Morning highs

[soozeee]

Hi wondering if anyone has any advice for me on morning high sugars.

I am currently waking up in the teens - this mroning at 18 when i went to bed with a sugar of 8 and did a test at 2am which was 9.8 (to check my basal). Any ideas as to what would casue the rise between 2am and 7am?? I am hormonal at the mo could that be having an effect?

Thanks

 

[Caroline]

Hormone do affect our highs and lows. Could also be something known as dawn phenomenone. Your liver dumps glucose into your system because it has been a long time since you last ate. Basically your organs need fuel (glucose) to carry on working and if you haven't had any in the any of food for sometime, your liver releases some of its supply of glucose into your system to help keep things working.

 

[Northerner]

Hi wondering if anyone has any advice for me on morning high sugars.

I am currently waking up in the teens - this mroning at 18 when i went to bed with a sugar of 8 and did a test at 2am which was 9.8 (to check my basal). Any ideas as to what would casue the rise between 2am and 7am?? I am hormonal at the mo could that be having an effect?

Thanks

It does sound like what Caroline says - it seems unlikely that you had a hypo and a rebound high if you were 9.8 at 2 am, so it looks likely that you were just steadily climbing through the night - you might have to do a 2 am and a 5 am test to check. I know that a few people have found that they need to have a correction dose of insulin at 5 am and that does seem to apply to the ladies more than men - you are just so much more complicated! 😉 Having a low-carb, low GI snack before bed sometimes helps reduce the Dawn Phenomenon effect.

 

[soozeee]

thank you both for the advise. Yet another thing to try and combat is the battle for the perfect hba1c eh?? il try the extra test and the low gi snack before bed. what type of food would be best? Thanks

 

[Northerner]

thank you both for the advise. Yet another thing to try and combat is the battle for the perfect hba1c eh?? il try the extra test and the low gi snack before bed. what type of food would be best? Thanks

There are a few strategies for tackling it on this page:

http://www.diabetes-support.org.uk/info/?page_id=143

I don't suffer from it myself (I know I'm very lucky!), so can't really vouch for what works and what doesn't.

 

[soozeee]

thanks for that i've had a look at the suggestions and will also ask my diabetes nurse about possibily adjusting my basal dose at night to overcome this
Thanks

 

[Robster65]

Hi soozee.

Long shot, but if you eat your evening meal fairly late and it's got a lot of protein or fat as well as carb, the GI of the meal can be lowered to such an extent that the 'spike' comes in the night and there's no bolus to cover it.

ANother possibility is looking at when you do your basal. If you do it in the morning, it may not be lasting as long as it used to.

Other than that, the hormones would be where my money is.🙂

Rob

 

[soozeee]

Thanks rob

last night i had sausage and mash with peas and gravy at about 5.30pm and did 9 units of bolus to cover this. I did however have some hula hoops and a babybell at about 9pm (thanks to hormonal hunger!) and did 2 units of bolus to cover this.

I split my basal (levermere) at the mo doing approx 13 at 7am and 18 at 8pm (which i know is very high and i am hoping will reduce with imrpoved carb counting and bolus inhections) and weight loss 😎

 

[AJLang]

I have a similar pattern of night time BGs as you. After lots of attempts with my DSN to alter the basal rates I spoke to my consultant who correctly guessed that it was diabetes gastroparesis. My main other symptoms included nausea, sometimes a bloated upper stomach and BGs being slow to go up after meals.

 

[soozeee]

Thanks for that, although I dont seem to have any of teh other systems over than the bloating which is most often due to hormones......

 

[soozeee]

****the other symptoms***

 

[DaisyDuke]

I am having this problem lately.

I can be in the 8's at bedtime and wake up with 14-18mmol in the morning.

I have tested at 3.00am and it is still in range and then up they go.

I also put 18 units of levemir at 9.00pm and 13 units at 9.00am.

I woke up to a 9.3mmol this morning afte putting a couple more units of levemir in but the DP crazes me.It seems to go up after about 4.00am.

