Morning Numbers

I have a question…

I’m at a point now where changing my meals & mealtime insulin are really keeping me at pretty decent numbers (I still have some one hour post-meal numbers that are like 150-170 and that’s frustrating, but it seems to be going down as the insulin gets worked out)

No matter how much insulin I take at night–it seems like my morning (fasting) number is never anywhere close. OFTEN, I have something like 140 when I wake up. The internist keeps giving me more insulin at night (now taking 70 units of humulinN (I have no idea if I’m spelling that right) and waking up with a 120-140 almost every day. This seems regardless of whether I have a snack, don’t have a snack, or what the snack is. It also happens if my after dinner number is like 90.

Are there any ideas out there on how to bring this down? Time of night? Place to give the shot? Anything? It seems the internist’s answer is just always to raise the insulin dose–but it seems so illogical because the numbers are not even budged by that insulin right now.

Thanks for any thoughts!

Piper, it sounds like “dawn phenomenom” to me. Early morning highs! I am on the pump so that is easily remedied. But with N, I have no idea. I can’t remember that far back. But I would skip the night time snack for sure, unless you have to have it.
Sorry I couldn’t be more help.


There is something called the “Dawn Phenomenon” which causes many people to experience higher numbers in the morning. It might be that your numbers are good during the night and only rise in the early AM.

Many of us require MORE insulin in the morning.

Another possibility is that if you go low during the night, your body often recovers too much (called the Somogyi effect). You might want to get up around 3 am and check your blood sugar every once in a while to see what it is doing then.

One thing you might consider is trying a different type of insulin. Many people have better success using Levemir or Lantus. I think that they are approved for use during pregnancy, but I’m not sure about that. You might want to switch insulins and see if your morning numbers are lower. You can give it in two doses during the day to make sure that you have slightly more active insulin in the morning hours.

Is there a reason why the doc wouldn’t want me on a pump instead? I think I’m going to try to test my numbers around 3AM and see what I get then. I think what I find surprising is that I would at least expect that the more the insulin, the lower that morning number is…but it is the same at a dose of 70 units as it was at 30…seems so strange.

I can easily skip the nighttime snack too, and I’ll start doing that…I guess I worry a bit that somehow going a longer time without eating may not have a good effect (if I finish dinner at 8 and then don’t eat until 9 the next morning, is that going to negatively effec this? )

On NPH I’m not sure how you’d fix it because if you increase the dose you are also increasing it at all times of day but you only need the increase at 1 point of day - it’s the dawn phenonemon you’re seeing. If you wake up at 4am or so and give 1 unit of fast acting insulin (or something like that), I bet that would solve it (basically most pump users increase their “basal” insulin at around this time of night, which is just using more fast acting insulin).

I started working out for 30 min at about 10:00pm and that helped bring my numbers down about 10 to 15 points. I know that is tough for some people to do at night though.