glucose levels quaestion..!!!???please help...

[snuffles]

hey
does anybody have any idea why my glucose levels read fine going to bed and i dont eat anything and then i wake up high..
Its really frustrating and im scared im going to have a terrible hba1c..
pleas reply..
thanks,
snuffles

[DeusXM]

Generally, there's three main reasons why your BG would increase overnight. All of them are to do with your liver.

The important thing to remember is that eating is not the only thing that will raise your BG level. Throughout the day and night, your liver will slowly release glucose into your blood stream to provide you with a steady supply of energy.

With this in mind, there's three possibilities

1. The amount your liver puts into your blood while you're asleep is greater than the amount of basal insulin you're currently taking
Your liver will continue to put out a small amount of glucose into your blood even when you're asleep. If you're not taking enough basal insulin, your BGs will go up.

2. You're having a hypo in the night
The other thing your liver does is put out large amounts of glucose into your blood in times of danger. Some people have hypos in the night but don't wake up during the hypo. In order to keep you alive, your liver starts chucking out lots of glucose in order to prevent your BG going too low. Generally it puts too much in, which means you'll wake up with a high BG, and probably a headache too. This is called the Somogyi effect.

3. You're having an early morning liver dump to wake you up
Your liver is designed to start pumping glucose into your blood shortly before waking, to ensure you have enough energy to get up and go find your first meal of the day. If this isn't covered with insulin, you will wake up with a higher BG. This is called Dawn Phenomenon.

What you need to is get up at about 2am and test your blood sugar. If it's looking low, you're probably suffering from the Somogyi effect and need to take less insulin. If it's high, you're probably not getting enough insulin. If it's normal, you're probably suffering from Dawn Phenomenon. There's a variety of ways to deal with DP such as eating a carby breakfast regularly, drinking a small amount of alcohol before going to bed, or adjusting the timing, splitting or type of basal insulin.

[Subby]

As well as the above 3 definite possibilities, I think it is worth looking at food eaten last before bed.

Watch long acting food, food with carbs and fats can have an extended effect on your BG that outstrips your rapid acting.

Here's an example. Pizza often causes people trouble. It can have an upward impact on my BG for up to 6 hours. I need to have a specific bolus plan to attempt to match it. Without that knowledge and plan, if I ate pizza at say 8:30pm for dinner, bolused, saw decent numbers at say 10:30 and went to sleep, I could well wake up with a very high BG, as the pizza continued to spike me beyond the action of my initial bolus.

[rostkowb]

Snuffles,
How long has this been happening? Days, weeks, Months? You will need to speak to your health care provider to allow you to adjust your "long acting insulin" to compensate for the high blood sugars first thing in the morning. Meaning you will most likely need to increase it slightly. This was my issue in the past except I was waking up with Low's. I decreased my Lantus down 4 units over one month. Now It has been a good balance waking up.

[sarahspins]

As well as the above 3 definite possibilities, I think it is worth looking at food eaten last before bed.

Watch long acting food, food with carbs and fats can have an extended effect on your BG that outstrips your rapid acting.


Don't forget the effects of protein! The liver has the ability to convert a whopping 60% of the protein you consume directly into glucose.... this is gluconeogenesis, and that can often have a fairly significant effect for a T1.

I struggled with a bad DP problem before pumping.. and a large part of the problem was that the effect was just SO inconsistent... it didn't happen every night, nor was it always as "strong". I think a large part of mine was in fact gluconeogenesis, not necessarily true DP. Since pumping, I've not only been able to refine my insulin needs overnight to prevent any somogyi effect (going low then high) or regular DP, but I am able to use either temp basals or extended boluses to deal with the effects of excess protein with dinner.

[CarrieJett]

If it's normal, you're probably suffering from Dawn Phenomenon. There's a variety of ways to deal with DP such as eating a carby breakfast regularly, drinking a small amount of alcohol before going to bed, or adjusting the timing, splitting or type of basal insulin.

I am curious about the carby breakfast helping with the dawn phenomenon. How does that work?

[jillrapp]

Snuffles, So sorry you are having this issue, many of us here experience it as well. In the search area on the right.. if you type in Dawn Phenomenon you will find a plethera of posts! I hope they help, if not, feel free to ask more questions! :)

[Belle'sMama]

About 2 mos ago I was having the same thing happen....would go to bed at 125 and wake up at 268! so we found out that I needed to increase my basal to 0.90 at 3am and it worked. I am still amazed at this because the only time I have ever needed a basal that high was when I was pregnant! I've been at that increased basal at 3am for quite a while now and it works, who knows!