high and lows

hi there my problem is that when i wake up 4 work at 5am i check my bg make an adjustment but do not have any carbs yet when i check my bg before brekfast between 8-930 ti is rising can anyone help

Is there a reason you are taking QA if no carbs and you're within target..eg. Today, there is no need to correct, which can then lead to hypo! Also some of your corrections appear very high!

if i dont take insulin when i wake up my bg will be 20+ iam taking insulin to try and keep it n range my bg is still high at b/fast even after a large adjustment the diabectic nurse on the dafne course deduced my night time bl from 10 -8 because of a hypo during the night im going to put it back up to see what happens

It may be worthwhile doing a test at 230/3am to see what's going on, as nighttime hypos can cause the morning highs! Would be best to do this for a few days before increasing bi, to check for pattern first.

ok i will try that thanks for all your help i will post the results in a few days time

There is an awful lot of correction going on during the morning. That tends to indicate that BI is too low, however you then tend to go low in the afternoons around 4 hours after taking QA so unless you are on a non-standard QA, that indicates the BI is too high. Confused yet?

Can you please answer the following?

1) Can you tell us a bit about what BI and QA insulin you are on?

2) In the afternoons, do you exercise, or do an activity that requires lots of blood sugar such as concentrating? If so, when you do this activity, can you please note it in the diary?

There are a few variables to work out here.

First is the correct BI dosage because if that isn't correct, then everything else becomes too hard to calculate. It gets a little tricky because of your split dose, but I'm not against split doses - I do it myself - but may need a little work to identify the correct BIs.

Second will be to work out your QA ratios which probably aren't too far off what you are already using, but a bit hard to tell with all of the corrections.

Third will be to work out what your correction doses are - how far do you drop when you have the correct BI and you take 1 unit of QA.

Post your results in a couple of days and let's see if the BI increase has helped things. Once we get the BI right, we can work on the others.

1) qa novo rapid bl lantus
2) ihave spoken to my diabetes nurse and explained what is happening in the morning she said its possible i have got something called dawn phenomenon as my body starts to wake up in the morning it is releasing glucose even if i didnt have a hypo during the night i checked my bg at 3am and it was 11.4 going to increase my bl to 10 tonight and see what happens

Hi, I have a similar issue and again I was told it was dawn syndrome - today I woke @ 4.2 bg had no carb breakfast and by 10am was 15bg. I hav upped my night time back ground which gives me a good start to the day - take another fast reading at 10am and adjust as required - the rest of the day then pans out ok. Keep an eye on your evening ratios when increasing night back ground as I had a few hypos to staRt with -took a few 3am readings to help adjust.

Sorry meant To say Also Bi changed from lantus to levemir as lantus was not lasting 24 hours.

Dawn Phenomenon is an annoyance and very common. Hormones released in the morning make you more resistant to insulin so you need more to compensate.

What you may find is that you need to increase your morning QA ratios to compensate for DP.

I think that your plan to increase night time BI is excellent. Like you I am on Lantus, and I split my dose in January because it was not lasting the full 24 hours, and the highs I was experiencing after dinner went away.

Do you still have your BG readings from your DAFNE course? Just wondering if your overnight hypo that led to the decrease in BI was within 5 hours of taking QA? If so, it may have been that you just took too much QA rather than the BI being the issue.