Night hypos?

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runner

runner

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Relationship to Diabetes
Type 1.5 LADA
I've recently split my lantus dose to try and lower morning readings without going hypo during the day. A couple of times, I've woken during the night and tested - the other night BGs were 7.5 at 5am and then 15 at 9.15 before I'd eaten. Are these signs of night hypos?
 
I'm not an expert, but this does not sound like you have had a night time hypo. The 15 before you have had breakfast sounds like what others have described as dawn phenomena. The liver gives you a boost of glucose because you haven't eaten since last night and thinks there is no food around.

If you're worried see your doctor or diabetic nurse, and I'm sure someone will be along with more accurate information soon.
 
Thanks, Caroline, I have heard others talk of 'dawn phenomina' and didn't quite realise what that was. Haven't experienced it before tho' and I am a night-time picker and often eat quite late. I am also still getiing into a routine of taking Lantus in the eve as well, and sometimes forget and take it late, along with any adjusting humalog - perhpas all a bit too much? :confused: I'll email the DSN, but any thoughts would be welcome.
 
I'm on pills so can't offer advice with regards insulin, but do contact the nurse. Things sort themselves out in time.

The other thing is if you worry the stress levels will send the sugar levels up to. It is all to do with the flight or fight mechanism from the days when we were cave dwellers.. We'd get a shot of adrenalin and glucose to give the enrgy for whatever course of action we took.
 
Hiya

I would just like to add something else into the mix here. Non diabetic people can get the dawn phenomenen as well as those with diabetes. You may not be going hypo but just be more prone to this.

The only couple of ways to tell if you are having a hypo is

1. Ask for use a CGMS (continuous glucose monitoring system) which you have to wear a sensor on your body somewhere and it is attached to a pager sized thing but the sensor takes blood sugar readings every 5 minutes and after a few days your team will download the data and you will be able to get a pattern of what is happened.

2. You test perhaps two hourly overnight for a week to get a picture. You'll be knackered but may well be worth it.
 
Thanks for the ideas. Ah caroline, i am stressed at the moment, but nothing to so with diabetes - yet another family situation! Stress does affect my levels, but I haven't had this kind of reaction so far, but who knows?
 
Hi Runner,

I think that I would ask my dsn if I were in your postion because although it might be dawn phenomenen it could be something to do with the times your doing your split lantus doses, i'm probably completely wrong but just thought I would share my thoughts! x
 
Thanks emma, emailing him now.
 
Guess what, DSN reckons it might be dawn phenomenon too! Has also recommended 60/40 instead of the 50/50 split I've been doing, so will give it a go. does anyone know of where i can find out a little more about the dawn phenomenon?
 
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here you go runner xx



Dawn Phenomenon
Very high blood glucose in the early morning due to the release of certain hormones in the middle of the night. The body makes certain hormones called counterregulatory hormones, which work against the action of insulin. These hormones, which include glucagon, epinephrine, growth hormone, and cortisol, raise blood glucose levels, when needed, by signaling the liver to release more glucose and by inhibiting glucose utilization throughout the body.
In the middle of the night, there is a surge in the amount of growth hormone the body releases, followed by a surge in cortisol, which effectively cranks up glucose production in the liver, presumably to prepare the body for daytime activity after a period of fasting. In people who don’t have diabetes, these processes are offset by increased insulin secretion by the pancreas, so blood glucose levels remain relatively stable. However, in people with Type 1 diabetes, whose pancreases don’t make insulin, and in people with Type 2 diabetes, whose livers may not respond to insulin well enough to stop glucose production, changes in glucose metabolism during sleep can have a profound effect on morning blood glucose levels. Typically, the blood glucose level rises between 4 AM and 8 AM.
It is important to realize that high morning blood sugar may be caused by something else: the body’s rebound from low blood glucose levels at night. Rebound hyperglycemia, also caused by the release of counterregulatory hormones, represents the body’s defense mechanism against low blood sugar. The only way to tell the two phenomena apart is to check your blood glucose level in the middle of the night (around 3 AM). If your blood sugar is high, you are probably experiencing the dawn phenomenon; if it is low, rebound hyperglycemia is probably at work.
If you experience high blood glucose levels when you wake up, talk with your health-care team. They can recommend further testing and changes in your meal, exercise, or insulin regimen to alleviate the problem.
 
Thanks Steff, that's very kind of you. BGs unexplicabley high after lunch too :confused: Just got over a cough and cold, hope I'm not coming down with something else! A bit low because finally downloaded stats from new meter and average reading is 9.0 and only 57% within target - bu**er 😱
 
I split my lantus too with a higher % in the morning and I don't have any night hypos on this split. I hope that it works for you. Remember to leave it 3 days before making changes so you know what the full effects are.
 
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