Glucose rise in the morning

I’m on Humulin R and N. In the last year my glucose level rockets up as much as 100 points after getting up. It doesn’t matter if my numbers are 100 or 250, and, I don’t eat breakfast, ever. I give myself my usual dose of 20 R but no N. My numbers will come back down but will not go low. I use to have a 6.6 A1c but even with my new to me Dexcom meter my last A1c was 7.2 Frustrating. Any ideas about what is happening. Any info would be appreciated.

You are probably experiencing “feet on the floor” phenomenon. It’s part of the dawn phenomenon, where your body starts dumping glucose the minute you get out of bed. R is too slow-acting to act in time to counteract this. Are you able to use a more modern insulin, such as NovoRapid, Fiasp, Humalog or Apidra? Also curious why you are using N, this is an ancient insulin compared to Levemir, Lantus or Tresiba which last longer and don’t have strong peaks.

have you considered pumping? that’s the only way I can get great A1cs and safer bg’s. the dawn phenom hits me pretty well, so pumping has been my best option. started in 1995. From 1978 to 1995 I had a ton of issues due to MDI not being sufficient for my needs. Also, the insulins weren’t as good (no Humalog til late 1995), and I didn’t get a meter until 1992, so that accounts for some of my bg control issues during that time.

Do you wake up at the same time every morning? Two things could be happening. First, when you wake up your liver could just be releasing glycogen to get your started. It us just the glucose it gives you to provide energy. This is a common thing, for diabetics and non-D.

The other thing is that it could be happening at the same time your N is wearing off.

If you get up at the same time every morning, try taking your N a little later in the evening. Or take a second shot of it, reduce the amount in the 1st shot and add it to the 2nd shot.

For example, suppose someone is taking 12 units at 8pm.

  • They could either try taking 12 units at 10pm instead of 8pm.

or

  • They could try 9 units at 8pm, and 3 units at 10pm.

Things like that can help buffer that morning rise.