Blood sugar level rising when fasting

[hurricane_jack]

Recently I have noticed my sugar levels rising quite a lot after fasting. I have tried upping my Lantus (24hr) dose a few times but doesn't seem to have made any difference.

Has anyone any experience of factors other than food making their sugar level go up?

 

[Inka]

Hi @hurricane_jack Have you done a basal test? When you say “fasting”, do you mean first thing in the morning test?

 

[hurricane_jack]

I have previously done a basal test, and been on the same dose for a long time without issue.

More recently I have upped my dosage to try and deal with these more recent rises, but it hasn't helped.

I work irregular shifts, and often eat at irregular times, so it's difficult to track.

 

[Inka]

Yes, I can imagine that the shift work makes it difficult in many ways. If you’ve done the usual things like start a new cartridge of Lantus and check your injection sites for absorption issues, then I’d be thinking about temporary things that could be having an effect eg the hot weather, illness, stress, weight gain, change of routine.

I find that two or three times a year I have to change my basal amount. There’s no obvious reason but I suspect the change of seasons and/or slight fluctuations in my weight over the year. Stress can have a huge effect too, even when I don’t feel particularly stressed externally.

Have you used any other basal insulins apart from Lantus? Have you considered splitting your Lantus dose?

 

[hurricane_jack]

Thanks for the reply.

I don't have any lumps at injection sites. Are there any other symptoms to check?

I have gained a bit of weight recently, and have a bit of stress/anxiety most of the time as well (don't we all?!). I didn't think that would cause the sugar level to fluctuate so much though.

Have used Lantus for a long time now, and only had issues fairly recently, so feel the issues are more likely to be down to other factors rather than the insulin itself. I only take 1 dose per day. Despite my mixed up routine, I have a set time to take it that suits quite well. I worry if I split it, I would forget)get distracted at work etc.

 

[Inka]

I found that sometimes injection areas can have a thickened feel rather than actual lumps eg on my thighs and arms. Hard to describe, but noticeable. So maybe moving to a new site is worth a try. Where do you usually inject the Lantus?

As for weight gain, I’ve found even 7-10lbs can make a difference. It depends on the individual obviously, but it doesn’t have to be a large amount. How much weight have you gained, if you don’t mind me asking?

And if your blood sugar is high in the mornings, have you tried testing at 2am?

 

[hurricane_jack]

Even if it's at a normal level before bed, it tends to have gone up by morning time.

As an example this morning around 4am I was at 6.1. by 9am it was 8.6, then 11am it had shot to 14.4, despite not having eaten anything.

I have already gradually increased my Lantus by over 20%

Don't know exact weight increase, just noticed clothes a little bit tighter! Getting back out on my bike to try and combat it!

My sites seem ok, athough there has been a few occasions where my level has dropped unexpectedly after Humalog (fast acting) should have already worn off. Used to use my legs, but currently use stomach.

Seems to be so many variables, seems a nightmare to work out!

Thanks again for your replies.

 

[grovesy]

Even if it's at a normal level before bed, it tends to have gone up by morning time.

As an example this morning around 4am I was at 6.1. by 9am it was 8.6, then 11am it had shot to 14.4, despite not having eaten anything.

I have already gradually increased my Lantus by over 20%

Don't know exact weight increase, just noticed clothes a little bit tighter! Getting back out on my bike to try and combat it!

My sites seem ok, athough there has been a few occasions where my level has dropped unexpectedly after Humalog (fast acting) should have already worn off. Used to use my legs, but currently use stomach.

Seems to be so many variables, seems a nightmare to work out!

Thanks again for your replies.

I suggest you also do a forum search of Dawn Phenomenon.

 

[Inka]

As an example this morning around 4am I was at 6.1. by 9am it was 8.6, then 11am it had shot to 14.4, despite not having eaten anything.

As @grovesy suggests, that sounds like Dawn Phenomenon and maybe a Waking Rise too. The first is caused by your blood sugar rising as your body gets ready to wake up for the day, and the second is basically the ‘stress’ of getting up. I get both of those. My blood sugar rises from about 4am and, if I don’t eat breakfast and bolus, it will go up to around 9 without insulin.

I have a pump so I set it to give me extra insulin to stop the Dawn Phenomenon. To stop the Waking Rise, I try to eat and bolus soon after getting up. If I can’t do that, i’ll small bolus without food to keep my blood sugar down.

I get what you’re saying about not wanting to split your Lantus but it might be worth a trial to see if it helps. What time do you inject it?

 

[hurricane_jack]

I suggest you also do a forum search of Dawn Phenomenon.

Thanks, will take a look.

 

[hurricane_jack]

As an example this morning around 4am I was at 6.1. by 9am it was 8.6, then 11am it had shot to 14.4, despite not having eaten anything.

As @grovesy suggests, that sounds like Dawn Phenomenon and maybe a Waking Rise too. The first is caused by your blood sugar rising as your body gets ready to wake up for the day, and the second is basically the ‘stress’ of getting up. I get both of those. My blood sugar rises from about 4am and, if I don’t eat breakfast and bolus, it will go up to around 9 without insulin.

I have a pump so I set it to give me extra insulin to stop the Dawn Phenomenon. To stop the Waking Rise, I try to eat and bolus soon after getting up. If I can’t do that, i’ll small bolus without food to keep my blood sugar down.

I get what you’re saying about not wanting to split your Lantus but it might be worth a trial to see if it helps. What time do you inject it?

12.30 lunchtime

 

[hurricane_jack]

As an example this morning around 4am I was at 6.1. by 9am it was 8.6, then 11am it had shot to 14.4, despite not having eaten anything.

As @grovesy suggests, that sounds like Dawn Phenomenon and maybe a Waking Rise too. The first is caused by your blood sugar rising as your body gets ready to wake up for the day, and the second is basically the ‘stress’ of getting up. I get both of those. My blood sugar rises from about 4am and, if I don’t eat breakfast and bolus, it will go up to around 9 without insulin.

I don't sleep well. Does that make me more likely to be affected by dawn phenomenon or a waking rise?

 

[grovesy]

I find it does not help.

 

[Inka]

I don't sleep well. Does that make me more likely to be affected by dawn phenomenon or a waking rise?

I don’t know but I do know that a poor night’s sleep often puts my blood sugar up. You’d expect the opposite but I think it’s the stress on the body that causes the rise.

You say you’re taking your Lantus at 12.30pm. Another option is to gradually move the timing of your Lantus closer to your bedtime in case it’s running out by the following morning. That might not completely solve your problem but it might help.

 

[hurricane_jack]

My bedtime and wake-up time varies due to shift times, which is why I take it at lunchtime.

A lot of my issues seem to be related/linked, but unfortunately I can't change the work aspect that's causing a lot of them, unless I can find another job with more settled hours.

I'll keep working on it! Thanks for all the replies.

 

[everydayupsanddowns]

I used to find that Lantus needed 2-3 days on a new dose to ‘settle’. Have you kept taking the higher dose?

Im another that needs more or less constant basal tweaking to get my meal doses to behave. At least monthly... not by much, but up a bit... down a bit... through the year.

Often I have to go up ‘too much’ for a couple of days, then drop back down to where I thought it should be. almost as if it doesnt notice the small tweak and I have to give it a bit of a shake!

 

[Inka]

Ah.... of course. It must be difficult. The only other answer is a pump, I’d say. You could set different basal profiles for different shifts and it would also stop any Dawn rise.