Morning Phenomenon

[RJT]

I’m new today to this forum. I’ve had T1 for 42 years and have been in excellent health. My management has been really excellent all these years until I reached menopause. The last 2 years have been so frustrating as I feel I’ve lost control due to the ‘morning phenomenon’ in particular. My blood sugars have just risen and risen in the morning and now late at night/over night. Since my hba1c is very good, my consultant didn’t think having an insulin pump was necessary but my average blood sugars are climbing. Has anyone else had this problem as I need some help. Thanks.

 

[janw]

I'm type 2 so not much help, but know the menopause is a force unto itself and no-one knows how long it may last, but I found some PDF info for diabetics that might be useful to you. HERE

 

[Inka]

Hi @RJT and welcome 🙂 How frustrating for you! What basal insulin are you taking and when? Have you tried increasing it, especially as you’re now going high earlier in the night?

Also, is your sleep disturbed? A disturbed night’s sleep can push blood sugars up a surprising lot.

 

[rebrascora]

Hi and welcome

I have only been diagnosed a short time.... 3 years tomorrow... but I have found that HRT has been life transforming with no negatives so far and has made my diabetes easier to manage but also improved my sleep enormously. I use patches and I manage on half a dose ie 1 patch a week instead of 2. I can't tell you what a massive difference it has made to my life and with no side effects. I battled menopause (hell) for 5 years before asking for help with it and to a certain extent I used my diabetes as a reason to try HRT because it was confusing my hypo awareness.

If you don't go down that route or don't have a sympathetic GP, then looking at your basal insulin would be worth while and particularly if you are on a long acting basal like Tresiba or Toujeo, then a change to a shorter acting basal like Levemir may be worthwhile. You can adjust the day and night time doses independently and the time you take them as well to better match what your body needs. I really love my Levemir for the ability to adjust it to what my body needs and experience those changes pretty much in real time rather than waiting 3 days with other basals to see the full extent of a change. I find that my body's basal needs change quite a lot and I have to tweak it pretty regularly but Levemir gives me the opportunity and flexibility to do that and Freestyle Libre helps to show me when I need to adjust it.

 

[SB2015]

I’m new today to this forum. I’ve had T1 for 42 years and have been in excellent health. My management has been really excellent all these years until I reached menopause. The last 2 years have been so frustrating as I feel I’ve lost control due to the ‘morning phenomenon’ in particular. My blood sugars have just risen and risen in the morning and now late at night/over night. Since my hba1c is very good, my consultant didn’t think having an insulin pump was necessary but my average blood sugars are climbing. Has anyone else had this problem as I need some help. Thanks.

Welcome to the forum, and god to have your experience on here.

Sorry to hear that you are having difficulties getting levels to stabilise. The menopause does create problems for some in general, and also can impact on glucose levels. The Dawn phenomenon is a pest. There are some things that could help including

• Switching to a basal insulin that you can split, such as Levemir.
  The split enables you to make adjustments to the daytime dose and night dose separately.
• Your bolus ratios might need changing.
  I find that I need different ratios through the day.
• Adjusting the timing of your bolus for your breakfast and evening meals.
  For my breakfast I find a longer gap between the bolus and eating than at other times in the day

You may have already tried these things and still had no joy. The dawn phenomonon along with night hypos was one factor in my applying for a pump, and will not be picked up through an HbA1c test, which is only going to give them and average. With the pump I was able to programme my basal insulin hour by hour I was able to get a lot more control of my levels. It also allows me to deliver my bolus in a variety of ways to suit different foods. For exercise I am also able to be a lot mo proactive turning down my basal before during and after the sessions. For me my HbA1c dropped by 10, and more importantly gave me back a sense of control and flexibility.

Do you have access to Libre sensors? Since these monitor your levels throughout the day it shows more than just an average reading, giving the percentage of time that you are in range, as well as the direction of travel of your levels at any time, enabling you to head off highs and lows.

Let us know how you get on.

 

[trophywench]

What they said - Thank God for Levemir!

Ruddy hormones - like my big sis said when we were both whinging about periods - 'Let's face it Jen, if men had them, they'd have found a cure by now!'

 

[everydayupsanddowns]

Sorry to hear how difficult Dawn Phenomenon is making things for you @RJT

Some members have found the only way they can couteract the overnight rise is to set an alarm and administer a small overnight correction dose. Of course this is a bit high risk, unless you can be sure that your rise is very consistent and never misses a day, so it’s not really something to embark on without checking with your Dr or DSN.

Hope you find a solution that works for you. 🙂