# high morning bGs if I eat too late at night



## Dory (Jan 19, 2013)

Hi all,

I've been noticing a trend for a long time now which really baffles me.  If I eat too close to bedtime (ie within 3 hours or so) and have anything more than a snack (ie a few bites of anything) my readings in the morning will be high.

It doesn't matter whether it's CHO food or not (it can be soup, a banana, cold sliced meats, cereal etc) - it still has the same result.  It's not my basal/bolus/correctional, as if I check my readings before I go to bed they're normal (6-8).

The only thing I can think of is that the food, which presumably won't get digested enough before my body goes to sleep mode, sits in my stomach and somehow causes the rise indirectly (it can't be as simple as the sugars in the food; as I say sometimes I don't even have CHO late in the evening).

Has anyone noticed this?  Does anyone have any tips?  I can't eat earlier - I don't get home from work until about 7pm eaach night as is (sometimes later) and most days during the week I have to then shoot off to the gym for classes and then dont' get home until 8.30-9pm.


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## pgcity (Jan 19, 2013)

That's really interesting. I have noticed this too. I had some cheeses at 10pm. Was 6.0 at 12am but 10.1 at 3am. I thought there must be some weird effect from the fat and protein but who knows.


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## novorapidboi26 (Jan 19, 2013)

could you test your blood every hour overnight when you do have something to eat........?

might shed some light.....


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## AJLang (Jan 19, 2013)

I have this happen because of my gastroparesis


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## Dory (Jan 19, 2013)

novorapidboi26 said:


> could you test your blood every hour overnight when you do have something to eat........?
> 
> might shed some light.....



but i know what's happening overnight - the sugars are rising   I need to work out why - as in what is it do do with eating food late....



AJLang said:


> I have this happen because of my gastroparesis



what's that AJ?


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## Dory (Jan 19, 2013)

pgcity said:


> That's really interesting. I have noticed this too. I had some cheeses at 10pm. Was 6.0 at 12am but 10.1 at 3am. I thought there must be some weird effect from the fat and protein but who knows.



Oh I'm so glad I'm not the only one noticing this.  It's so frustrating!  my DSN has suggested I just give myself a bit more bolus than usual but that's a bit dangerous as I will have no idea how much to give myself for each different type of food (not to mention bolusing for cheese seems wrong!  )

I don't really know what to do - I can't not eat as usually I've had nothing by the time I get home from the gym and like to eat some chicken/turkey.seafood etc to get protein back in my body (plus if I don't eat then I'll be starving the next morning)


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## AJLang (Jan 19, 2013)

Hi Dory it's a complication of diabetes which causes delayed emptying of food from the stomach into the intestine which causes erratic blood levels but also other symptoms such as nausea/vomiting, bloated stomach etc.  It has to be diagnosed through tests such as a gastric emptying study which is completely pain free.  It's a form of neuropathy caused by damage to the vagus nerve.  Treatment varies but I have four doses of domperidone and erythromycin a day, test my BG about ten times a day and make adjustments as necessary..  I use a multiwave for my evening meal but that still isn't good enough for the sudden 3am increases so I'm currently experimenting with increasing my basal from 2-4am but this then risks a hypo if I have a "good" gastroparesis day.


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## Pumper_Sue (Jan 19, 2013)

The simple solution is to have a different carb ratio for that time of the evening and see what happens. 
If I eat a lot of protien/fat for an evening meal then I need to set an extended bolus or a temp basal to counter act the rising blood sugars.


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## Dory (Jan 19, 2013)

Sue - that won't solve it, as when I'm having food with no carbs (ie sliced chicken, or scrambled egg, or cheese or something) i don't even bolus!!  hence my concern above at having to bolus even when I'm having no CHO!


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## Pumper_Sue (Jan 19, 2013)

Dory said:


> Sue - that won't solve it, as when I'm having food with no carbs (ie sliced chicken, or scrambled egg, or cheese or something) i don't even bolus!!  hence my concern above at having to bolus even when I'm having no CHO!



There lies your problem it's a load of protien and or fat. Many if not all type 1's who just have a protien meal need as much insulin for that as they would for a carb meal. 

You have proved this by saying your blood sugar rises each time you eat like this.


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## Dory (Jan 19, 2013)

yes but if i changed my evening bolus ratio i would be low before bed (my bedtimes readings are currently 5-6).  ideally what I need is a bolus that will release 3-4 hours after I go to bed.  the only thing I can think of is an extended bolus, but how on earth do i work that out for protein food?!!!!!


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## Dory (Jan 19, 2013)

and also, if it is just the type of protein, why does this not happen during the say (ie if I have a chicken salad at lunch and bolus I would go low a while later!)  Why it is only at night?  Is it because the body doesn't convert he protein perhaps as it would during waking hours?


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## trophywench (Jan 19, 2013)

Well it could be because of lack of activity, yes.

