Yes I have fasting highs in spite of Dr B and taking Metformin at night. I was encouraged to take my Metformin before bed but fear that it does nothing to my dawn phen. highs… either that or I’m worse than I thought in the diabetes dept.
Very distressing - I feel for you.
Hi Gerri just now getting a chance to reply to your comment. You asked me why I ate in the morning if my BG was 186, I thought it would help stop it from rising higher. I read some where in DR. B’s book to eat protein early in the AM to stop DP from raising your BG higher. Any way I am now taking my Lantus at about 10pm at my bed time and so far so good. Then I take it again in the morning with my Humalog. I know this isn’t exactly rocket science, but man, I feel like this is a NASA challenge trying to figure out how much to eat, when to eat it, why isn’t my insulin working like I want it to etc.
I am really happy for you that you are in control of your Diabetes. Someday I hope to be too.
Hi Yolanda,
I challenge any NASA scientist to figure out how to hit a moving target with more variables than can be known or accounted for. I don’t feel in control & muddle along like everyone.
Lowest BG for normal people is between 2-4 AM. Starts rising as sleep cycle ends in preparation for waking. Of course diabetics don’t have insulin (or have insulin resistance) to regulate BG from getting too high from the glycogen ouput–dawn phenonmenon. Once awake with high BG, not eating won’t lower BG & eating very few carbs (Dr. B’s 6 carbs for breakfast) & protein along with insulin lowers BG.( I’ve not eaten breakfast with high fasting & watched the numbers climb.) So, this is different than waking in the middle of the night with already high BG, not taking insulin & eating protein.
Thank you Gerri for clearing up for me when the appropriate time to eat with a high BG is. It’s funny because this morning I woke up with a BG of 219 so I took my 8 units of Humalog and 8 units of Lantus 45 minutes before breakfast. I ate a Wasa Cracker with half a teaspoon of peanut Butter and some coffee. Two hours later my BG was at 220. I seriously don’t understand it. I waited five hours for lunch and checked my BG and it was at 193 so I took 7 units Humalog and waited 30 minutes and ate a hamburger pattie with cheese and one cup of broccolie slaw with oil and vinegar. Well, an hour after I checked my BG again I was at 165 so I took 5 units more of Humalog. With in the hour I was low with a BG of 68 so ate two glocouse tablets finally stabalizing out at 110. Maybe if I could just figure out how much Lantus to take at night to wake up with a lower BG then my whole day won’t be so hard to figure out?
You’re most welcome. Hope it made sense.
Does caffeine usually send you high? Does for me & the effect lasts a while.
What was your BG before bed? Other things can impact fasting BG–eating too close to sleep, dinner meals that are protein/fat heavy that slow digestion, not getting enough sleep.
Hate starting out the day with high BG. Curious, what’s your correction ratio? When I was taking Lantus, I noticed a drop in potency by the 26th day & it was pretty much useless by day 28. Any vial can go bad & I’ve exchanged insulin with no questions asked by the pharmacist.
You could try increasing your night Lantus by 1 unit. I was told to do increasing by only 1 unit at a time & to keep at that new dose for three days.
My BG before bed is usually in higher 100’s like 156 or so. Last night I set an alarm to check my BG at 12:30am. I ate dinner at 7:30pm of chicken and salad took my Humalog at 7pm by this time of night my BG was at 189. I took 10 units of Lantus which I upted 2 units from the previous 2 nights at 10pm. By 12:30am my BG was 279. I took 5 units of Humalog. Since I was already awake I had a hard time going back to sleep so at 1:30am and 3:00am checked my BG. which was already down to 125. By 5am I got up for the day and my BG was at 112. I was kinda of afraid to take any fast acting insulin but did anyway. 3 units Humalog and 10 Lantus. Ate the same breakfast of Wasa and Peanut butter with coffee which I mix half calf/and half de-calf. I don’t think it makes my BG high. Now it is 6am and doing ok. Maybe the secret is waking up in the middle of the night and taking an extra shot of fast acting to avoid DP. I think DR. B says in his book that he does it.
