Fasting Levels

[Wood90]

Morning all,

I'm a fairly new t1 about 6 weeks in. Just a question about morning bs levels. Every morning when I wake up. My sugars are always high. Last night before I went to bed I testing and they were 7.4. I've woke this morning tested and I'm at 16.
How can I get them lower in the mornings.

Any help is appreciated 🙂 still trying to get use to it all.

Thanks

Aimee

 

[helli]

Morning @Wood90
There are two main things which can affect fasting blood sugars - your background insulin dose is not high enough or Dawn Phenomenon.
What insulin are you taking at the moment? It is usual to take a daily insulin (basal) and a short acting one with meals (bolus).
The purpose of the basal is to keep your blood sugars level in the absence of external influences like food and exercise. If your levels slowly rise during the night, it is usually a sign that your basal insulin dose is too low.
However, most of us are also affected by Dawn Phenomenon (DP). Our bodies helpfully prepare for the day ahead. Our livers dump glucose into our blood to give us the energy we need to get out of bed. A healthy pancreas will react by dumping insulin. An unhealthy (diabetic) pancreas cannot do this and we see our levels rise. It is not easy to counteract DP. Some find a small snack before bed helps. I find exercise the day before helps. Others find they just have to take a correction bolus dose as soon as they wake up.
I guess tere is a third option - if you eat just before going to bed and don't take enough bolus insulin, your levels will rise. Unfortunately, some foods have a delayed response. For example, pizza can take 5 hours (or more) to digest and affect our blood sugar levels so we could see a high in the morning, if we didn't take enough bolus with our evening meal.

I think you need to work out whether your levels rise slowly through the night or remain stable until the early hours. If you have a Libre, this is easy - you can look at your graphs. Otherwise, I am afraid, you will have to set an alarm and doing a finger prick in the middle of the night. But I recommend requesting a Libre - more than half of the people with Type 1 now have them and the NICE recommendations have just changed to make it even easier to get them in England.

 

[Wood90]

Morning @Wood90
There are two main things which can affect fasting blood sugars - your background insulin dose is not high enough or Dawn Phenomenon.
What insulin are you taking at the moment? It is usual to take a daily insulin (basal) and a short acting one with meals (bolus).
The purpose of the basal is to keep your blood sugars level in the absence of external influences like food and exercise. If your levels slowly rise during the night, it is usually a sign that your basal insulin dose is too low.
However, most of us are also affected by Dawn Phenomenon (DP). Our bodies helpfully prepare for the day ahead. Our livers dump glucose into our blood to give us the energy we need to get out of bed. A healthy pancreas will react by dumping insulin. An unhealthy (diabetic) pancreas cannot do this and we see our levels rise. It is not easy to counteract DP. Some find a small snack before bed helps. I find exercise the day before helps. Others find they just have to take a correction bolus dose as soon as they wake up.
I guess tere is a third option - if you eat just before going to bed and don't take enough bolus insulin, your levels will rise. Unfortunately, some foods have a delayed response. For example, pizza can take 5 hours (or more) to digest and affect our blood sugar levels so we could see a high in the morning, if we didn't take enough bolus with our evening meal.

I think you need to work out whether your levels rise slowly through the night or remain stable until the early hours. If you have a Libre, this is easy - you can look at your graphs. Otherwise, I am afraid, you will have to set an alarm and doing a finger prick in the middle of the night. But I recommend requesting a Libre - more than half of the people with Type 1 now have them and the NICE recommendations have just changed to make it even easier to get them in England.

I take 8 units of lisbro before breakfast and lunch and 6 units before evening meal. I then have 18units of toujeo before I go to sleep. The drs upped my toujeo a couple of weeks ago. Does this mean they may have to up it even more.
I'm due back to see the consultant in a couple of weeks so I hoping the give me a CGM.
I exercise most days. I'm quite active but I've found that whenever I exercise my levels always rise.
So frustrating at times. I know it takes a while following diagnosis for your body to get use to it and to find the right dosage ect. But it's so frustrating when you keep getting high levels.
Thanks so much for replying. Really appreciate it 🙂

Aimee

 

[helli]

@Wood90 it is possible that they could increase your insulin dose.
It would also be great if they could give you the knowledge and confidence to do it yourself, especially with regard to carb counting with the lispro. Currently they are assuming you eat the same number of carbs for every lunch and evening meal (it is common to eat the same breakfast so that makes sense to have a fixed dose). If you have a lower carb meal (e.g. an omelette with salad and no chips) you could hypo.
High level are frustrating. Over time you will gain the knowledge to reduce them but it is not a good idea to bring your levels down too fast as this could damage your small cells.

 

[Wood90]

@Wood90 it is possible that they could increase your insulin dose.
It would also be great if they could give you the knowledge and confidence to do it yourself, especially with regard to carb counting with the lispro. Currently they are assuming you eat the same number of carbs for every lunch and evening meal (it is common to eat the same breakfast so that makes sense to have a fixed dose). If you have a lower carb meal (e.g. an omelette with salad and no chips) you could hypo.
High level are frustrating. Over time you will gain the knowledge to reduce them but it is not a good idea to bring your levels down too fast as this could damage your small cells.

Yeah when I last spoke to the diabetic nurse she spoke to me about carb counting and eventually being able to change doses myself so I think I'm booked in for a session with someone in a month or 2.
Hopefully things will get better 🙂

 

[trophywench]

Mate - never worry about the exact dose of insulin you happen to need - your body is different to anyone in the world else's and it needs what it needs when it needs it!

It's literally as changeable as the weather - most of us need less when the weather is scorchio and more when it's freezing but anyway, being of the female persuasion you may well discover as you get more daily blood test results to compare that you need more just prior to that time of the month ...... or not !

Anyway let it be known and understood that neither insulin brands nor doses of it, are not fixed in stone by any means, so something else we gradually get used to and eventually happily just change them ourselves without stressing about it, eventually.