Thank you, liver?

OK I’m too embarrassed to post the starting numbers (really) but I’ve been fasting for over fifteen hours (mostly sleeping because I didn’t feel well this morning and stayed home from work) and injecting more Novolog every four hours and my blood-sugar STILL won’t come down.

At 4:15 I was at 203 mg/dl. I injected 11 IU of Novolog and just checked again and I’m still at 201 mg/dl.

I’m on water and air here. Where is the glucose coming from?

Thank you, liver?

How do I shut it down? What’s the minimum I have to eat to get it to back off?

If I eat too much when I’m already high, it just perpetuates the cycle. But if I don’t eat, my liver “helps” by dumping out glucose.

What’s the best way to break the loop? Why does it take me DAYS of near-perfect eating to recover from overeating, when other people seem to be able to just bolus once and move on?

I’m getting a bit hysterical over here. Dawn phenom at 5 in the afternoon? Gah.

I am not sure how much you need to eat because I don’t usually have problems fasting. But you aren’t alone with the days in trying to get it to come back down. I know other people have the same problem also. I might get mine down with one big shot, but it doesn’t stay down for long - it is a 2 day battle to keep it down.

I don’t have any brilliant suggestions, Jean. You sound like you have two factors (the DP and the need to eat little) that are making it hard to get the numbers down.I understand why this is stressing you! I don’t know much about DP as I’m lucky enough not to have it. If I don’t eat my basal keeps me stable. So question:Can you eat anything to combat the DP or does it have to be carbs? Sorry if it’s a dumb question. If you can eat anything to keep the liver dumping down, I would eat as little carbs as you can. If you have to eat carbs, guesstimate the minimum you can get away with. You don’t want to be hungry but you can supplement the non or low carbs with protein and fat and vegies (yeah, I know they have carbs just very few).

What I do want to say to you is to be careful. I can hear how frustrated you are and I understand! But when I get frustrated or overwhelmed I tend to just act with relatively little thought…lol. So I could see you continuing to correct and correct some more. We all know there’s a tipping point where all of a sudden the insulin clicks in after being “stuck” for awhile. I don’t want you to have a dangerous low hit you! Better to tolerate the 200s for a bit longer and be safe.

Have you checked your insulin; do you have another vial or pen you can use to make sure that insulin wasn’t bad? If you use a pen have you primed the pen to make sure insulin is coming out? I know it’s boring to hear, but could you be getting sick or have a bad tooth or anything. Are you unusually stressed (aside from your blood sugar, that is?

Speaking of stress, easy to say, but it won’t help. The 200s are not good and you probably feel pretty beat, but it’s not dangerous territory (and since you won’t mention where you started you obviously did have some success getting down from that peak!). So do what you can, then try and relax, watch a movie, take a bath, whatever helps.

Aside from the safety concern and having no idea what I’m talking about when it comes to DP (has that ever stopped me?) I’d tend to think the impact of carbs is worse than the impact of your liver kicking in, so I would eat but as low as you can on the carbs. Hang in there, just another diabetic blip but hard to remember that when you’re blipping like mad!

I keep forgetting that I’m a slave to insulin resistance. There’s no escape from it, not even for “special” occasions.

I get punished for days whenever I forget to bow to its altar.

I wish I could just accept my fate, because fighting it is exhausting.

fighting it is exhausting but you still need to tell it where to stick it once in awhile!

Thanks for the reminder to not go off the deep end with the Novolog.

I just ate something high in protein and fat and not too high in carbs and I bolused for it but resisted the urge to add a too-soon correction factor. That way lies madness, I know.

I’ll keep testing every hour or so and see if this successfully knocks some sense into my liver: “See? There is food in the world. You can stop now.”

The good news is that I’m Googling “liver dump” like mad and finding all kinds of people with the same problem, so I don’t feel quite so insane: “I didn’t eat anything! Really! For hours and hours! And dawn was 12 hours ago, so WTW?!?”

I guess the trick is that I have to eat something tiny when I wake up and every few hours afterwards, or my liver will attempt to “save” me with all its dysfunctional tricks. One person suggested just a bit of cheese rolled up with a thin slice of meat – just anything to reassure my liver that I’m not starving. I can do that.