In which case could you set up a separate basal pattern to cater for it? and just swap to that at bedtime if you have eaten such a meal?  (if you have one spare)

But if you are saying it's unpredictable (doesn't always happen even if you do have the same meal at the same time after having done that same gym activity) then it could be gastroparesis, because as Amanda and others will confirm, that little darling is NOT predictable.  In fact, that is about the only thing you can be absolutely sure about with it! - that it is unpredictable.


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## Dory (Jan 19, 2013)

Thanks all.  Will try a diff basal rate for nights like that but you're right, sometimes it doesn't happen sometimes it does...I really hope it's not GP as I have enough wrong with me already because of this damn diabetes (PCOS and hypohyroidism)!!!


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## megga (Jan 19, 2013)

Hi Dory, its the same with me, i have dawn highs, but when i fast i find the levels are fine. So at night not to stick any carbs in me i would have, boiled egg, cheese, ham ect but my bg in the morning my bg was high.
After joining this forum i started th reserch protien and fats efects on the blood, i found that (for me) it turns in to glucose and sends my b/s high over night, taking this info on board, for the last 6 mornings my bg has been singl figures.
Its a complete bugger, but diabeties just dont behave, and carb = insulin is not the equation. 
But saying that, at least you questioning it, and thats the right track.


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## Twitchy (Jan 20, 2013)

megga said:


> Hi Dory, its the same with me, i have dawn highs, but when i fast i find the levels are fine. So at night not to stick any carbs in me i would have, boiled egg, cheese, ham ect but my bg in the morning my bg was high.
> After joining this forum i started th reserch protien and fats efects on the blood, i found that (for me) it turns in to glucose and sends my b/s high over night, taking this info on board, for the last 6 mornings my bg has been singl figures.
> Its a complete bugger, but diabeties just dont behave, and carb = insulin is not the equation.
> But saying that, at least you questioning it, and thats the right track.



Do you mind me asking what you do Megga? Do you dodge the fat/protein in the evening or have you figured out a bolus ratio? Thanks!


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## pgcity (Jan 20, 2013)

I,m going to try try adding 0.5u to my bolus and extending half over 3 hours for high fat/protein meals


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## Dory (Jan 20, 2013)

Twitchy said:


> Do you mind me asking what you do Megga? Do you dodge the fat/protein in the evening or have you figured out a bolus ratio? Thanks!



Yep, I'm intrigued to know how Mega got round this too.

Also PG I think I'm going to do the same - ie even if I have a protein only meal later at night will give myself a little extended bolus.  Perhaps start off sloe and do 1u over maybe 3 hours??

Guys, I cannot thank you enough for the support and help you've given me about this.  It has caused me no end of grief for the last few years (since I first started noticing the problem) and just this thread has lifted this huge weight off my shoulders.  You are all so helpful - more help than I've ever had with the DSN nurses (who I'm lucky if they contact me once a year).  Thank you thank you thank you......


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## Pumper_Sue (Jan 20, 2013)

Another suggestion......... branching out from what TW has already said.
Have a protien meal/snack and then basal test, see exactly where you start to rise and follow through until the morning. From the amount your blood sugar rises work out how much extra basal you need and from when then set that as another basal pattern. If the rise starts at midnight then start the bolus at 11pm.
Chicken is the worst ofender for me and unless I make sure I have extra insulin to kick in around the 4 AM time then I can guarantee a higher than desired fasting level


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## Dory (Jan 20, 2013)

What a good idea Sue - will try that tonight and see how I get on 

A work from home day is calling tomorrow me thinks......


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## megga (Jan 21, 2013)

Yep, i just dodge eating at night, i just cant get control otherwise. But i suppose its better for me as my tummy is expanding a little.
If i do snack, its on a carrot and th.ats it


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## Robster65 (Jan 21, 2013)

Just noticed this thread and ended up having main meal at midday, with a lighter meal at teatime, usually around 5 or 6pm. Anything later or heavier and I'll be higher in the morning.

came to same conclusion as you re the slowed metabolism but could be a touch of gastroparesis too. 

Hope you've found a long term solution that works for you.

Rob


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## heasandford (Jan 21, 2013)

Can I just ask why the need to eat a protein meal rather than carbohydrate? 

If the protein you eat is being turned into glucose then it's a very expensive and inefficient way of providing glucose/energy for your body nutritionally. You mentioned something about 'replacement after exercise' - broadly, protein is body-building, carbohydrate and fat are fuel. (Of course the added problem with diabetes is knowing exactly our response to them!)


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## Dory (Jan 21, 2013)

I do a lot of evening gym classes (muscle toning as well as high cardio intensity) so eat the protein to help rebuild the muscles and I don't get home from those until about 8-9pm.  then in bed for about 11pm for a 6am start for work!!  I don't eat a big amount of CHO beause it just sits in my stomach and also mucks around with my sugars (although protein seemingly having the same effect!)


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