I don't get it

[mariwood]

Does this mean when I arose with a fasting bs in the normal range and my skipping breakfast sent my bs upwards, now you are reading this correctly, 300 points....does this mean that I have to take more Lantus at bedtime? My bs returned to normal after I ate 45 grams of carbohydrate for lunch. In fact, it was perfect. But I was horrified that day.

[rzrbks]

If I understand all this "Wonderfulness" correctly-----if we skip a meal or go too long without ingesting some food---there's a dump that occurs from the liver that skews the B/G all over the place

I'm sure someone will correct me if I've got this wrong

[Harold]

rzrbks stated it in a nutshell, and it's why a fasting diet does not work for type 2s. As for taking more lantus I doubt it would be recomended, however having breakfast I know comes highly recomended.:)

[am1977]

I'm not sure exactly why you experienced this, but my advice would be to keep an eye on your blood sugars in the morning and note any further highs or lows for that matter. If you continue to see high levels in the morning that would mean that something would need to be adjusted with your Doctor's help. It could be anything that caused this, it could just be a fluke-y kind of thing.

[IceMan]

Anytime I get an unusually high read I immediately wash my hands and resample from the other hand. Most of the time the alarming read turns out to be a false high. My meter does throw an outlaw read from time to time...probably from something on my fingers from lunch...:)

[Andrea]

I agree with rzrbks and harold. This high morning glucose does not necessarily mean that you need more lantus. It more likely means that you should eat breakfast! We all need energy in the mornings to help us go from a semi-comatose state of sleep to a wakeful one. If we don't provide our bodies with this energy, our bodies will do it on their own.

The liver stocks glucose in the form of glycogen for occasions exactly like this one. Under the influence of glucagon and some of the adrenal hormones, glycogen is released from the liver in the form of glucose, but of course, for those of us with diabetes, if there isn't enough insulin around to handle that glucose load, or if our cells are resistant to that glucose, the energy intended stays as glucose in the blood stream.

Andrea

[eevee]

Quote....B]and it's why a fasting diet does not work for type2s[/B]

It doesn't work for T1s either, of course....Eevee[

[Ella1]

well, missing just one breakfast wouldn't have caused such a spike...

mariwood which type are you? Some young Type1s experience such thing as a dawn phenomenon, when BS go up in the morning. The liver releases its glycogen on the wakening. Though it wouldn't raise it by 300 points...

[dpav]

Here is another possibility. If you are using plasma based meter, the meter can and often does give incorrect or different, readings. Try doing a series of tests. You will find that with plasma meters that they will sometimes give readings that are not close to each other.
It could be you as well. But check your reading first to be sure. I always do an extra reading if I go high.
Don

[KLD]

I hadn't heard that plasma based meters are less accurate than whole blood meters. Is that what you're saying, Don?

Karen D.

[dpav]

Sorry
I don't mean to say that at all. Plasma meters are supposed to be more accurate. It is simply that they will on a lot of occasions have different readings with a large range of difference. Not inaccurate just not always consistent. That is why I check my test again if I get a high reading. To do a comparison. If they are both high then I believe them. If they read one high and one low I do a third and trust the 2 most closely together.
Don

[rzrbks]

My InDuo uses OneTouch UltraSmart strips and I still keep my old
Acsensia Elite XL Glucometer just as back-up and to check if the InDuo seems way off.

They are always about 12/.6-16/.8 apart but at least I know between the two I can get my "Panic Level" down.

[Ella1]

Having thought about it more.. It could be that you were visited by Mr. Somogiy... There is a thing like Somogiy effect. you can read about it in the "c-test" thread in the same forum. I think Shy described it..

Ruling out the incorrect meter reading.. this could be the only possible answer. I would check your basal insulin if I was you.. It should keep you fasting bg on the same level - not lowering or raising it

[IceMan]

More On Somogyi.....

Somogyi Effect is a swing to a high level of glucose (sugar) in the blood from an extremely low level, usually occurring after an untreated insulin reaction during the night.

The swing is caused by the release of stress hormones to counter low glucose levels.

People who experience high levels of blood glucose in the morning may need to test their blood glucose levels in the middle of the night.

If blood glucose levels are falling or low, adjustments in evening snacks or insulin doses may be recommended.

This condition is named after Dr. Michael Somogyi, the man who first wrote about it. Also called "rebound."

And This.....

A common problem encountered in persons with type 1 diabetes is fasting hyperglycemia. Three potential culprits of this hyperglycemia are insufficient insulin, the dawn phenomenon and the Somogyi Effect. When there is insufficient insulin, the duration of intermediate or long-acting insulin has ended during the night; therefore, circulating insulin levels will be low and blood glucose will rise. Low insulin levels can be suspected if the blood glucose is elevated around 2:00 - 3:00 a.m. Treatment may involve increasing the intermediate or long-acting insulin at bedtime.

[Katjic]

If you really don't want to eat breakfast (like I don't ) and you have a high readings in the morning, maybe you should try taking just a few units of premixed insulin, 30/70 I believe it is.
Before I was on pump, I was taking a few units of humulin N in the morning to keep my blood sugar stable until the lunch time, but that's humulin N again, I'm not sure about lantus...

[IceMan]

It has been my experience with lantus that it is absolutely critical to establish the proper dose before you will see a stabilizing effect on your blood sugars...not just the fasting numbers either but the full 24 hour coverage....which is not a blanket that covers all of us...I believe the actual time frame a single dose of lantus will cover is between 18 and 24 hours. Timing of the daily injection comes into play also. Some T1s I know find that splitting their long acting dose helps their control...for me 30uL @ 2100 every day gets the job done.

Many doctors do not provide their patients with adequete instruction to determine the optimum dose of long acting. Either because they don't know or because it would take too much time they could be billing to the next patient.

Determining the correct dose can take weeks and patience is required.

[rzrbks]

IceMan is right--------I know that if I let my timing for Lantus injection become varied, my B/G starts jumping up and down and control goes to &@^&*)%

[Clint]

me too.. but the Rise in BG in the morning is also called the 'Dawn Phenomenon'... I forget why it happens but....

[Ella1]

We managed to get rid of the Dawn Phenomenon by moving the night time injection of Lantus to 10pm. The dawn phenomenon usually kicks in after 4am, and Lantus has its tiny peak after 6-8 hours of injection. So this peak should be just before the BG creep up in the morning. If the peak gets in the middle or will try to sort it in the end, when BG is already high, it won't work. It should foresee the event and not let it develop. When the injection of Lantus was at 11pm, the morning BG were always over 10 mmmol/l. Once the injection moved to 10pm, BG before bed = BG before breakfast. I hope this will help someone too