Sky high sugars first thing in the morning

[Fayegracey]

Hi everyone
I’m new here, my partner is type 1 and has been for many years. He recently started with the liber device.
Since having this rapid monitoring system we have noticed sugars climbing high about 9am in the morning (every morning) and continuing up steadily. Even though he has had adequate nova rapid and levimere the night before and had nothing further to eat.

Has anyone else had this before or can shed light on the issue at all?

 

[Robin]

Oh yes, mine does that! The problem is that the liver trickles put glucose 24 hours a day, to keep the vital organs ticking over, even if we’re not eating. And thinking back to the days when we had to get up and go and hunt a Wooly Mammoth for breakfast, it helps out by trickling out a bit extra in the mornings, often from 4am for some people (known as the Dawn Phenomenon), but for others, as soon as their feet hit the floor when they get up in a morning.
Extra basal the evening before doesn’t help, because it would make me go low overnight. My solution is to inject my breakfast bolus as soon as I wake up, and allow a couple of extra units over and above what I need for the carbs, then eat breakfast anything up to an hour later when my glucose levels stop climbing and start to fall.
This works for me,as I’m retired, but may not fit in with someone who has to get up and go to work. Some people have found that going on to a pump sorts the problem, because different basal levels can be set for different parts of the day.

Oh, and sorry, welcome to the forum! I tend to get stuck straight in to answering questions and forget my manners.

 

[rayray119]

Hi welcome to forum this is guinelly known as foot on the floor it's when your liver starts pumping out glucose because your up and moving its likes it's saying "hey Thier doing stuff so they need energy". If not eating breakfast then it might help to have a bit of insulin to conterout the rise. If eating backfast then he could try adjusting his brackfast radio to deal with it. Although I'm only just over a year in so allot less experienced

 

[DaveB]

Hi. Does your partner split the Levemir dose into two injections per day i.e. morning and evening? Many of us find that is necessary and you can then adjust the split so it may not be 50:50. Doing that can make it easier to reduce big spikes.

 

[everydayupsanddowns]

Good old Dawn Phenomenon / Foot On The Floor.

I’m not sure when my body will realise I am no longer living in a cave, and I don’t need an injection of glucose when I wake up to go out and snag a woolly mammoth for breakfast.

Amazing the things Libre traces can show you though, eh!

And interesting to watch how things ebb and flow through the year, and how some of these bits of diabetes randomness can rise and fall in different seasons.

 

[nonethewiser]

No breakfast means my bg spikes without correction or increase in basal rate, so make point of having something to eat each morning, besides enjoy breakfast anyway.

 

[rebrascora]

I am another one who injects my breakfast bolus (mealtime insulin) before I set foot out of bed and then tootle about for 45 mins getting washed and dressed and drinking coffee before I eat breakfast to prevent a morning spike due to that Foot on the Floor liver dump of glucose. The length of time everyone needs is different so it is safest to start with just 20-30mins before breakfast and then increase it by a few mins each day until he finds the best timing for him. Overcoming morning spikes takes a lot longer than other mealtimes and I only need to inject 15-20 mins before meals at other times of day.

It sounds like your partner only injects his Levemir once a day, which is surprising but perhaps that works well for him. Has it ever been suggested that he splits the dose to morning and evening. Levemir doesn't generally last 24 hours so it can run out in the afternoon/evening if you take it as a single dose at night and sometimes be too much during the night but not enough through the day. I inject the majority of my Levemir before I get out of bed with my breakfast insulin (sometimes I set an alarm for an hour earlier and inject it then so that it has got going by the time I get up which also helps with that Foot on the Floor rise. I then just inject a small amount of Levemir on a night because I need very little overnight.... but perhaps your partner's body has a different circadian rhythm of needing insulin to mine and he needs more at night. Understanding how the individual insulins work helps to fine tune it to your body's need.