope she calls soon. In the meantime everyone stay safe and well ❤

 

[Amity Island]

Thankyou for everyones comments it's been helpful having your suggestions. I'm still waiting to discuss the different things I could do with my diabetes nurse. Don't know where she is but she hasn't rung back I've left 2 voice messages. I'm getting frustrated because it's all over the place my sugars lately and the heat of the weather is giving me hypos too in the night. guess I'll have to wait for my nurse to ring hope she calls soon. In the meantime everyone stay safe and well ❤

Hi Ditsy,
Just worth a mention, if contacting your diabetes nurse by phone, if you haven't done so already Ditsy, get everything written down before you talk with the nurse. I've only once tried to get help over the phone and got a bit lost on the phone. Perhaps write down a typical day with it's typical problems, all doses, insulin types, timings, results. As much as you can on one piece of paper. So matter what question the nurse asks you have the answer immediately. This should make things run smoothly and get down to the crux of the problem.

 

[Inka]

It could be that some staff are off sick or self-isolating @Ditsy daisy so give them a little while to get back to you. If they haven’t called you back by Monday, I’d give them another call.

Just to add that carb-counting is sometimes made out to be Extremely Difficult necessitating a Special Course and days and days of ‘training’. That’s completely untrue. Basic carb-counting is pretty simple and you don’t need to go on a course to do it. It also makes life a lot easier.

 

[grovesy]

Thankyou for everyones comments it's been helpful having your suggestions. I'm still waiting to discuss the different things I could do with my diabetes nurse. Don't know where she is but she hasn't rung back I've left 2 voice messages. I'm getting frustrated because it's all over the place my sugars lately and the heat of the weather is giving me hypos too in the night. guess I'll have to wait for my nurse to ring hope she calls soon. In the meantime everyone stay safe and well ❤

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