Why can’t my body just USE all this body fat for goodness sakes!?! Without spiking me up so high? Isn’t that what body fat is for?

See, I told you that you weren’t alone! I have heard some people say that they reach for a snack as soon as they get up or their BS goes up.

Did you happen to read Susi’s post about her 25 year old friend? Someone put a link to an interview with Jenny Ruhl of BS101. I listened to it the other day and she was talking about how people that go low carb and then eat some carbs – she said your liver gains the weight and you can gain 6 pounds just from eating what should be an average meal of carbs. I meant to Google that and forgot until you started talking about your liver. That happens to me and no one believes me that I gain 6 pounds from eating something carby.

Well, eating the eggy meal and bolusing for it is a bust so far…223 mg/dl. (Two hours after correcting, one hour after bolusing and eating.)

I’ll give it a couple more hours and then I’m going in AGAIN with a Novolog correction before I go to sleep.

(…bangs head on desk…)

Who wants to bet that I wake up in the 200’s again?

I was just going to suggest it, but someone else beat me to it. Eat something small and low-carb (I’d say low-protein, too) like a salad, or just some raw vegetables. If it’s truly a liver-dump, that might be enough to tease your body into thinking you’re eating now, and it can stop. The reason I’d avoid high-protein is that protein does have the effect of raising BG, just over a long period of time. For me (a T1) the hardest highs to come down from are when I’m fighting the delayed BG rise from a high-protein meal.

The other suggestion - if you normally take insulin before meals, is to have a small meal, and add the correction to the meal bolus. For some reason, I find I’m more responsive to large doses of insulin than multiple smaller “correction-sized” ones.

That’s a good idea. Next time I’ll try a cup of steamed broccoli or some lettuce – maybe that would be enough carbs to get my liver to give it up already.

I think you probably have a pretty bad infection somewhere and now is the time to get down to the hospital or you could end up in a coma.

You may or may not know if you have an infection - a sore finger or toe you can see, but of course there are so many other infections that you could have but are not aware of - this has happened to me on several occassions and because I have asthma I thought the coughing might be to do with that - but in fact it was a chest infection and I have ended up in DKA which meant several days in ICU. I would not want that for you and if you do end up in ICU then you are denying someone else who might need it, so there is no harm in going to get it sorted out BEFORE you get that bad. Last time I went in I was 1/2 hr from going into a coma and I do not remember much about the first 48 hours!

Please go to the hospital and get checked out. You probably need IV insulin and antibiotics.

Let us know how you get on.

Another suggestion I have just thought of.

I learned on this site that it is a good idea to inject larger doses of insulin (for arguements sake 20 units) in several smaller doses - at the same time - for example 4 x 5 units in different sites - and that seemed to help with me. It takes less time (obviously) for the insulin to be absorbed in smaller doses than one big one. I know it is a faff but does seem to work for me. Thanks whoever gave that tip! I cannot remember who it was. But I have done it on several occassions.


I believe you!!! It happens to me too! Oh, I can’t stand it!

It seems like one slice of bread will put 1kg on my weight. So hard to lose again too! Sounds like tiny snacks are the way to go, Jean.

I have a wicked case of Darn Phenomenon. If I just fast, it gets bad, really bad. I think many of us see this. If you fast all day, can you still be experiencing DP at 5pm? Sure. In fact, a bad DP morning can mean a bad blood sugar day. While we think of blood sugar regulation being something where insulin just acts on our body to restore normal blood sugars, it is much more complicated. Your body actually releases (or inhibits) hormones (above and beyond insulin) in response to eating (and even just thinking of eating). These hormones, such as glucagon can do messy stuff like causing your liver to go into overdrive.

So eat something. Anything. Lettuce. And do that every morning, unless you have some real reason for not eating.

And you may well be sick, you may have become more insulin resistant from the highs and it is just all piling on. But hang in there, you will get it under control.

Thanks but I’m not that kind of sick.

Thanks for your reply – I’m still high and overwhelmed, but at least I better
understand dawn phenom. A bit.