Advice please

I have been using levamir as BI for a while now and I have got the dose right for the day but try as I might I cant lower the early morning levels. My BG is normal at 3am but at breakfast its more like 8,9,more sometimes. I know about dawn effect and after breakfast it lowes to near normal. I have altered the eve BI dose to no effect any other ideas please???

If its the dawn phenomenon, then you cant really stop it, it will always happen, i think the drug metformin can stop glucose dumps from the liver but i couldnt comment on its effectiveness................

moving your BI dose to immediately before bed may help as you will then have more units in your system at the 4, 5 am time...............i moved mine from 1800 to 2230 and can wake with single figures now..............but trying to get the daytime dose to last longer or compensating with QA in the evening may be needed......

that could be an option for you if your sure the dose is correct......

getting up earlier to carch the rise in BG is another option...........i get up at 630, so my body starts the hormonal response about 430-530, this is probably down to my internal body clock being used to the 630 wake, if i got up an hour earlier the response may even start ealier, so you might never be able to catch it effectively........

some think that eating slow released carbohydrate before bed results in you still digesting food/absorbing carbs in the early hours that essentially tells the liver that the glucose dump is not required, and so dropping the BG slightly, there will still be increased insulin resistnce though.............

theres lots of ways to try and trick the liver but sometimes this is not enoug and pump is needed, but you will need to prove this with results obviously......

I have moved the eve BI to just before bed, the last meal I eat is at 7pm at the latest because I cant sleep if I eat late,I will keep recording the results but Im thinking a pump is the next step

What would happen during the day if I wasn't taking enough background insulin

your bg levels would be higher to be sure try a cp free meal to see if your bi is working

as saxman says, you would see higher results, even if you continued to up your insulin/carb ratios, but the critical point would be that you couldn't adjust your QA doses properly, and as you did adjust to compensate, your doses and BGs get even more complicated to understand .......

Thanks novorapidboi26 that seems to be whats happening no matter what adjustments i make during the day my BG stays high.I adjusted my background last night i will monitor it for a few days and see what happens thankyou again

kevin prosser said:
i will monitor it for a few days and see what happens