[Psycho Penguin]

It seems like every time I go to sleep "normal" (around 80-90), I wake up super high, and I've heard of something called a "rebound effect" and "dawn effect" that can cause sugars to go high if they are normal or low during the night.

So, is it okay to go to sleep a little higher, like 140? Or will this make me go really high?

I guess I could just try tonight, I am just trying to find out how to stop waking up in the 200's!

[genie86333]

Try a protein-based snack just before bed. It may keep your blood-sugar level from dropping too far over night & keep the DP from striking. If that doesn't work, then yes, maybe a bit of carbs (as well as the protein) will raise it just enough (and keep it more level) throughout the night.

[Subby]

Originally Posted by Psycho Penguin

It seems like every time I go to sleep "normal" (around 80-90), I wake up super high, and I've heard of something called a "rebound effect" and "dawn effect" that can cause sugars to go high if they are normal or low during the night.

It helps to be really specific with these things,to work out what to do.

1. Dawn phenomenon - natural release of hormones and internal energy by the body, usually around early morning.

2. "rebound effect" - liver release of energy, a response to bg dropping too low.

These are very different occurrences and require very different actions (often almost the opposite) to correct for. The first thing you need to work out is whether you are going low (then a rebound) or whether you are just going high (maybe not enough basal insulin, or it could indeed be DP). To get a better idea of which it is set an alarm in the night, more than one if you can, and test your BG over a night or two. Say 1am and 4am would do for a start. Let us know what you find

[Psycho Penguin]

Thank you both, I will try those suggestions.

Subby, I am feeling like both are affecting me. I've gone to sleep normal and woke up high, and I've gone to sleep somewhat low and woken up super high (might be because I tend to overeat when I am low, though)

[Subby]

You may well be getting one, or the other, or a combination of both. The testing should help reveal.

The rebound effect should be the most obvious to discover and the most "fixable", because either lowering basal, or perhaps a snack like genie suggested, or a similar tactic or a combination, should allow you to completely avoid it.

The DP however is probably here to stay, a natural cycle of your body. There are of course things to try to overcome the high effect, but it certainly can be tricky to deal with on MDI.

So the first step is probably to find out/rule out/fix up the rebound Have fun testing.

[Psycho Penguin]

I went to sleep testing at 277 and woke up at 117.. I guess taking 25 units of 70/30 at 1 AM and not eating many carbs helped.

[DeusXM]

It sounds to me that your insulin intake simply isn't matching your insulin needs. You need to determine precisely WHY your BG is increasing, be it the Somogyi effect or dawn phenomenon. You then need to adjust your insulin according - as said before, it's less basal if it's from 'nypos', more if it's DP.

Going to bed with elevated BG isn't the solution to the problem. It's an option but the better solution is to match your insulin to your body's needs.

Oh, and if it's DP, you might find a small alcoholic drink shortly before retiring might do the job.

[xMenace]

You need a typical overnight profile, but it's hard to get. The best way is to pick a night and stay up all night testing every hour or half hour. The other way is to take a bedtime reading, say 10pm, then pick a couple of hours in the night to wake up. Do that several nights untill all hours are covered, then adjust the numbers based on the 10pm readings.

The critical questions are
- are you dropping, staaying flat, or rising between 12 and 4?
- how low are you going?
- what time do you start rising?
- how much are you rising in the mornings?

You need several similar nights to get a good profile.

In my experience, these profiles are pretty consistent. It's the other things we do -- corrective insulin, snacks, exercise, alcohol, etc -- that create variability. Find the profile, attack it, then treat variability.

BTW a pump was made to treat this stuff

[lorilei]

gee, stevo...this all sounds so familiar...so have at it! and i mean that in the most supportive way possible!

[Psycho Penguin]

Woke up at 89 this morning.. I hope I have figured this out since that's two mornings at normal now.. thanks for the help, guys, your advice has really helped! (even you too, lori :P)

[lorilei]

Steve,
i just got my own copy of the DF popular book..Think Like a Pancreas...it really is a good, and straightforward, read...may help with some of those frustrating numbers that keep popping up...you know me and my legwork!

[lorilei]

P.S. i'll forgive the sarcasm...i know you meant it in the sweetest way possible.

[Psycho Penguin]

Thank you Lori, I will check that book out.. and you're right, I meant it in a very nice and sweet way. Our friendship is based off silly sarcasm, M I RITE?!?

[jillrapp]

so exactly what did you do to get normal?

[Psycho Penguin]

I'm taking 25 units of 70/30 at 1 AM instead of 20 units at 11 PM