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Jen's Diabetes Blog - Jan 2007jen carter writes a regular diabetes blog on being a mum of a diabetic daughter

31st January 2007

Insulin Pumps & High Blood Sugars in The Morning

There's little else as disheartening as going to be with a good sugar level, only to wake with a high blood sugar.

It's a phenomenon that many people experience and one that's sometimes hard to get to the bottom of.

What most diabetics know is that if you start the day with a high level, it's really hard to achieve anything approaching a normal level during that day.

Our own experience with the pump is that you need to really look at what's actually causing those bad morning levels.

At our last clinic visit, we spoke to a young woman who was experiencing quite high levels before breakfast. 

Given our own experiences of several years ago, whilst on injections, it seems quite likely that this was caused by her having a hypo during the night and sleeping through it.  The key indicator is a strange taste in the mouth on waking and a thick headache which makes it hard to think straight.

What we did to reduce the problem

As you're probably aware, foods like cheeses and meat include fats and proteins that take some time to enter the bloodstream.

As these can take around four to five hours to affect your blood glucose level, it's helpful if you can eat earlier, so that the levels have increased before bedtime.

For Alissa, this means that she is eating her evening meal between half past five and six in the evening, then checking her level at around half past ten, just before bedtime.  On the whole, her food has been safely digested and her level is now likely to be unaffected by food.

She's also changed her diet to eat most of the carbohydrates during the day, with a lighter meal in the evenings.

It's also wise to minimise exercise in the evening, as the effects of this can result in dropped sugar levels several hours later (in our experience, 4-5 hours later).  Otherwise, it's worth making adjustments to your basal rates to take account of regular exercise patterns - thankfully many of the latest pumps have the facility to have different basal rates for different types of day.

When we found that Alissa was regularly waking with higher levels when she was younger, several nights I would get up and check her levels every two hours so that we had a pattern of what was happening.

If you're experiencing a similar phenomenon, checking your nighttime levels at three-hourly intervals will help your diabetic nurse and doctor to find out what's likely to be causing the problem.

Some people have what's called a dawn phenomenon, where blood glucose levels drop in the early mornings resulting in the need for a higher basal rate of insulin.  It's important to establish whether or not you experience this before adjusting your levels, check with your health care professionals.

If you're experiencing poor levels and are unsure why, don't wait too long to involve the experts. 

Whilst you're able to make minor adjustments to your basal rates, larger problems should be swiftly referred to your diabetic team.

Make use of their expertise and experience to help you manage your diabetes and achieve better, near-normal sugar levels.

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