Gerri thank you again for your help. Since I don’t have any health insurance or an Endo I am trying to treat myself, and really rely on advice from those like you. If my insulin is not potent enough I can’t go exchange it, since I have no DR. I don’t have a prescription and am forced to by insulin through an on line pharmacy in Canada.
Hi Yolanda,
The issue is that you’re too high after meals. Lantus isn’t going to help there with overnight & morning highs, of course. So, you need more Humalog & you may also want to experiment with the timing. Sounds like you’re eating too close to bedtime. With 279 five hours after eating, you’re digesting slowly & by then the Humalog is gone. What are your readings 1 hour & 2 hour after meals? Is the Humalog close to expiring?
Hi Jean, I also started 2 weeks ago. I take a long acting insulin at night, but still also have some high bs in the am. I am lower than I had been so i am thinking this is progress. I like your idea of checking at 4 am, but would you inject a short acting or long acting insulin? I am rereading the book again…there was so much information…
This past week has been my first time for DP highs and I mean HIGHS. The first morning after a night of fasting my Bg was 336, Yesterday morning ( Saturday ) my Bg was 398, after a night os fasting. What is going on? Have I hit the time and age where my Pancreas has said " I’m tired " and stopped turning out my body’s Insulin. This past week my A1c estimated 5.7%. WHAT IS GOING ON ?
I like to refer to this list of potential causes for raises in blood sugar as sort of a checklist–it may be DP, but here is a list of other potential causes. I know when I am getting sick I see my BG rise substantially before I feel any physical symptoms:
http://www.dsolve.com/news-aamp-info-othermenu-60/27-how-tos/94-bloodsugars
Thanks, Phishery! That’s a very helpful, clear list.
I’m beginning to think that Gerri is correct, and that what I thought was dawn phenom is actually partly a result of my eating so very late at night, and partly a result of delayed gastric emptying.
I’ve been getting a lot of bloating and a feeling almost like I swallowed a sock (!!!) and that my food “won’t go down” when I eat a really meaty meal (e.g. steak, pot roast or baked chicken.)
When I lie down to sleep and relax everything inside, I think my stomach is finally emptying in the night and shooting my bg up because there’s no more Novolog left to cover it.
I think what I need to do is stop eating at around 6:30 or 7 pm and check and correct my blood glucose at 10:30 or 11 pm before I go to sleep.
I may also need to break my Novolog in half and inject half when I start eating and the other half an hour later to cover the delayed emptying. I tried it for two nights and I think it helped, but the third night I ate really, really late again, and way too much. Bad habits…gah.
Eating smaller meals through the day might help, too, so I’m not so hungry at night, but I don’t know yet how to handle MDI with the “six small meals” that are recommended for gastroparesis.
I hear you, Chele.
Diabetes can be SO very frustrating.
Maybe you’re getting an infection? Or are super stressed? Cortisol (stress hormones in general) make your blood glucose go UP, too. Lack of sleep raises our blood glucose, too.
Are you on insulin? Could it be going bad?
Glad to know my suggestons are helping!
I don’t eat six small meals, but I’m careful what I eat. Portion control is critical for both diabetes & gastroparesis. Nothing too high fiber (especially at night) & raw foods are problematic. I chew everything well, don’t eat meat rare & take digestive enzymes. Regarding protein, fish, poultry & eggs are easier for me than red meat.
Gastroparesis can be far worse with pain, vomiting, diarrhea, so I’m doing whatever I can to not have it worsen. Keeping BG in check is the best route. That’s a Catch-22 with the unpredicatable nature of gastroparesis, but I’m trying.
Ideally, the smallest meal should be dinner, but that’s hard.
Hey Dr G, of course it’s helping! ;0)
Still working my way through my books, too.
The on-line “diets” for gastroparesis seem kind of ghastly to me. I like cream of whatever soup but pureed dinner every night? Yow.
