Very confusing!

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Northerner

Northerner

Admin (Retired)
Relationship to Diabetes
Type 1
My lantus, which I take at night, is 5 units - possibly about to be reduced to 4. After my recent lows, I have reduced from 8 units, and now my levels appear to be good through the night. My levels are also good in the late afternoon and evening, so it's obviously lasting nicely.

However, my morning levels are weird! For breakfast this morning I wasn't very hungry, so had a yoghurt with 12g carbs. Based on previous experiences, I took 6 units of novorapid with this. By lunchtime, I was 7.5 - high for me and suggesting that the 6 units should probably have been 7. Here's the thing though, for lunch I had a cheese and tomato sandwich, another yoghurt and a chocolate biscuit - around 65g carbs. For this I took 8 units. Five hours later I was 4.4, showing that although I'd only had two more units of NR, I'd got the dose pretty spot on! Part of the extra sensitivity may be due to going running after breakfast, but this doesn't seem to affect me until a few hours afterwards.

I'm just very confused by the fact that I need a huge amount more NR with breakfast than any food later in the day. By evening, my NR dose is even smaller in relation to my carb intake. Anyone else have such a huge difference in requirements through the day?
 
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Oh yes! I often need 3 times as much insulin at breakfast than any other meal of the day. For years breakfast was a major issue and always sent my BS up. For ages I was terrified if I put my dose up I'd end up with major hypos, but when I eventually plucked up the courage there were very few hypos. Just my weirdass body much more insulin resistant in the morning!

If there's one thing I've learned it's that insulin requirements change all the time. One day my BS can be perfect, I won't change a thing and the next day they're yo-yoing again. I've given up trying to understand everything that goes on - I just identify the patterns and adjust accordingly.

I'd lastly like to let you know that 7.5 after a meal would be a major result for me - so don't stress too much!

Em
x
 
bigpurpleduck said:
...I'd lastly like to let you know that 7.5 after a meal would be a major result for me - so don't stress too much!

Em
x
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Thanks Em, glad to hear it's not just me 🙂 The 7.5 is before the next meal, rather than the peak after breakfast which is usually around 9. I know it's not bad, but as you say I keep expecting hypos because of all the insulin I took for so few carbs! Wish I had a CGM! I did think it might be because I have such a small basal dose in relation to my bolus, but the rest of the day and night doesn't bear that theory out.
 
I need alot more insulin for breakfast too, but because I haven't had breakfast for a long time,I can't actually remember how much more I need 😱
 
Northerner said:
Thanks Em, glad to hear it's not just me 🙂 The 7.5 is before the next meal, rather than the peak after breakfast which is usually around 9. I know it's not bad, but as you say I keep expecting hypos because of all the insulin I took for so few carbs! Wish I had a CGM! I did think it might be because I have such a small basal dose in relation to my bolus, but the rest of the day and night doesn't bear that theory out.
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Have you ever asked to borrow one Northe? you could perfect your doses even more after using one of them 🙂
 
katie said:
Have you ever asked to borrow one Northe? you could perfect your doses even more after using one of them 🙂
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It's crossed my mind, but I think I'm a bit lazy and the need doesn't seem that pressing as my control is pretty good. Not too keen on wearing one either - I want one that uses light and you wear like a watch!
 
Could be the "dawn phenomenon."
 
DO you not produce Cortisol at different levels throughout the day (i.e. your levels are high in the morning and then lower..... ) which affects your body's response to insulin? (Is that the same as the dawn phenomenon?)

...which is also why people with Cushings (ridiculously high cortisol) have trouble controlling diabetes, and why your blood sugars go higher when you're stressed?
 
I think it is common to be on a higher ratio at breakfast. Pregnancy I was 1.5 units for 10g cho, and 1 to 10 the rest of the time.
 
Before 12am I have 1 unit per 5g
Lunch and Dinner I have 1 unit per 10g

It seems like people are higher in the mornings!
 
A lot have said morning they need more, I actually need less in the mortning and more during day, I guess that's the fun of this "thing" we are all different!

hope you sort something out soon pal,

Rossi
 
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Lauren said:
Before 12am I have 1 unit per 5g
Lunch and Dinner I have 1 unit per 10g

It seems like people are higher in the mornings!
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I only have 3 to 5 units in the morning- I would only have a little more if my blood sugar was high in the morning- also morning is my busiest time- use up a lot of energy- and gradually during the day, ease down. I am starting a carb counting course in September. Sheena🙂
 
http://www.diabetes-support.org.uk/joomla/dawn-phenomenon

Could be the cause of insulin resitance in the morning.

The lower levels after excercise (u state it's a few hours later) is probably becasue your body is trying to replemish its glycogen stores.

I presume its not immediate, as during running your body is trying to produce energy. Glygogenesis, adrenaline release etc increases the sugar and keeps your sugar from dropping.

Don't take this as a medical explanation, I'm only trying to understand+explain it from what I've learnt.
 
Mornings for me, are always a pain in the arse with regards to blood sugars. usually awake on a nice 5.0 mol. but its always close to 6 mol before i leave for work, and the stress and cortisol will send my sugars to 7 mol as soon as get into work . i see more crazy fluctuations in my bloodsugar during the morning than at any other time of day. i avoid carbs in the morning now. usually have a few eggs or a bit of cheese. i dont like going to 7 mol, it gets me annoyed. so i reluctantly resorted to a more protien breakfast and alot of green tea in the morning. i hate it, but it seems to keep my sugars in the 5 -6 mol range in the morning.
 
Also- i found that eating any heavy carbs before i go to bed- ie bread or crackers etc will give me high reading in the morning - usually 7-8 mol in the morning.
 
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