# Blood sugar levels in the morning etc



## Emmal31 (Dec 3, 2008)

Hi Everyone,

I was diagnosed at the start of this year with type 1 and have recently discovered why my blood sugar's are sometimes high in the morning when I've had a normal level (or so called normal level by the hospital) when testing my blood for my lantus injection.The reason why your blood sugar levels can go up overnight is that your Liver has a store of glucose which it releases overnight to give you some energy when you are asleep.  If the background insulin (Lantus) level is not right you will often see a higher level in the morning than at bedtime.The level you go to bed on should be similar to when you wake up.  

I don't really quite understand why I wasn't told about this before because I feel it is quite important. Does anyone else feel really rough all day after they've had a high blood sugar level all night? Also do people think that we really should be helped more because so far I've had little help whatsoever and I've done okay for the most part but I just think it's unfair that were left to it so to speak. 

Also when I told my doctor I was on 30 units of lantus he thought this was extremely high but when I wake up in the morning my blood sugar is at a good level so what's the problem??

Thank u in advance for reading my ramblings


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## sofaraway (Dec 3, 2008)

Emma I agree i think it's terrible how people with diabetes are just kinda left to figure it out on our own, i said in another post i think I have learnt 90% of what i know about diabetes though online forums like this one. I think that everyone diagnosed should go on a DAFNE/DESMOND about 3 months after being diagnosed.

there are 2 reasons why blood sugar in the morning is high, dawn phenomenon-as you have described and also somogi effect- where basal is too high causing a hypo that you sleep through and the liver kicks in and releases a ton of glucose causing you to wake up with a high blood sugar. 

if you blood sugars are good then is doesn't matter what dose you are on. 30 units isn't a huge dose. how does it compare to your units of bolus insulin each day?


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## Daisy (Dec 3, 2008)

Hi Emma
My bs is generally high in the am and continues to rise if I don't eat breakfast! - I have increased my evening lantus ( I take it twice a day in the am and at night) by 1 unit and now I go low every night. I heard that your bs can drop by 2 overnight and that is pretty average - I wish! Oh to be on a pump....
BTW 30 units is in no way a large dose. Sounds like your doc is getting his basal and bolus mixed up. Would'nt surprise me at all!


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## Viki (Dec 3, 2008)

Best way to see exatly whats happening during the night is to set a lovely alarm for 3am and see what your levels are like then!! Should tell you if your BG is going up or down during the night and will help you with what to do during the next day and when you wake up high.

Night high BGs make me feel ropey the next day too, but nothing like a night hypo which can leave me completely zombified and unable to get out of bed at all!


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## Emmal31 (Dec 4, 2008)

Sofaraway - I'm prob being thick here but what is Basal and Bolas? I just use lantus and novorapid? 

Thank u all for ur responses. I really wish I had found this website sooner because I've spent the last 11 months in complete isolation from other diabetics!


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## sofaraway (Dec 4, 2008)

Emmal31 said:


> Sofaraway - I'm prob being thick here but what is Basal and Bolas? I just use lantus and novorapid?
> 
> Thank u all for ur responses. I really wish I had found this website sooner because I've spent the last 11 months in complete isolation from other diabetics!



No you're not thick at all.

you are on a basal bolus regieme (even if you didn't realise it)

basal is another name for the long acting- which is your lantus

bolus is the name for fast acting which you use for meals and to correct high blood sugars- which is your novorapid

other basal insulin are levemir and insulatard
other bolus insulins are humalog and aprida

hope that helped


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## katie (Dec 4, 2008)

I use 24 (lantus) at night and I often wake up with a higher glucose level.  Ive tried going up to 26 (cant do 25) but it usually makes me hypo.  im not sure if it's because i quite often eat near bedtime or if my lantus is wrong...

think I will try the 3am alarm sometime.  If anyone has any other suggestions it would be much apprieciated


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## tracey w (Dec 4, 2008)

Hi,

i have never been told to take corrective doses by my team. is this because I am on humalog 25, a mix of long and short acting, so would not be appropriate?

Would be great to be able to correct as I sometimes go very hi in the afternoons. Today i was 17.9 3 and half hours after lunch!

So true you really are just left to get on with things on your own, you really do have to find out by yourself!


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## delta (Dec 5, 2008)

my son is on mixtard so this may not be the same but he was having a lot of hidhs in the morning so i lowered his insulin i know sounded daft to me to when his nurse told me but it worked as you are right if you go low your liver will use up its stores of glucose but if youve been having a lot of low your body will run out of stores


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## aymes (Dec 5, 2008)

tracey w said:


> Hi,
> 
> i have never been told to take corrective doses by my team. is this because I am on humalog 25, a mix of long and short acting, so would not be appropriate?
> 
> ...



mixed insulins are not usually used for corrections, this is because although the rapid acting element would bring your numbers down you'd then also have more background insulin kicking around, increasing risk of hypo and generally throwing things off! It may be worth talking to your dsn (or similar) to see if you can have a separate prescription of rapid insulin for corrections if suitable, although in my experience they prefer you to go on the basal bolus system if you're correcting.

A


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## Emmal31 (Dec 5, 2008)

sofaraway said:


> No you're not thick at all.
> 
> you are on a basal bolus regieme (even if you didn't realise it)
> 
> ...


