I am relatively new to the diabetes game...

general question - in the past few weeks I have seen a sudden jump in my morning fasting numbers, 170, 150, 130, although sometimes 90 - there doesn't seem to be a pattern.

Now I think I am noticing that I need to visit the bathroom more often than normal - or it's just in my head after trauma of being undiagnosed and waking up 4 times a night or more...

What are the causes for sudden jump in fasting numbers.

I take Levemir and NovoRapid - before recent I always had between 80 and 100 for fasting #'s

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Hi Shea

I see you were diagnosed over a year ago. It is entirely possible that your honeymoon period is coming to an end and you are producing less insulin on your own and so need more injected insulin. If the higher numbers you are seeing are mainly fasting, then you need to up your basal. If you take it at night try increasing it by one unit for a few days and see how that affects the fasting. But depending on how often you test, if you are experiencing increased urination than perhaps you have highs at other times too. Do test on a regular basis (if you don't already) and keep good notes to determine when the highs come to see if you need to consider increasing your I:C ratios as well. But for now I would recommend upping your basal slowly and seeing how you do.

Thank you, this is very welcomed and helpful advice! I will put this into practice and see what comes about. My numbers in the day seem to be usual, raising up sometimes to 140 - 160, but usually coming down within a reasonable time frame.

I am going to keep an intensified testing period of a week and work from there.

Thank you again - it's a big relief to be able to get such a speedy and helpful response

In addition to the fact that you may be ending your honeymooning, I would suggest that sometimes things just change. I believe modern medicine does not have the tools to accurately predict insulin needs sometimes. Weather changes be related to decreased activity, increased weight, stress, changing dawn phenomena, etc. The important thing to realize is that things sometimes change and you must adapt to maintain (near) normal BGs. Sometimes you should not beat yourself up trying to figure out why because you will never figure it out.

I recommend that if your fasting numbers are creeping up higher than you want, that you increase your basal very gradually for 2-4 days, then take a look at your results and assess if you need further changes.

Thanks so much for your advice, I hear what you are saying - many things may effect the BGs.

My basal is Levemir. Is there a normal amount that one should inject or is it dependent on the indvidual. Someone told me they took a course in the UK and was told any more than 28 units a day is unnecessary. I inject 22 in the morning and 22 at night. Plus short term at meals...

My goal in insulin management is to achieve (near) normal BGs. Everyone is different so I would go as far to say that if anyone tells you a hard fast rule about diabetes, they are most likely wrong! Except insulin will make your BG go down (or not up as fast) and carbs will make it go up (or not down as fast).

I do not care when or how much insulin I take, instead I care about what my BG is. My total daily dose is 57 units/day with 42.5 units/day being basal, on average.

I would suggest that you consult or physician about how to increase your basal dose or make an educated guess using information about the "average" activity profile of levemir: http://www.levemirpro.com/efficacy/once-daily-24-hour-effect.aspx. I have never used levemir (I used lantus), it appears that a typical user sees pretty constant coverage with a peak around 10-12 hours?

Perfect example of weird numbers. Last night took 24 units of Levemir around 8pm with dinner and 6 Novo Rapid for meal.

perfect example, last night and this morning:

before bed, 2145 - 76 (after going low and coming up with a spoon of honey and 3 crackers)

woke up 2310 - 114 (took 3 units novo rapid to see if i could maintain between 70 - 100 over night)

woke up as usual at 0400am - 170

checked again before leaving the house 0440am - 197 (took 4 units novo rapid to bring down)

got home at 0720am - 118

Great point, Capin! I've been on insulin for 3 1/2 years now and I still can't shake the obsession with "why". Sometimes there is a why, and it's important to know because it tells you what to change. (Like say a certain food always spikes you or a certain type of exercise always drops you or for pumpers you may have a bad site). But the most important thing is to recognize patterns (as opposed to occasional occurrences which are normal to Type 1's.)Then when you recognize a pattern in your insulin needs, slowly change your doses (I:C, basal or ISF). What I'm getting better at is doing that more quickly and not losing days (or weeks!) in the "whys".

I am a type 2, but I struggle with high morning numbers as well. I don't consider my morning numbers my "fasting" level. My fasting level is the level 3-5 hours after a meal. My morning numbers are my Darn Phenomenon (DP) numbers and are basically disconnected from my fasting numbers. DP happens to a lot of us, different people have different explanations, but in the end our livers dump glucose in the morning which cause a sometimes disturbing rise in blood sugar. You can fight this by raising your overnight basal levels, but for many of us you can only go so far, when basal levels go too high we have hypos during the day.

My approach to DP has been to establish a basal rate (about 24 units/day) that keeps me right on target when fasting between meals and when I sleep. I split my basal injections, so I take a morning shot of about 12 units. At night, I take the rest of my basal, but I also stack up more insulin to help my overnight numbers. And I stack about 3 times my basal rate, attempting to time my evening injection to peak in the early morning hours of 3-5am. Despite this, I still often struggle with higher morning numbers. So I just do my best, and accept that if I awake high I will have to correct.

Your insulin still has a tail on it at 3 hours. there is no insulin on the market that is fully finished at 3 hours. the 3-5 is the post meal number. Have you actually skipped eating for at least 8 hours and tested?

Yes, I have done fasting tests throughout the day. My point was really that morning fasting levels often reflect DP, not actual fasting levels that are seen between meals.

There is a difference in basal needs the week before your period and I think can happen during ovulation for females. Our teen's basal needs overnight do change and do not remain the same and I don't think it is always exercise related. I get a blood sugar at midnight after there is no insulin on board and 1:30 am and 2:30am. This is how I gauge the basal overnight and I adjust her day's pattern based on this. If she is dropping on the basal for these three checks I lower all basals from midnight to 5pm the next day. Same for rising on her existing basal pattern. Ideally, you are supposed to get three days data before you make a change. But we have been at this for seven years and this works for her. There is also a difference in weekday and weekend basal patterns due to activity level, different arising times from sleep. Get Pumping or Using Insulin by John Walsh, Think Like a Pancreas Gary Scheiner and Type 1 Diabetes Ragnar Hanas. Lots of tips. I believe everyone is different so I think you should find your own patterns and not adjust like we do, but use three days worth of data before making any changes.

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