I want to do whatever I can to prevent it from progressing, too.
I hear you on liquid meals. Ick! I have soup for dinner sometimes, but only because I like soup & I couldn’t stand that every night. I also have protein shakes for dinner when I’m too lazy to cook. They’re yummy & filling, but don’t satisfy the need to chew. Even with non-solid meals, it takes hours & hours to digest for me. Often, I can feel my stomach empty & run for the meter. It’s a strange sensation, not uncomfortable.
I know just what you mean! I’ve been feeling this “why won’t this ball go down” feeling grow and grow and then sometimes poof, it just seems to go away.
Oh, gosh. I hate this. It only started in the last few months and it’s gotten much worse in the past few weeks – it’s scaring me. Even if I eat something soft like scrambled eggs and drink milk and water with it, my stomach seems to fill up more and more after I eat sometimes (digestive juices? yuck!) and swells to twice the volume of whatever I consumed. Not every times, but often.
Is this what eating is going to be like from now on? A little tug-of-war in my belly?
At least I don’t have the nausea yet, most of the time. I sometimes get nauseous in the morning after I take my synthroid with a glass of water on an empty stomach (per my doctor’s instructions). It’s like the water hits my stomach and it goes into spasm.
Oh, joy.
Soon I may be having Ensure for dinner, like my 76-year-old mother. I thought I had a few years left before it came to that.
That is very possible, with the insulin going bad. However, I use the Novolog Flexpen and do discard after 28 days. I also use the Lantus SoloStar pen and discard that after 28 days. Shortly after those spikes I discard the FlexPen I was using at 24 days and started a new pen. So far things are fine, curious to see what happens around the 24th or 25th day with this pen. Have an appt. with Endo this Friday and see what she says. Will let you know.
Chele
My doc explained mine to me:
My BS goes too low at night, so my liver kicks in and will spike my BS. So he wants me to eat 15g of carbs at night about an hour before bed. I haven’t really started doing that yet though. Mine don’t go too high. (156 DP)
Alicia,
Have you tested during the night to know this is happening? Doctors assume this, but without testing you don’t know for sure. Other things can cause morning spikes besides liver dumping glucagon. Eating dinner too close to bedtime can cause high morning fasting BG, along with what’s eaten. Best to eat dinner 4-5 hours before bed to be sure the meal is fully digested. A meal that’s fat/protein heavy will digest slowly & could account for high morning readings.
While DP is more commonly a T1 problem, T2s can experience it also. What’s your BG before bed?
If you know from testing in the middle of the night that you are having lows, eating a small amount of protein (cheese, nuts, etc.) before going to sleep will help keep your BG level & is a better option than 15 carbs.
What your Dr. described is technically known as the Somogyi effect. As Gerri said the only way to see if this is what's going on is to set your alarm clock and test throughout the night.
Everyone has dawn phenomenon its just the release of certain hormones to get you ready for the day. One effect of these hormones is for the liver to release some glucose into the blood stream. T2s and some T1s have insulin resistance factoring in. One effect of insulin resistance is that the liver does not respond to the signals to stop releasing glucose, thus your blood sugar keeps rising, this is commonly referred to as a liver dump.
Metformin can help with insulin resistance but in the early morning your levels will be low. Some people move their evening dose to bedtime. The best I have been able to do is blunt the effects. I eat almost no carbs in the morning sticking mostly to meat and eggs. It also helps to eat immediately upon rising even though I sometimes would rather wait a while. I also take my metformin immediately upon rising. Even doing these things I commonly see a 30+ point rise in the morning off a meal that typically contains only 2 or 3 grams of carbs, very frustrating.
Personally a carb snack seems to raise my fasting number so I stick to things like cheese and nuts. That's not to say your Dr's advice won't work for you, the best thing to do is to experiment with different types of snacks carb, protein, fat and let your meter tell you what works for you.
Here's a good article about the Somogyi effect and dawn phenomenon