Blood Glucose in the morning

When I take my first blood glucose (at approx 7.30am) the readings are normally quite good, between 4 and 7. I don't eat until 9am when I get to work only having a cup of coffee but by 9am my blood glucose has on average risen by 5mmol. Why is this and how can I stop it happening
Thanks

Welcome to the forum......

Its sounds like the dawn phenomenon........

A lot of people will experience the rise as they wake, however some do not.........

There are 2 elements to the dawn phenomenon.....

1. Your body has been fasting and your stomach is empty, a few hours before waking your body releases hormones, one of which come from the pancreas, gulcagon, this arrives at the liver and instructs it to release some of it glucose stores to assist you in starting the day.

2. This process continues until you provide yourself with fuel and start the digestion process.

So basically, you will need to, or at least give it a try, having something to eat as soon as you wake.

When I was injecting [now pumping] I used to have a 125g pot of yogurt, 19g of carbs, low GI. As I was always in double figures because of the dawn phenomenon, this was all I could stomach. It worked well though.

So if you don't feel up to something substantial, something like a small yogurt would be ideal.....

Thank you so much I will give that a go.

Yes, definitely sounds like DP. If it is ALWAYS happening, then taking a small dose of QA when you wake may help. If you know a rise will happen, then it is OK to take some QA without any carbs. Just start with a small dose and increase it if need be.

I do the same at bedtime when my BGs are about 5 after a dinner of slow release carbs like beans, lentils or chick peas. I know my BGs will rise if I don' t take the extra QA, so I take it and avoid going high, and haven't had any trouble with hypos by doing this.

I tried a small yoghurt this morning and my BG still rose but not as much but I think I will try the QA dose as well as the rise is every morning, just 1 unit of insulin though?
Although I have had diabetes for 37 years this is all new to me so your help is really really appreciated. Only just started counting carbs and finding it a bit daunting but determined to stay with it to finally get my BG's under control.

Better late than never!!

I was on a ratio of 3:1 when injecting at breakfast so that may have helped me......you could try something more substantial to trigger the digestion response......everyone is different you see......

You may need a larger ratio for breakfast also as you will be more resistant to insulin at this time due to the cortisol, one of the hormones released with the glucagon.....

What is your ratio for breakfast....?

At the moment I using a ratio of 1.5:1 but I think this needs to be increased as my BG 2 hours later is in double figures although it drops before lunch but then rises again 2 hours later. These reads are always in the teens though. By about 6pm my BG is down to low 3's which mean I have to have something to eat but then levels out during the evening. It feels as though my insulin (Novorapid) is taking longer to work than it should. Is this possible?
I am using Lantus at night, 18 units.

the onset and peak of the novorapid will vary in everyone.......

once you have got your ratios right you can play about with the timing of your injection in order to tackle the mid meal spikes.........

i personally give my dose a minimum of 30 minutes before i eat........

Struggling a bit myself with getting to grips with it all. My sugars are a lot better am than before DAFNE but still around the 9 mark. Would it make sense to increase my levemir by one/two units at night?

Hi Rafa,

If you find yourself giving correctional QA after most BG readings, then that would be an indicator that your basal insulin (levemir) is a bit low and may need to be increased by 10-15%. Remember to wait 2-3 days after chaning though to see what changes to your BGs have been made.

Cheers,
Warwick.