Many people with diabetes have a sharp rise in their blood glucose just before they wake up in the morning. There is still some argument about precisely why this is, but many researchers believe that it is simply because blood insulin levels are getting lower. However, earlier in the night, your blood glucose may have been low, even hypoglycemic. If you are waking with high blood glucose levels, check what is happening to your blood glucose during the night. Use an alarm clock to wake yourself up at, say, two and five in the morning to check your blood glucose level. Managing high pre-breakfast glucose levels depends on the type of insulin you are taking and whether you also have nocturnal hypoglycemia.
High all the night If you are running high throughout the night, the solution should be straightforward. Increase your long-acting or medium-acting evening insulin or, if you are overweight, eat a little less before you go to bed. If you are on very long-acting insulin, taken only in the mornings, you may have to increase it, and then you may have to readjust your diet so that you do not go low in the afternoon or evening. If you have a late main evening meal, after about eight o’clock, you may need to increase your evening short-acting insulin, rather than the long-acting one.
Low then high It is a little more difficult to sort things out if you are hypoglycemic during the night and you then awaken with a high blood glucose level. Obviously, if you increase your long-acting insulin, you may become seriously hypoglycemic at two or three in the morning, before the insulin runs out. One way of coping is to have a rapidly absorbed snack just before you go to bed, rather than a very high fibre one from which the glucose is absorbed more slowly. This can be combined with a slight increase in your evening medium-acting or long-acting insulin and a slight decrease in your fast-acting insulin. Altering the quantity and timing of your main evening meal may help, if this is practical, and altering the time at which you give your insulin injection can also help sometimes. Discuss this with your doctor. If you cannot get it right on twice-daily insulin injections, consider splitting the evening injection so that you have the short-acting insulin before the main evening meal and the long-acting or medium-acting insulin before going to bed. Another approach is to try a CSII pump, which will give a constant insulin infusion throughout the night. Some models also allow you to program for delayed insulin boosts to cope with an early morning rise (for example, the CPI 9100 model).
People with insulin-treated diabetes should always eat a snack before going to bed.
*28/102/5*
THE DAWN PHENOMENON IN PEOPLE WITH DIABETES
Many people with diabetes have a sharp rise in their blood glucose just before they wake up in the morning. There is still some argument about precisely why this is, but many researchers believe that it is simply because blood insulin levels are getting lower. However, earlier in the night, your blood glucose may have been low, even hypoglycemic. If you are waking with high blood glucose levels, check what is happening to your blood glucose during the night. Use an alarm clock to wake yourself up at, say, two and five in the morning to check your blood glucose level. Managing high pre-breakfast glucose levels depends on the type of insulin you are taking and whether you also have nocturnal hypoglycemia.
High all the night If you are running high throughout the night, the solution should be straightforward. Increase your long-acting or medium-acting evening insulin or, if you are overweight, eat a little less before you go to bed. If you are on very long-acting insulin, taken only in the mornings, you may have to increase it, and then you may have to readjust your diet so that you do not go low in the afternoon or evening. If you have a late main evening meal, after about eight o’clock, you may need to increase your evening short-acting insulin, rather than the long-acting one.
Low then high It is a little more difficult to sort things out if you are hypoglycemic during the night and you then awaken with a high blood glucose level. Obviously, if you increase your long-acting insulin, you may become seriously hypoglycemic at two or three in the morning, before the insulin runs out. One way of coping is to have a rapidly absorbed snack just before you go to bed, rather than a very high fibre one from which the glucose is absorbed more slowly. This can be combined with a slight increase in your evening medium-acting or long-acting insulin and a slight decrease in your fast-acting insulin. Altering the quantity and timing of your main evening meal may help, if this is practical, and altering the time at which you give your insulin injection can also help sometimes. Discuss this with your doctor. If you cannot get it right on twice-daily insulin injections, consider splitting the evening injection so that you have the short-acting insulin before the main evening meal and the long-acting or medium-acting insulin before going to bed. Another approach is to try a CSII pump, which will give a constant insulin infusion throughout the night. Some models also allow you to program for delayed insulin boosts to cope with an early morning rise (for example, the CPI 9100 model).People with insulin-treated diabetes should always eat a snack before going to bed.
*28/102/5*
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