Morning sugar on Insulin

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Finwiz

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Am T2. Recently started on insulin (Abasalgar 14 unit once a day at night). DSN said it might be a while to adjust to the correct dose). Morning sugar is around mmol when I wake up. This rises by about 2-3 before I have tea and breakfast.

I use Libre 2 and also test bloods with lancets. The readings between the two are within 1-1.5 range. Should I expect a rise when I wake up? I have read about "The dawn phenomenon" - can it be this or other factors and can it be managed?
 
Hi @Finwiz You’ve missed out the actual number your morning blood sugar is in your post above.
 
If the rise happens before you get up (very roughly from around 4am) then it’s Dawn Phenomenon. If it happens once you’re up (before you’ve eaten) then it’s Foot on the Floor @Finwiz Both are annoying.

If you’ve only recently started the insulin, then it’s possible you’re simply not at your optimum dose yet.
 
Finwiz said:
Am T2. Recently started on insulin (Abasalgar 14 unit once a day at night). DSN said it might be a while to adjust to the correct dose). Morning sugar is around mmol when I wake up. This rises by about 2-3 before I have tea and breakfast.

I use Libre 2 and also test bloods with lancets. The readings between the two are within 1-1.5 range. Should I expect a rise when I wake up? I have read about "The dawn phenomenon" - can it be this or other factors and can it be managed?
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I started using a long lasting insulin 6 months ago , i was started on 12 units and experienced similar readings like your having, now i have 32 units and have regular moving reading mostly 5s i also have a Libre 2 so can track how my BS behaves.
 
Pam123 said:
I started using a long lasting insulin 6 months ago , i was started on 12 units and experienced similar readings like your having, now i have 32 units and have regular moving reading mostly 5s i also have a Libre 2 so can track how my BS behaves.
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Just what I am going through! Did you start with once a day and are you still on once a day? Not where I read but I thought (may be wrong) that once a day can only go up to 20 units at a time
 
Yes i am taking one dose a day in the morning, i started with 12 units and on the advice from my DN i increased it by 2 units every few days, over the 6 months i have had to go up to 32 units the last increase was about 3 weeks ago and now everything is fine hope that helps
 
Pam123 said:
Yes i am taking one dose a day in the morning, i started with 12 units and on the advice from my DN i increased it by 2 units every few days, over the 6 months i have had to go up to 32 units the last increase was about 3 weeks ago and now everything is fine hope that helps
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Thank you. I know everyone is different but this explains some of my questions
 
The scenario that @Pam123 describes of starting on a conservative dose & adjusting upwards until you hit the sweet spot is typical. If you haven't been recommended to do that then there's probably a conversation to be had with your DSN. Although they may just be wanting to see how you respond initially.
 
RBZ5416 said:
The scenario that @Pam123 describes of starting on a conservative dose & adjusting upwards until you hit the sweet spot is typical. If you haven't been recommended to do that then there's probably a conversation to be had with your DSN. Although they may just be wanting to see how you respond initially.
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I started insulin about 5 weeks ago and the DSN is monitoring at regular intervals. As you say, the dose will be adjusted over the next few weeks. Hopefully then it will settle down. Being a new user, there is always some anxiety!
 
Some people (by no means everyone) find that injecting an insulin dose greater than X units (or Y units or Z units etc) results in it not being absorbed well by their body and hence decide to split their dose into 2 separate injections. Not all insulins are prone to doing that either. People just ARE different from each other!
 
I split my basal insulin dose, currently 20units, into 2x10u and jab one into each buttock. I just feel that it is better for the subcutaneous tissue not to have larger quantities injected into one spot and I feel that spreading it across 2 sites means that I should get better absorption and it is simple enough and just takes a few seconds longer. I don't use a new needle or anything.
I think there is a guideline maximum dose but believe it is much larger than this, at maybe 60 units per injection.
 
Finwiz said:
I started insulin about 5 weeks ago and the DSN is monitoring at regular intervals. As you say, the dose will be adjusted over the next few weeks. Hopefully then it will settle down. Being a new user, there is always some anxiety!
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I ended up having to speak to the doctor as at my doctors surgery the DN only attends at random weeks and i went directly to the head diabetic lead doctor, he told me he was very impressed with my progress, and although i had thought i needed insulin when i had food he said i didn't need it and it was the pharmacist when i had my medical review who told me to increase the dose as well as the DN, but in all honestly she seamed to know better
 
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