Don't get this one

[mikeydt1]

Going to be starting Lantus in due course but between then and now i have been asked to do some fasting BG readings but this one has totally thrown me.

Last night before going to bed my BG hit over 14 so took remaining diabetic med to try and reduce the levels. gets up early this morning and checked BG showing 8.1 all good but then re-checked about an hour later still on fasting it has climbed to 12.1!

Had no milk or foods only some fluids so not sure why the big jump.

Any ideas as to why that has happened? have got an appt next Wednesday to discuss diabetic stuff so will let the person know about this situation.

 

[John Gray]

Research dawn phenomenon!

 

[rebrascora]

Totally normal. My levels can rise 6mmols in that first hour after getting out of bed. I need to inject 1.5-2 units of fast acting insulin as soon as I wake up to prevent the rise.
As mentioned it is Dawn Phenomenon or Foot on the Floor syndrome where your liver pumps out extra glucose in the morning to give you energy for the day ahead and is believed to stem back to prehistoric days when we didn't have a kitchen with food in the cupboards and fridge and had to go out and hunt or gather our first food of the day. It doesn't take anywhere near that amount of glucose to walk to the kitchen but our liver is clearly a bit slow to catch on that this function is no longer required. People without diabetes have te same but their body produces adequate insulin to remove that glucose and store it for later, whereas those of us with diabetes see our levels heading up sometimes pretty rapidly into orbit!

 

[RichardsUsername]

Going to be starting Lantus in due course but between then and now i have been asked to do some fasting BG readings but this one has totally thrown me.

Last night before going to bed my BG hit over 14 so took remaining diabetic med to try and reduce the levels. gets up early this morning and checked BG showing 8.1 all good but then re-checked about an hour later still on fasting it has climbed to 12.1!

Had no milk or foods only some fluids so not sure why the big jump.

Any ideas as to why that has happened? have got an appt next Wednesday to discuss diabetic stuff so will let the person know about this situation.

I would just add that you will find what works good for you. Other members on here said they can go 6 to 8 hours without food in response to me posting 3 hours is normal. If I did that, when it hit hour 6 and I sat down to dine my BG would be over 20.0 when I'm finished.

 

[snowball12]

Happens to me all the time. I only test just before dinner twice a week as the stress will send my levels through the roof

 

[Jasmin2000]

Totally normal. My levels can rise 6mmols in that first hour after getting out of bed. I need to inject 1.5-2 units of fast acting insulin as soon as I wake up to prevent the rise.
As mentioned it is Dawn Phenomenon or Foot on the Floor syndrome where your liver pumps out extra glucose in the morning to give you energy for the day ahead and is believed to stem back to prehistoric days when we didn't have a kitchen with food in the cupboards and fridge and had to go out and hunt or gather our first food of the day. It doesn't take anywhere near that amount of glucose to walk to the kitchen but our liver is clearly a bit slow to catch on that this function is no longer required. People without diabetes have te same but their body produces adequate insulin to remove that glucose and store it for later, whereas those of us with diabetes see our levels heading up sometimes pretty rapidly into orbit!

I always thought the DP was different to the FotF syndrome. DP occurs from 3-6 am whilst you're asleep but FotF begins when you actually get up and exert effort.

At least for me DP occurs at 3-6 am an can be reduced with basal and fast acting but FotF occurs about 30-60 min after rising and is much more insulin resistant. I can clearly separate them on the Libre.

 

[rebrascora]

I always thought the DP was different to the FotF syndrome. DP occurs from 3-6 am whilst you're asleep but FotF begins when you actually get up and exert effort.

At least for me DP occurs at 3-6 am an can be reduced with basal and fast acting but FotF occurs about 30-60 min after rising and is much more insulin resistant. I can clearly separate them on the Libre.

They are both caused by the same mechanism though..... the body's circadian rhythm triggering the liver to release excess glucose into the blood stream to give you energy for the day ahead.
I never get DP and I have a feeling that it may be because I worked rotating shifts for a lot of years, so perhaps my body learned not to start up until I actually got out of bed, but then I get a very consistent and impressive surge which thankfully allows me to preemptively jab Fiasp for it as soon as I wake up and that works really well. I tried setting an alarm and injecting my basal insulin an hour before I intended to wake/get up, but the novelty of that wore off quickly enough 🙄 and the Fiasp is really good as long as I wake up with my levels nice and low. If my levels are above 7 I have to get really heavy handed with it.

 

[Jasmin2000]

They are both caused by the same mechanism though..... the body's circadian rhythm triggering the liver to release excess glucose into the blood stream to give you energy for the day ahead.

But there are very different triggers, mechanisms and treatments for these so-called counter-regulatory responses, such as the DP, FotF, the Somogyi effect, and responses, such as abnormal catecholamine secretion, and different forms of diabetes (Type 1 and 2 or gestational diabetes) can skew the factors at play.

I never get DP and I have a feeling that it may be because I worked rotating shifts for a lot of years, so perhaps my body learned not to start up until I actually got out of bed, but then I get a very consistent and impressive surge which thankfully allows me to preemptively jab for it as soon as I wake up and that works really well. I tried setting an alarm and injecting my basal insulin an hour before I intended to wake/get up, but the novelty of that wore off quickly enough 🙄 and the Fiasp is really good as long as I wake up with my levels nice and low. If my levels are above 7 I have to get really heavy handed with it.

Exactly, some treatments and activities may suppress one form but not another, and this demonstrates that the profile of triggers (hormones and other factors) is different for each response. This is important if you're tying to manage hyperglycemic responses, as you don't want to pump in insulin when Metformin or Glinides is more appropriate.

 

[mikeydt1]

Knew about the dawn thing but lost me a tad with 2 different things poss going on. With the BG jumping up it does then pose a problem as eating anything during the day just then keeps increasing the glucose levels causing hyper attacks. all very well but not so good when you have heart disease and so on can be very damaging. picked up the Lantus now.

 

[Jasmin2000]

Knew about the dawn thing but lost me a tad with 2 different things poss going on. With the BG jumping up it does then pose a problem as eating anything during the day just then keeps increasing the glucose levels causing hyper attacks. all very well but not so good when you have heart disease and so on can be very damaging. picked up the Lantus now.

There are multiple such counter-regulatory responses, depending on your diabetes type, carb intake and general lifestyle, and whether you're pregnant (I work in gestational diabetes).

But all of the causes are secondary to getting control of your BG and whilst Lantus should give you some overall stability it's not the insulin you need to balance out carb spikes and for this you may need to supplement the basal with a fast-acting insulin.

 

[mikeydt1]

just got up no nothing since around 6.30pm and up to 12.1! was on a day ward and they knew about these fasting high levels going on told me they were going to refer to the diabetes clinic and no nothing. luckily i have an appt first thing Wednesday morning to try and address.