BS going up 2 hours after waking

I have been noticing that when I wake up earlier in the morning that my initial fasting sugars are sometimes in the high 90’s, like today. Then 2 hours later I feel numb hands and some minor lightening zaps in the hands, re-check the BG and it is 181. I only drink coffee with Splenda and not even a cup of milk. I had only drank half the cup by the time I checked my BG again. I know one cup of milk has 13 grams of carbohydrates, but that is hardly enough to cause my BG to go to 181. I also notice that if I wake up later with a BG of 130/140 and just wait an hour or two, it will also climb even higher. This can happen even without the coffee. I’m still only eating 1 large meal a day and always go to bed with BG under 100, but never higher than 130. I work nights, so I usually get up in the afternoon. What’s the point of even trying to behave and control this disease if it just does whatever the heck it wants to do? What do you guys suggest other than going Keto? I have even worse morning numbers on nights when eating just a salad with chopped ham and un-breaded chicken wings with some blue cheese dressing. This is really starting to test my resolve. Any how, I hope you all have been doing well. I really appreciate the help.

J

I went four days just eating 1 meal a day of salad with chopped ham and home made baked hot chicken wings. No sugar added, just a small amount of carbs from the blue cheese dressing and nothing more. My morning fasting numbers were the same. Every morning 140/180, even when eating a small snack of a few wings before going to bed. Then the forth night I have a large pizza, 80 units of insulin and have a 120 fasting the next day. I know the fake sugar does not raise BG because after correcting the morning high’s I continue with a second and third huge cup of coffee and two to three bottles of diet iced tea and BG stays under 100 for 12 hours.

First there is DP which is dawn phenomenon, it’s a release of hormones usually around 5-6 am that raises your BG levels in preparation for the day. Then there is what we call FOTF which is sort of the same thing but literally after you put your feet on the floor you get a BG boost. You can test DP by setting your alarm and testing at 4:30-5 am and your BG probably hasn’t increased yet.

The only thing that can be done about it is to take extra insulin just to combat it, Some people wait until they get up and give a shot first thing. Some people say a keto diet can help, but that doesn’t work for a lot of people.

The easiest way is to get an insulin pump, mine isn’t as bad as it used to be and sometimes I don’t barely have it anymore, but I used to set my pump to deliver 3x my normal hour dose between 5-7 am. Now I need just a slight nudge more. But I have another nudge that starts when I first get up.

This hormone release also causes insulin resistance, you need more insulin in the am for anything you eat or to bring down your numbers. Frankly it was easier for me just not to eat in the am and I still usually don’t.

Coffee, probably because of the caffeine, causes a lot of peoples BG to rise even though there is no carbs in it. And sugar alcohols cause an increase in Bg’s in some type 1’s but not everyones.

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Your body may not be happy with one meal a day. Try eating something in the morning besides coffee. Your body is kicking out glucose to fuel itself. Nancy50

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My initial guess is that 1) you are eating that 1 meal within 4 hours of going to bed. If so, eat that meal a lot earlier where your daily activities will work off some of the glucose and calories. Try to eat that big meal at least 10 hours before going to bed. 2) Look at how many carbohydrates you are eating in that big meal. Forget about Keto, just start cutting the carbohydrates by 25% to start and keep cutting them down until you are at about maximum 50 grams of carbs for that big meal. I am sure you will see a huge improvement within 2-3 days if you try this.

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Two things have helped me:

  1. Have a small amount of carbs right before bed. A spoonful of peanut butter is enough to help take the edge off. Some people need a cracker or two.
  2. Eating as soon as I wake up. A hard boiled egg or some nuts work well for me. As Nancy50 said my body is revving up without me because I haven’t eaten, and the longer I let it go that way the worse things get. If I eat right away it obviously doesn’t prevent what has already happened, but the rise stops there.

I still have DP but it’s much better.

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What happens when you eat nothing in the AM?

I’m putting money that it raises some because that’s common.
My BG would jump 80 points from a glass of milk at any time of day, but certainly in the AM when I require much more insulin. How much would you expect it to raise from the milk? You have run 1 test. 15g = 80 points. Run a few more.

Whats your tech? Syringe insulin?

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You might be right. I’m gonna start drinking almond milk in the next week and see if that helps. I just did not think it was the milk because there are some day when fasting will be 120 and even after the coffee and milk, it will not go higher, sometimes go lower.