Oh right okay thank u very much sofaraway as the saying goes you learn something new everyday!


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## katie (Dec 5, 2008)

katie said:


> I use 24 (lantus) at night and I often wake up with a higher glucose level.  Ive tried going up to 26 (cant do 25) but it usually makes me hypo.  im not sure if it's because i quite often eat near bedtime or if my lantus is wrong...
> 
> think I will try the 3am alarm sometime.  If anyone has any other suggestions it would be much apprieciated



Last night I tested my blood and it was 12.6 so I just took my Lantus (24) and went to bed because I didn't want to risk a night hypo by correcting.  I don't think I had eaten anything since dinner.

I just tested and all ive had so far is a cup of tea with one sugar and it's 16.8


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## tracey w (Dec 5, 2008)

aymes said:


> mixed insulins are not usually used for corrections, this is because although the rapid acting element would bring your numbers down you'd then also have more background insulin kicking around, increasing risk of hypo and generally throwing things off! It may be worth talking to your dsn (or similar) to see if you can have a separate prescription of rapid insulin for corrections if suitable, although in my experience they prefer you to go on the basal bolus system if you're correcting.
> 
> A



Thanks Aymes, this is what I thought. I will be seeing them on the 18th. Have been thinking I might need to go on this regime myself. didnt want to at first but hey what difference does another couple of injections make, the main thing is better control!


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## katie (Dec 12, 2008)

YAY! I have changed my Lantus to 20 now. and so far my morning readings have been lower. woo! thanks - my diabetes nurse only suggested taking a higher level of lantus in the eve, not a lower one


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## WorzelGummidge (Dec 12, 2008)

Daisy said:


> Hi Emma
> My bs is generally high in the am and continues to rise if I don't eat breakfast! - I have increased my evening lantus ( I take it twice a day in the am and at night) by 1 unit and now I go low every night. I heard that your bs can drop by 2 overnight and that is pretty average - I wish! Oh to be on a pump....
> BTW 30 units is in no way a large dose. Sounds like your doc is getting his basal and bolus mixed up. Would'nt surprise me at all!



Is there a reason you're on two Lantus injections instead of one? Because it has no definable peak there's no benefit to splitting it, it just means an extra jab!


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## Inland-Revenue Man (Dec 12, 2008)

Mine tends to go high around tea time (Evening meal at 18:00)

Whilst it has been ok recently, I think it has gone high due to not giving enough insulin at lunch.

Having said that, I have had trouble with the morning tests in the past, although it has tended to be waking up too low as opposed to too high (I have only been hospitalised twice in 21 years of type 1 diabtetes, once for attempting to take a shower whilst hypo, gaining concussion as a result and once waking up in bed with a paramedic in my room!)

I found that doing a few tests at 4 in the morning helped (Although I didn't appreciate the alarm!) as it showed my levels were dropping too sharply during the night.

Goodluck with controlling your morning results, as I find that if I start the day well, I will have decent reslts throughout. Conversely if I start badly and have to adjust, the day ends up being a write off.


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## Andy (Dec 13, 2008)

I am Type 2 and have been diagnosed for about 2 and a half years now. I have recently (about 3 weeks ago) been referred by my GP to the diabetes clinic at the hospital and saw the consultant there for the first time about 3 weeks ago. My H1bac was 9.3 and I was taking 3 x 850mg metformin, 4 x 80mg gliclazide per day for the diabetes. When I saw him my readings in the morning were always around the  13 - 15 mark and indeed on the morning of the appointment when the nurse check my bloods it was 14.7. He has decided to put me on yet another tablet on top of the others which is 1 x 100mg of sitagliptin which I believe is a fairly new drug. Anyway it doesn't seem to be bringing my readings down very much as I do test twice a day as apparently this drug combined with the gliclazide can cause low readings and hypos (mind you I wish I could get low enough!!).

I feel that I would be far better on insulin (although I obviously don't want to inject) as at the moment I am so lethargic and don't feel like doing anything. My readings are still high especially in the morning when they should be at their lowest. My next appointment with the clinic is 2nd April for a review of my medications etc. 

Can anyone advise whether they think I should call for an earlier appointment and ask to go on to insulin? Or am I being over cautious? Oh I forgot they found protein in my urine so have got an abdominal ultrasound scan on 7th Jan which is an added worry.

Can anyone please offer any advice/guidance on any of the above issues.

Thanks and regards.


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## WorzelGummidge (Dec 13, 2008)

I'm really sorry you're feeling so lethargic and worried Andy. I think you should discuss your concerns with the consultant or nurse. They might be trying to avoid putting you on insulin to save you having to inject, or they might not think it would solve the problem. I used to accept whatever my consultant or nurse decided to do with my diabetes but now I feel much more comfortable questioning their decisions or letting them know if I don't want to do something. Unless you ask, they won't know that you think insulin might be a good idea.


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## Andy (Dec 14, 2008)

Thanks Worzel. Yes I have already asked but they seem determined to just put/keep me on tablets even though I have said I feel that insulin is the only answer to getting my bloods down. What worries me is having high readings is fine but what is it doing to my body long term? I am 51 so would like to prolong my life rather than end it ha ha (only joking). 

Very frustrating and when I eventually get the ok for insulin I am sure I will be saying I told you so and believe me I will be very quick to let them know that.

Regards.


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