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miketurco

Pre-correcting for AM dumps with insulin

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miketurco

When I wake up in the morning, this is my routine: measure my BG and shoot 28u of R. I usually skip breakfast, but sometimes have something that is mostly fat and protein, such as two eggs cooked in butter. This morning insulin thing has been in my routine for a couple months now.

 

I get three kinds of results from that. Most mornings, it keeps my BG from shooting wayyyy above 125, which is my personal limit as to what I consider an acceptable number.

 

Some mornings it doesn't work and I go high anyway, although with the insulin I do stay south of 140 and that's good.

 

And sometimes I go low. Not very often, definitely less than once a week, but it happens.

 

This practice really scares the heck out of me. There's an enherent danger of going really low. Especially since my need for insulin as of late has decreased significantly. I can't beat the problem

 

Anybody else do morning pre-corrects? I'm going to discuss this with my doctor, but won't be seeing him for a couple weeks.

 

 

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Hammer

No, I never do a morning pre-correction shot of insulin.  I use Novolog, which acts faster than your R, so if I was using R, I would be even more inclined to not take a pre-correction shot.  Insulin takes time to be absorbed into your tissues, so taking a shot at, say, 8 am when you first get up, might not begin acting on your glucose levels for hours.

 

The thing to do is to try to prevent those high wake up BG readings, but that takes a lot of experimenting to find out what will work for you.  I take 99 units of Lantus every night, and that typically gives me a wake up BG of 60's-70's, but some days, like today for example, I woke up to an 80.  I think that 80 was most likely due to not taking enough Novolog before my last meal the day before.  I need to experiment some more to see if this is what's happening to me.

 

The same applies to you....you need to experiment to see what you need to do to prevent those high morning BG levels.  Think about it....when you got up and tested, you had high BG levels.  Okay, so how long has the BG levels been that high before you got up and tested?  You don't know.  Taking a pre-corrective shot of R insulin....how long were your BG levels high before the insulin began to lower them?  Add the two together and your BG levels were high for a good while.  If instead, you never went high to begin with, well that's what we all shoot for, so it's better to see what you need to do to not go high in the first place.  While I am able to control my BG levels with Lantus and Novolog, I realize that not everyone can afford the rip-off prices that they charge for those types of insulin, so if that's a factor for you, then you need to experiment with the types of insulin that are within your budget.  It might take some time, but eventually, you will be able to figure out what you need to do to not wake up with high BG levels.

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miketurco

I wake up anywhere from 80 to 110, but lately that fasting reading has been going down. Over the next one to three hours by bg raises. So the problem is due to a morning liver dump, not somogyi or DP.

 

Novolin takes about an hour to start kicking in and then last for two hours, so it really hits the spot. If I time it right, my bg will be under 90 in an hour, instead of , say 125, and over the next two hours it will stay fairly steady. It works really well, actually, most of the time.

 

My big concern is what if some day I wake up and the liver thinks to itself, "OK, I'm not gonna dump today." Oy vey, that could be a real mess.

 

There is a correlation between my fasting bg and how high my bg goes up but it doesn't seem to be consitent. When I do wake up in the 80's, I take a little less insulin.

 

I've thought about skipping the morning shot to see how high I would go without it. Then treat it as a correction. Two problems, though. One is I doubt the dump runs like ol' faitful. Also, I don't want my bg to go that high. When I hit 160, etc., it takes days to get things back to how they usually are.

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