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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Am Type 1 Diabetic. On Insulin, Novorapid. Have High Level Of Sugar In The Morning. Suggestions?

Hi,
I am type 1 diabetic, since 2008. My insulin regimen
Novorapid: 6, 6, 7, Adjusted according to the food intake.
Lantus: 14u in the night around 10:00 PM

More often that not I end up having a high sugar level in the morning. In excess of 200. I have checked levels in the night, 11:30 PM, 02:00 AM, they are generally low, but seem to raise in the morning.

I had a recent lower UTI and treated.

Can you please guide.

-J
Sat, 29 Jun 2013
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General & Family Physician 's  Response
HI, thanks for using healthcare magic

There is an effect called Somogyi rebound effect. This refers to rebound hyperglycemia ( increased blood sugars) in response to low blood sugar.

There is also the dawn phenomenon where there is an increase in morning blood sugars in response to decreasing insulin and increasing growth hormone which prevents the insulin from working effectively.

Based on the fact that you stated the levels are generally low in the early morning the somogyi may be more likely.

It is diagnosed by intensive monitoring. Treatment may involve reducing the evening insulin.

You should speak to your doctor about the blood sugar readings and the need for any adjustment.

I hope this helps
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3 Doctors agree with this answer

Diabetologist Dr. Pratap VGM's  Response
DEAR SIR/MADAM

USUALLY TWO PHENOMENON HAPPENS IN OUR BODY, ESPECIALLY IN PATIENTS WHO ARE TAKING THEIR DOSAGE AT NIGHT TIMES.
1. DAWN PHENOMENON
2. SOMOGYI PHENOMENON

BUT YOU ARE TAKING GLARGINE INSULIN AT NIGHT TIMES IT WILL CONTROL YOUR SUGARS WITH OUT PEAKS, I THINK YOUR BASAL INSULIN DOSAGE IS NOT ENOUGH

MONITOR THE BLOOD GLUCOSE LEVELS BY INCREASING GLARGINE SLOWLY.

THANKS
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Am Type 1 Diabetic. On Insulin, Novorapid. Have High Level Of Sugar In The Morning. Suggestions?

HI, thanks for using healthcare magic There is an effect called Somogyi rebound effect. This refers to rebound hyperglycemia ( increased blood sugars) in response to low blood sugar. There is also the dawn phenomenon where there is an increase in morning blood sugars in response to decreasing insulin and increasing growth hormone which prevents the insulin from working effectively. Based on the fact that you stated the levels are generally low in the early morning the somogyi may be more likely. It is diagnosed by intensive monitoring. Treatment may involve reducing the evening insulin. You should speak to your doctor about the blood sugar readings and the need for any adjustment. I hope this helps