Long Acting Insulin Not Working For The Entire 24 Hours
THIS WAS THE CULPRIT FOR ME! I would normally go to sleep with a blood sugar of between 6.5 mmol/L and 7.5 mmol/L. Between 3:00 a.m and 4:00 a.m I would have a reading of between 12 mmol/L and 16 mmol/L. I normally took my basal insulin in the morning around 7:00 a.m. Lantus is supposed to be active for 24 hours controlling your blood sugar levels when you are not eating. However, in some individuals like myself, it only lasts about 18 to 20 hours. During long periods of time when we are not eating , the liver releases glucose to fuel the body. In my case, there was no long acting insulin in my body to handle this glucose, resulting in my high fasting blood sugars.
Also note that not eating will not help the issue. One may tend to not want to eat if they have a high fasting blood sugar. Eating and taking insulin will signal to the body that the fasting period is over and there is no need for the liver to release glucose into the bloodstream.
If You Are Having Trouble Controlling Blood Glucose Levels Please Talk To Your Doctor Or Your Diabetes Management Team
They will help you figure out why your blood sugar levels are high and develop a plan specifically tailored for you. This is important, as good control of blood glucose levels can help avoid serious health problems.
For more information and support, see your GP, your endocrinologistor your diabetes management team.
For information about how glucose and insulin are regulated, see our information about the pancreas.
The Diabetes Australia website has more information and resources.
Dr Kimberly Cukieris an endocrinologist at Geelong Endocrinology and Diabetes Clinic and a senior clinical lecturer at Deakin University. She specialises in diabetes care and is actively involved in teaching medical students and training new physicians. Dr Cukier is a member of the Endocrine Society of Australia.
Robyn Perlsteinis a Senior Dietitian at Geelong Endocrinology and Diabetes Clinic and is a Research Fellow at Deakin University. She has specialist interests in type 1 and type 2 diabetes and is actively involved in ensuring future doctors have a better understanding during their training about nutrition.
Jehan S, Myers AK, Zizi F et al . Obesity, obstructive sleep apnea and type 2 diabetes mellitus: Epidemiology and pathophysiologic insights. Sleep Med Disord, 2, 52-58.
How Does Your Body Manage Blood Sugar At Night
âYour body uses different types of energy in different ways at different times of day,â says Paul.
At night, your body uses less glucose because you are inactive. Instead, it burns more fat for energy, but it still needs glucose for vital bodily functions.
âYour brain relies almost exclusively on glucose for energy and still needs plenty of it even when youâre asleep,â explains Paul. âSo itâs very important to have a constant supply of glucose overnight.â
To ensure this happens, the body uses various biological feedback mechanisms, including hormones like insulin, which encourage your cells to remove sugar from your blood after you eat.
There is also glucagon, which tells your liver to produce more glucose from fat and other sources if your blood sugar is dipping.
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A Good Nights Sleep Can Help Control Morning Blood Sugar Levels
Experts recommend 6-9 hours per night, as poor sleep can aggravate insulin resistance and contribute to high blood sugar levels.
If you snore or wake up feeling unrested, talk to your doctor or your diabetes management team. You may have a condition called sleep apnoea , caused by your airway becoming partially blocked while you sleep. Sleep apnoea causes oxygen levels in the body to fall, which in turn causes some hormonal changes that lead to impaired glucose control. Sleep apnoea is a risk factor for type 2 diabetes, and type 2 diabetes is a risk factor for sleep apnoea .
Expert tips about sleep and blood glucose levels
Dr Kimberly Cukier recommends monitoring your sleep habits and discussing sleep concerns with your health care professional.
What Is The Dawn Phenomenon
Your body uses glucose for energy and it is important to have enough extra energy to be able to wake up in the morning. So for a period of time in the early morning hours, usually between 3 a.m. and 8 a.m., your body starts churning out stored glucose to prepare for the upcoming day.
At the same time, your body releases hormones that reduce your sensitivity to insulin. In addition, these events may be happening while your diabetes medication doses taken the day before are wearing off.
These events cause your body’s blood sugar levels to rise in the morning .
Causes Related To Diet
Processed foods and sugar
Diet and how it relates to blood glucose values can vary immensely from person to person. But, research suggests that eating processed foods can increase blood glucose.
Overeating or grazing
Itâs a common belief that snacking throughout the day will keep blood glucose levels steady. But, a 2013 study found that eating two large meals per day helped reduce blood glucose more effectively than six small meals per day. Itâs also important to keep our meals to the right proportions, as overeating can raise blood glucose levels as well.
Some research has found a connection between low water intake and a greater risk of hyperglycemia. This is most likely because less water in the body means the concentration of glucose in the blood is higher.
