BGL's climbing

I have a question that maybe can be answered by others on here. Lately I have been waking up to BGL’s ranging from 95 to 130’s. I’m satisfied with that. Then after I drink my daily glass of ice water, I see that my BGL’s start to rise into the 200’s within 3 hours before my regular time of taking my daily injection and have not eaten anything. I don’t eat breakfast, just a glass of 1% milk to take my oral medications after my injection. Any ideas?

Milk has carbs. Are you bolusing for those?

Hi @rs3880 mornings are tough. You have stress hormones in the morning which can affect insulin sensitivity. Your body (liver) releases sugar in the morning to help you wake up. You can look up “Dawn Phenomena “. Also I agree. Milk has carbs. I do better when I get up and eat a 20gram carb breakfast that includes protein. My morning shot is bigger than what I need at lunch for 20 grams carb because I add that extra bit I need in the morning. Good luck :four_leaf_clover:

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In addition to @srozelle 's recommendation re carbs, it’s possible your basal needs are going up.

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This all makes sense except my BGL’s keeping rising even before I drink my milk to take my pills and I take my injection before I do that. It rises with an empty stomach from 95 to 200’s. If I take my injection earlier in the morning it will wear off earlier in the night to wake up to a high BGL.

Got it. It sounds like you’re on MDI, then? If your sugar’s consistently rising in the AM even though you’re fasting, then that says your body needs more basal insulin during that window. Like Joe and Dorie said, it’s common to need more basal then. Unfortunately, with MDI, you’re getting a constant rate for the duration, so you’re pretty much going to have to choose between

  1. too little in the morning but right the rest of the day (sounds like what you have now, and you’ll just take correction boluses as needed), or
  2. enough in the morning but too much the rest of the day (which you could compensate for with regular snacks).

For us, the biggest selling point of a pump is the ability to have different basal rates at different times of the day, the ability to suspend insulin entirely during exercise, etc. Doesn’t mean it’s right for anyone else, of course, and plenty of examples of successful people using MDI. YMMV.

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Yes, I take a daily syringe dosage of Novolin 75 units of NPH and 40 units of Regular in a mixed dose. Then at night I may need to do an additional dose of just the Regular using the sliding scale if BGL’s rise above 150. It’s in the mornings after waking up with acceptable BGL levels that they rise by just breathing air.

I use a pump and can’t speak much on MDI but I’ve read that the timing of some long acting insulins can make a difference. I suggest you talk with your doctor for guidance on adjustments or other recommendations.

Thank you all from your valued advise. I’ve given it a lot of thought and decided to increase my long lasting insulin 5 units, and decrease my fast acting insulin by 5 units and see if that extra will keep the climbing morning BGL’s at bay. I don’t bolus extra insulin during the day because it causes severe drops in my BGL’s to which I have to ingest sugar that screws up everything BGL wise. Besides after my daily dose of combined insulin’s my BGL’s drop to within an acceptable range. Plus I had forgotten about liver glucose surges during the wake up process so thank you for reminding me. Thank you all again for your help, it’s never to late to teach an old dog new tricks.

Been a long time since I was on NPH. Unlike Lantus, which has a fairly steady background action, NPH usually peaks and falls. It’s just that it’s a gradual arc. What you’re describing could be your dose running out.

Personally, even when I was on Lantus (which did keep things more steady) I was one of the people who needed to split the shot. It’s supposed to last 24 hours, but that doesn’t work for everyone. I needed two shots a day to keep my sugars on target.

Might be worth talking to your endo about when you’re taking your NPH and whether it might be worth trying Lantus or Ultra Lente.

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With my pump I find that small changes can make a big difference. You know your body but just keep an eye on your numbers (Captain Obvious here😊). Let us know how things work out!

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Thanks for the ideas. Insurance copay’s are too high for Lantus and Ultra Lente, that’s why I went to Novolin. With BGL sensor copay’s and other med’s copay’s milking me dry I’m doing the best I can with what I’ve got.

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I hear you. Insulin prices are nuts. It’s unconscionable.

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Just when I thought I had a plan after weeks of rising BGL’s as I described earlier when asking for advise, BOOM, I had a low during sleep last night and my BGL’s have stayed at 95 to 120 all morning. So I guess I’m going to hold off on changing my insulin dosages until the issue rears it’s ugly head again. Some days it just makes you wanna crap and rub it in your hair, just kidding.

Try switching to unsweetened almond milk and see if the effect still occurs. There is a veryslight color difference and very slight taste, but only 1 carb per cup. I didn’t try it for a few years thinking it would taste weird and was surprised how good it was. And, it isn’t expensive if you buy a store brand.

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I think “diabetes “ is a code word for “expect the unexpected “. Glad you are ok.

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Three nights in a row going down to 60 and dropping then the CGM alarm sounds. Keep decreasing my NPH, maybe tonight will be restful.

Frustrating, I’m sure. And having your sleep interrupted is awful, I’m so sorry.

In case it helps, when we were using NPH, our daughter needed to be around 130 or higher before bed to prevent a low from the NPH peaking while she slept.

I hope you got some rest last night!

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Thank you so much for your concern and advise. Went to bed with a 110 even after drinking some juice and some crackers and it dropped all night, 4 times. My CGM alarm sounded like a construction site with bulldozer backup alarms working. We had an unexpected super busy day, and I had not compensated for all of the extra activity. Lowering the NPH again today, keeping fingers crossed.

Ugh, I’m so sorry. My grandmother always said, “Better busy than bored.” Nothing better than T1D to keep us from being bored, but I’m pretty sure this isn’t what she had in mind!

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