Fasting readings, when and how soon?

I suppose I should know the answer to this question, but I'm unsure, so I"ll ask the experts .... you. I was told when I started Lantus a week ago to increase it 1 unit each morning that my FBS was not at 120 or below. So my morning routine is to get up, get dressed, let the dog out, feed the dog, and then I take my readings. This morning the dog got into a fight with a stray cat, and I had to go break that up. NOW, the question, my FBS was 151 --- after the fight. But since starting Lantus, my sugars have come down....some...but not near 120....so I am up to 15 units which they tell me is nothing. But are you supposed to take your sugars before you do anything else for the day, or is later ---- like 20 minutes after getting up giving me an okay reading? If this doens't make send, say so and I will try to answer better. Thanks

First thing in the morning!

I was told check your bg level first thing, and that's what I do.

I am not in a huge hurry to check mine in the morning and usually at least stumble around the house long enough to let the dogs out and put some coffee on… I have definitely noticed that a stressful / adrenaline situation could spike my levels first thing in the morning (like breaking up a dog/cat fight). I’ve also been told by my doctors and have found it to be good guidance for me to not adjust basal doses more frequently than every 2 or three days during times of adjustment-- that gives things a chance to settle out— 1 erratic fastinf reading generally shouldn’t justify a basal adjustment but a trend of them over time would…

For me I consider the term “fasting” literally and it only means having not eaten— only bizarre events like you just described make much difference. Although at times I’ve noticed. A hot shower can also upset the apple cart.

An adrenalin situation such as a dog fight will spike your blood sugar no matter what time of day it is. As for the fasting readings, I do mine before I even get out of bed. I keep all my stuff at my bedside during the overnight. So before I put one foot on the floor, my blood sugar has been checked and any dosing that is required gets done. As soon as you get up and start moving around your liver is going to start cranking out sugar as fuel for you to start your day. That’s going to compromise your true fasting reading.

You are following a relatively common way of working towards a proper basal rate. It is slow but very safe (at least from the doctors view). I actually test as the first thing I do in the morning, if I let anything disrupt things then it won't be a proper reading. I has to be done first thing upon waking. If this means keeping the meter on your bedstand then that is ok.

Every morning will be different, if I have disrupted sleep I will be high in the morning. And I have to tell you, you will probably look back in 2-3 weeks having gotten your Lantus up to 30-40 units and still not have gotten your blood sugar down to 120 mg/dl. But that is ok, over time you will get the dose right and you will be totally awestruck by having normal blood sugars.

Just your routine to - get up, take my readings, get dressed, let the dog out ...

Dawn Phenomenon

"Rocky Morning Highs"

For me it is worst right after waking up especially if I don't take morning insulin and eat breakfast right then.

If I get up and test at 80 or 90 and start working around the house for an hour without taking insulin and eating something... I can find that in my hour sometimes my bg can go up to 200, 250, or even 300.

Most of the time I will go up from that first reading when I wake up even if I stay in bed and read etc.! So if I want my true fasting, I test before getting up or right after washing my hands. I have my testing stuff, insulins, candy/glucose tabs and so on close by.

Usually I need to get up, bolus and eat to head off dp unless it has already spiked before I wake up but I still need to do the same anyway most of the time. Two days this week I was able to control dp by eating flaxseed/chiaseed and some cream before sleeping although yesterday I went hypo after eating it, no bolus, but then I went back to normal with a correction and had no spike till much much later in the day when basal ran out.

I have a CGM so I sort of cheat but I usually turn coffee water on, heat up leftover cup of coffee (we have a French press, so it's not totally gross and it has caffeine in it...) and then test. If you are trying to get a handle on dosing, I think that it makes sense to test close to immediately. If you're trying to get a handle on readings at that time of day, it may also be useful to test again, 20-60 minutes later, to see what's going on, even if you haven't had breakfast. A lot of times, if I don't get around to eating, my BG will ooze up.

I test first thing when I wake up before getting out of bed. For me, even if I just lay in bed for 45 minutes, it will be higher at the second testing.

This is all very interesting to me, I've been doing some experimenting this week after reading all the posts...and consulting my CDE...so I put a meter by the bed and started testing before getting out of bed. WElLLL, for the last four days, my am FBS has only changed maybe 5 points from taking it when I get down stairs and take care of the dog. Is it worth it, well, I'm not sure. Since all I am trying to do is get an idea how much lantus to use the night before. I'm at 15 U and that gets me to 120 with 5 points one way or the other....but I will keep up the test so I know what I am doing is right until my next A1C and CDE visit. Keep you all updated