Vitamin and mineral deficiencies
Treating High Morning Blood Sugar
A blood sugar high in the morning “can be tough to treat, acknowledges Amori, but with the help of your medical team, you can try different approaches. Talk with your doctor about these strategies:
Adjust your pump. If youre testing high regularly and you use an insulin pump, you might be able to program it to help manage your morning highs.
Check blood sugar before bed. Granted, many people have morning high blood sugar after an acceptable blood sugar before bedtime. Even so, “don’t go to bed with high blood sugar,” cautions Amori.
Take basal insulin. Taking basal insulin at bedtime could help, but be sure to clear any changes in dosing with your physician before you try it.
Adjust medication. If in fact your high morning blood sugar is a rebound response to a low blood sugar level while youre asleep, you might need to change the dose of any medication you take in the evening that could be causing low blood sugar. Talk with your doctor about whether your medication schedule should be adjusted to treat morning highs.
Have a healthy pre-bed snack. For those experiencing the Somogyi effect, a healthy mixed snack of protein and carbohydrates could help prevent your blood sugar roller coaster at night. Amori advises working with a registered dietitian if youre not sure how to fit a pre-bed snack into your daily diet.
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How Can You Tell The Difference
The Somogyi effect can occur any time you or your child has extra insulin in the body. To sort out whether an early morning high blood sugar level is caused by the dawn phenomenon or Somogyi effect, check blood sugar levels at bedtime, around 2 a.m. to 3 a.m., and at your normal wake-up time for several nights. A continuous glucose monitor could also be used throughout the night.
- If the blood sugar level is low at 2 a.m. to 3 a.m., suspect the Somogyi effect.
- If the blood sugar level is normal or high at 2 a.m. to 3 a.m., it’s likely the dawn phenomenon.
How Does Hyperglycemia Happen
Insulin is a hormone that lets your body use the sugar in your blood, which comes primarily from carbohydrates in the food that you eat. Hyperglycemia happens when your body has too little insulin to use the sugar in your blood.
People with type 1 diabetes can have episodes of hyperglycemia every day. Although this can be frustrating, it rarely creates a medical emergency. Not taking enough insulin can lead to hyperglycemia .
Other things that can cause hyperglycemia include:
- Having trouble seeing or concentrating
- Experiencing stomach pain, nausea, or vomiting
- Having sweet-smelling or fruity breath
- Cuts or sores that do not heal, infections, and unexplained weight loss may also be signs of long-term hyperglycemia.
If you notice any of these symptoms, you should check your blood sugar. If your blood sugar is very high, you should also test for ketones in either your blood or urine.
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Why Blood Sugar Levels Rise Overnight
When you go to bed, your blood sugar reading is 110, but when you wake up in the morning, it has shot up to 150. Why does this happen?
To understand how blood sugar levels can rise overnight without your eating anything, we have to look at where glucose comes from and where it goes while we sleep.
During the day, the carbohydrates we eat are digested into glucose and absorbed into the bloodstream. Some of this glucose goes to the liver, where it is stored for later use.
At night, while we are asleep, the liver releases glucose into the bloodstream. The liver acts as our glucose warehouse and keeps us supplied until we eat breakfast. The amount of glucose being used is matched by the amount of glucose being released by the liver, so blood sugar levels should remain constant.
How To Lower Blood Sugar In The Morning
As with any time of the day, lowering blood sugar will usually mean taking medication.
If youre taking other medication for diabetes, just make sure youre taking the right amount at the right time of day. With insulin, you might want to use insulin to lower your blood sugar back to a stable level.
To figure out how much insulin you might need, you can let Hedia assist you in your calculations. Tell Hedia what your blood sugar level is, and the insulin calculator will take your basal insulin into account.
If youll be having breakfast soon after waking, youll probably want to include that in your calculation. If you have a favourite breakfast that you eat most mornings, you can add that to your favourites in Hedias food database for a quick add. Find out more by getting Hedia from the App Store or from !
On the topic of breakfast, it may be worth considering a low-carb breakfast, so as not to push those blood sugar levels even higher.
Regardless of what youre eating, Christel Oerum from Diabetes Strong points out the importance of eating any kind of breakfast. Having regular mealtimes that give you the energy that you need throughout the day ought to allow you more stable blood sugar without the adrenaline swings.
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Why Does Blood Sugar Spike In The Morning
Our diabetes expert has the answer.
Joan Bardsley, RN, CDE, is an assistant vice president at MedStar Health Research Institute.