 

[soozeee]

sorry to hear your struggling too! Although great to know im not alone in this strange occurance! What ur plan for combatting it? I dont know if i can face tests and corrections at 2 and 5am - waking once in the night to test is bad enough; i miss a full nights sleep! but also cant stand these morning highs as knocks my control out for the day! x

 

[mcdonagh47]

I am having this problem lately.

I can be in the 8's at bedtime and wake up with 14-18mmol in the morning.

I have tested at 3.00am and it is still in range and then up they go.

I also put 18 units of levemir at 9.00pm and 13 units at 9.00am.

I woke up to a 9.3mmol this morning afte putting a couple more units of levemir in but the DP crazes me.It seems to go up after about 4.00am.

might not be relevant but you and soozee might look at the Somogyi Effect

http://en.wikipedia.org/wiki/Chronic_Somogyi_rebound

 

[Natalie123]

Hi, I sometimes get something like this too, I find that I rise quickly in the morning especially if I have a lie in and don't get up straight away! I find a small snack before bed helps (like nuts or the babybell would work). Don't worry about the doses you are taking, this bothers me too, I take 12 units of levemir in the morning and 32 before bed, but it depends on the person. To me it looks like you would need more levemir before bed, this would bring the 2am reading down and will give you better morning levels

 

[novorapidboi26]

I too suffer from the Dawn Phenomenon...........

Every morning at around 4:00-4:30 the hormonal response kicks in, this time varies for everyone and I believe is dependent on when your body clock thinks you are going to rise......

Having carbs for breakfast will definitely help as your liver can then stop its glucagon release in response to the carbs eaten..........

My strategy is to give my evening dose of Levemir at about 10:30, as opposed to 5:30-6:00pm, a 12 hour split with my 6:00am dose.........this then gives me more units of my evening Levemir active at 4:00-4:30, so far this has been a success, obviously you will need to ensure you evening dose is correct by doing 3 am tests and confirming your before bed test is within 1 0r 2 mmols of the 3am test.....

However late meals/snacks and drinking all throw this careful tuned tactic out the window, its an on going battle....

 

[soozeee]

Yep def an ongoing battle; prob not helped by my love of a evening snacks in front of telly (but i do calculate the carbs and do extra bolus for this)

Yday I woke up at 8.3 which was pleased about. Today I tested at 3am and was 7.4 but when tested for bfast at 7.30am it was 15.5 so def getting the dawn rise. May start doing more levermir and do it later as suggested. Usually do it at 8pm but may push back to 10ish and see if helps.

had 3 hypos in day yday so reduced 7am levemir to 12 today

Cheers for everyones advice 😛 x

 

[DaisyDuke]

Yep def an ongoing battle; prob not helped by my love of a evening snacks in front of telly (but i do calculate the carbs and do extra bolus for this)

Yday I woke up at 8.3 which was pleased about. Today I tested at 3am and was 7.4 but when tested for bfast at 7.30am it was 15.5 so def getting the dawn rise. May start doing more levermir and do it later as suggested. Usually do it at 8pm but may push back to 10ish and see if helps.

had 3 hypos in day yday so reduced 7am levemir to 12 today

Cheers for everyones advice 😛 x

Your blood sugar rises are just like mine so I also am going to start injecting at 10.30pm and see if that helps me also.The night before last I was 8.1 at 3.00am and then at 6.00am I was 14.3.

 

[Vicsetter]

I think you can afford to increase your evening dose. I found I needed a higher evening dose than the morning one, which makes sense because you are probably eating more in your evening meal than the rest of the day.

Try using the adjustment guide here: http://medweb.bham.ac.uk/easdec/prevention/lantusnotes.htm.

Injecting your evening dose later will only have an effect if your dose is not high enough and is getting exhausted before you wake up (which is what I suspect is happening). I would suggest you inject at the same time each day about 12 hours apart (which is how long roughly Levemir lasts). Aim to go to bed with a reading closer to 6.5 than 8+. Eat your evening meal earlier, I eat at 7pm so that by 10pm I should be close to/under 7.