I use the older Novolin R insulin and thin needle syringe from BD. I really need to see a diabetes specialist. Just have so many different medical conditions, I do not know where to start and my insurance is not the best. I got tired of doc’s not even spending 15 minutes in a room with me. You can’t get stuff figured out in 15 minutes so now I only see the doc when there is an emergency. Mohe, I’m going to run a test tomorrow where I only drink diet iced tea for the first 2 hours and see what happens.

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Let us know what you find.

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You basal needs change throughout the day.
Some times of day, you just need more insulin because your liver is dumping more sugar (glycogen) into the blood stream. Also, coffee/caffeine stimulates they liver and can raise BG all in it’s own, even unsweetened.

While I think it’s most likely one of the above, the meds/vitamins you take in the morning could also be a reason. I have to bolus for niacin, which is a really common B vitamin for heart and lymphatic system health.

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I never eat in the morning because I have terrible fotf. I need up to 2 units of fiasp, even if I walk/hike all morning. My BG starts to drop gently around 12.30. My big meal us at 1, with a far smaller meal at around 7 pm but I need only 2 units. I am low carb and on toujeo.

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Hi J,

The same thing happens to me as Type 1 diabetic. It’s due to the release of hormones including cortisol and adrenaline, which serve the purpose of getting your body ready for the day.

It doesn’t matter if I only drink coffee or have a cup of water. Upon waking I take 2 units of insulin to combat the high blood sugar.

Something else that has helped is making sure my carbs before bed are either complex of nonexistent.

I recommend reading more on the dawn phenomenon.

All the best,

MSJ

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Eliminate the artificial sweetener (Splenda) and see what happens.

John

My BG goes down slowly the whole time I’m asleep, then starts up as soon as I wake up, even without eating anything. No matter when I go to sleep (10pm to 2am) or when I wake up (5am to 9am), I see the same pattern. I use the Dexcom G6 for monitoring.
Now I’ve created a “Sleeping” profile and a “Daily” profile with my Tandem t:slim insulin pump. Activate the “Sleeping” profile before bedtime and “Daily” upon waking. I’m still adjusting the settings for typical nights/days. Extenuating circumstances calls for manual adjustments, but at least I know what is going on and can make the adjustments via bolus.

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For sure if taking meds, coffee, etc in the morning, but the effect he is describing occurs just by getting up in the morning before doing anything else. I see the same thing wake up to see BG has been falling all night. Sit at the edge of the bed and read for a few minutes to fully wake up and BG is already rising.

Oh yes, my blood sugar is normal when I wake up, around 5.5. But it always rises as the morning goes forward - I used to take a 2 units of fast insulin (Fiasp or Humalog) on a regular basis when I’ve eaten nothing. It seems to work…

Mornings are the wild card part of the day for me also. Similar experience with 30-40 point rise with zero food. Coffee or no coffee does not seem to matter. Often the CGM graph is flat all night and like clockwork starts to go vertical as soon as I am vertical.

The morning dose responds to the overnight reading and not the end of the dawn phenom. Breakfast is multi-course over about a 1-hour period. First the protein and then the carb, then a walk. Seems to calm down the blood glucose roller coaster. Could not do this without the CGM showing me all the movement.

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I was unaware this was happening to me until I got a CGM. I could run a straight 90 all night then without fail it will start rising around 5AM, if I keep sleeping it will eventually go up to 180 within a few hours. So I wake up at 5am and take 3 units of Novolog and go back to sleep (even if I’m still at 100 or so), by 8 AM I’m at 100-110.

I need to get one of those dex com monitors and start looking at 24 hour cycles to pin this thing down. Maybe I will buy one or the free style and see. On my insurance they aren’t going to pay for a pump. So, that is out of the question for now. I have been just injecting between 10 and 12 units every morning right when I wake up. That usually leaves my blood sugar at 100 -110 a few hours later. One day it was 80, and yesterday on ten units it was 70 and had to eat a piece of candy before work, because if it is low when I go to work and still within the 4 hour period of taking insulin, I will drop low. If I was just going to sit at home a 70 is fine. I’m saving on test strips because I just inject and only check before work a few times a week. Any how, thank you everyone for all of the sound advice.

J