Q. Why does my blood sugar spike in the morning?
A. There are many reasons for a high reading.
First, look at food. What you ate the night before may be behind the blood sugar spike — for example, if you ate much more than you usually eat, or if the amount of food was more than your medications are made to handle.
A second cause could be your medicine. Perhaps the medications you take aren’t lasting through the night, or the dose isn’t high enough to keep your blood sugar in check.
Another possibility is one that happens naturally in the body in response to low blood sugar. When your blood sugar drops, your body releases stored sugar — mainly from the liver — and overcompensates. If your blood sugar level drops in the middle of the night, this overproduction of sugar can cause a high level in the morning. This is called the Somogyi effect. When your blood sugar is low, it’s best to eat about 15 grams of carbohydrates, and then wait 15 minutes before repeating the process.
Or, the spike could be due to the release of hormones between 4 a.m. and 7 a.m. that raise blood sugar. Your body needs to balance these high hormone levels by making more insulin. When it can’t make enough insulin to compensate, your blood sugar will be high. You may need to manage the timing or amount of your medicine.
Why Is My Morning Blood Sugar So High
A complex array of factors affects blood sugar levels, including hormones, diet, and lifestyle.
Q: I have prediabetes and now eat minimal carbs and sugar. My doctor told me to monitor my sugar levels, morning and night. At night, two hours after eating, my sugar levels are between 112 and 130 mg/dL . But in the morning, my fasting sugar level is always higher than the night number. Why is that? What am I doing wrong?
There are a few reasons why your blood sugar may be elevated in the morning. First, its important to understand that certain hormonal changes that occur overnight may lead to high blood sugar levels in the morning.
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Why Might Your Blood Sugar Increase In The Morning
âYour body relies more on fat burning overnight but in the morning you have a preemptive shift back towards glucose, which can cause variations in blood sugar,â explains Paul.
As your body prepares for the day, it increases the amount of glucose it makes, triggering an increase in insulin levels in order to keep your blood sugar levels stable as your metabolism powers up.
However, if you are insulin resistant or have diabetes, your body may not respond adequately to this insulin in your blood, resulting in increased blood sugar levels before you wake. This is known as the âdawn effectâ and tends to only be seen in people with diabetes.
In people with diabetes who rely on insulin, morning blood sugar spikes can also be caused by taking too much or too little insulin before bed, resulting in a rebound effect in the morning. This is called the Somogyi phenomenon.
How To Prevent Hyperglycaemia
There are simple ways to reduce your risk of severe or prolonged hyperglycaemia:
- Be careful what you eat be particularly aware of how snacking and eating sugary foods or carbohydrates can affect your blood sugar level.
- Stick to your treatment plan remember to take your insulin or other diabetes medications as recommended by your care team.
- Be as active as possible getting regular exercise can help stop your blood sugar level rising, but you should check with your doctor first if you’re taking diabetes medication, as some medicines can lead to hypoglycaemia if you exercise too much.
- Take extra care when you’re ill your care team can provide you with some “sick day rules” that outline what you can do to keep your blood sugar level under control during an illness.
- Monitor your blood sugar level your care team may suggest using a device to check your level at home so you can spot an increase early and take steps to stop it.
Page last reviewed: 08 August 2018 Next review due: 08 August 2021
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High Blood Sugar Levels In The Morning
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A person usually has slightly higher blood sugar or glucose levels in the morning. But, in some people with diabetes, these levels are significantly high.
that get worse over time, due to these blood sugar spikes.
According to the National Institute of Diabetes and Digestive and Kidney Diseases, healthy blood sugar levels are:
- from 80130 milligrams per deciliter just before eating
- below 180 mg/dl 2 hours after eating
In addition, they note that:
- A low blood sugar level is under 70 mg/dl.
- A high blood sugar level is over 180 mg/dl.
There are two main causes of high blood sugar in the morning: the dawn phenomenon and the Somogyi effect.
This article explores these causes, including what they can mean for a persons health and when to see a doctor.
The dawn phenomenon relates to natural body changes that occur during the sleep cycle.
In the morning, everyone experiences a slight rise in blood glucose levels. A person without diabetes will not experience effects, as their body can adjust. For a person with diabetes, however, this rise can be significant, and it may need treatment.
At the same time, the body is producing glucagon, another hormone, which can lead to a further rise in blood sugar.
This happens just as nighttime levels of insulin are starting to taper off.
Wake Up At 3 Am And Cant Fall Back Asleep Consider Low Blood Sugar
Do you consistently wake up around 3 a.m. and cant fall back asleep? Many patients first come to me with this complaint. Although the reasons for sleep problems can be complex, waking up too early is often a symptom of hypoglycemia, or low blood sugar, and can be remedied through dietary changes and nutritional therapy.
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