high bloods tiny carbs

I could do with some advice please.
My blood sugar rises through the morning up to lunchtime and I want to know why? I do not eat at breakfast time. I sometimes do not have lunch either. tea is usually late and can have little or no carbs in it.
My breakfast fasting blood sugar is usually very good. I am not eating until lunch except for 2 cups of coffee with milk. Would the splash of milk raise my Blood? After a pre meal test I take a corrective dose. In fact most of my QA insulin is given as corrective doses. How can I pre-empt what my Blood sugar will be so I can take a corrective dose before my blood rises.
I have 2 injections of Lantus. I overlap them to help with the highs I have most mornings. I have nearly doubled the dose in the last year. Now take 15 at 8amish and 15 at midnight-ish.
I am on a 2:1 ins to carb ratio all day except evening when I am 1.5:1
I am no more active than the average person. On and off this has been a problem for me for over 10 years.
Thank you.

Looking at your results in the morning you usually have 1 unit of insulin but no food/carbs. By not giving your body any food, especially carbohydrate, your body attempts to raise your blood sugar by other sources to keep your blood sugars in a normal range. This would happen fine in a non-diabetic because their pancreas can then release extra insulin to stop your body (the 'new' sugar comes from your liver) making your blood sugars too high. As this doesn't happen in a diabetic, you can see there is no mechanism (i.e this one unit of insulin is not enough) to cap this increased blood sugar. Therefore you have high blood sugars around 12.00- 13.00. As you also exercised on Wednesday and this would have the same effect. There may also be a problem with your background insulin- it may not be high enough to keep your blood sugars sustained?
By including more carbs in your diet you are giving your body something to match your insulin dose to. Is there any particular reason why you don't eat breakfast or many carbohydrate foods? It really is important for a balanced healthy diet to contain around 50% carbs to give your body that important fuel source. Have you any appointments with your diabetic team coming up that you could put some of these issues across to?

Sarahlou,
Thanks for your comments. One of the advantages explained to me of DAFNE is if I want to eat I can, and if not I don't have to. Have I got this wrong? I did dafne a long time ago maybe this has changed. The insulin I have in a morning is 2:1 ratio. So 1 unit is ok for 0.5 Carbs. On Fri morn I had a small 0.2 carb intake but also a slighlty elevated BG. 1 unit should have worked. 0.5 of a unit for the 0.2cp's and the other 0.5 of a unit should lower my BG from 7.5 to 6.5. 1unit = -2m/mol. for me.
I still haven't got the hang of adjusting around exercise. I'll persevere.

My next appointment is in May.

I have no real reason other than when I eat carbs I put on weight. I do have days, when I eat a varied amount of carbs. I try to eat when I'm hungry. This is usually in the evening.

Thanks for your support.

Hello

Have you tried checking your bg in between the meals to see when it rises? Might help to know if was bi or QA related. But given the tiny amounts of carbs I would have thought it was bi related. The only other thing would be that there was more carbs in what you are eating than you think but I expect you have already checked that out. Do you just avoid carbs and fill up on non carb stuff or eat very little all day?

I used to have weird blood sugars that went very high and then dropped very low and got put on a pump which has been brilliant but also showed how I need drastically different amount of bi throughout the day. I tend to email my dafne/diabetes team with my results, copied and pasted from here, and I think that being able to do this really helped them know what was happening with me and helped me get a
pump.

Hope you sort things out.

Jenny

Hi JennyNZ,

Thanks for your comments. I think it could be BI linked but I get unexplained rises in BG throughout the day similar to dawn phen. I'm not wanting to eat much at the moment, really it seams to help. When I do, it is generally non carb veggi's and some dairy. I have sent emails to my diabetes team, No answers as yet. I love the DAFNE approach but I still struggle.

Do you prefer pump therapy? What are the pumps like? Thanks again.

I did dafne first 4.5 years ago before having children. The ideas are great but I always struggled to get the right background insulin. I tended to rise very high post breakfast and slightly less dramatically after lunch, but then drop suddenly before lunch and late afternoon. Changing my ratios for breakfast did not help only giving me more hypos.

The pump is good because you can set different basal rate (like the bi) throughout the day. So from 2am to 7am I am on much more than I am after breakfast. (1.01u per hour down to 0.45u per hour, approximately) I only got it in November so I am still getting used to it and I still have highs and lows but I definitely have a change in my before breakfast readings. My hbA1c dropped from 7.4 to 6.8 in 3 months.

Putting the canulla in has got easier. I was dreading it each time initially and also if you don't get them in right they can get sore and not work. Wearing it is not too much of a problem. I don't really notice it. Only when using the toilet as the tubing tends to get caught on my jeans.

Jenny (not JennyNZ, a different one!)

Just from your results it would seem that your 15 BI dose is not enough...................Another theory for similar BG behavior at this time is the dawn phenomenon, but it seems you are waking on target and are having a tiny carb with insulin, so those two factors can eliminate the dawn phenomenon contributing...........

So if you continued with similar results in the following days, it definitely time to up your dose and do some carb free testing, which shouldn't be too difficult as you carb free regularly..........


Good luck............

Hi,
Firstly Jenny I am sorry for the name mix up. Your experience is very valuable to me as I can see many parallels.

novorapidboi26, I could push up my BI a little as you suggest. As you say though my morning bloods are on target. I use Lantus which lasts 18hrs+. I overlap it in the morning. If I am having DPhn I was hoping this would help. If the truth be known my old insulin Insulatard did a brilliant job throughout the day. It had a bump which unbeknown to me at the time helped keep the mid morning BG rise in check. Thanks for advice.

Dont be afraid to try other insulins', I have been on Lantus, Levemir and Humulin I, and in that order, ended up back on Levemir.................

DAFNE is to allow you to eat what you like when you like, so i would keep persevering with it and you seem to have insulin: carb ratios calculated. Like others have said here the main problem must be your background insulin as you are still injecting quick acting throughout the day. I struggle to adjust for exercise too but if we keep experimenting will we end up knowing what works