Okay. I need help from my fellow Diabetics. I’ve been wearing my CGM for a few weeks now, so I’ve been seeing that my bloodsugars spike up to low-mid 200’s around 3AM. It comes back down at 6AM but it’s still high 100’s - low 200’s when I wake up. It’s gotten better (when I first started my CGM I saw that I was going up to the 300’s during my nightly “spike,”) but I can’t seem to get it to not go above 200 and it’s really frustrating me. I’ve started exercising at 8PM every night, I stopped eating carbs after 7PM. My basal rates are ridiculously high (even for me) at this point. I’m literally at a loss as to what to do. I’ve gotten my bloodsugars to the point that my A1C SHOULD be around 6.7, except for these nightly spikes keeping it up. And I am SO proud of that (it has been an immense struggle getting that much control of my diabetes). So I am SUPER frustrated. Why can’t I get my sugars not to spike around that time?? Any suggestions?
Sounds like your version of Dawn Effect, which raises bg to help non-diabetics have the energy to wake up. Usually happens a bit later, but undividual variations happen. Google "diabetes dawn effect for a full description.
This raises the question about how you take your insulin, shots or pump? If shots you may need an evening shot of slow insulin at a time that takes effect around 3AM. Try a small dose and adjust until it works well. You could also get up at 2:30AM, test and take fast acting insulin to adjust bg
If using an insulin pump just set a higher basal rate for 3AM. Try a higher basal dose and adjust until it gets what you need.
3 AM, pardon my expression, is well known as “the witching hour”. my basal rate is almost double from 3-6 AM.
dawn phenom is one issue, but what does your CGM say at 2 AM? anything below 100 mg/dl could cause a liver dump (look up somogyi effect) in my opinion, if you are sensitive, anytime you get a little low at night your body can dump liver sugar in a well meant (in non-t1’s) attempt to raise blood sugar. in really sensitive people it might be better to run in the 120-130’s at night to keep this from happening.
Thank you! I feel better knowing that it’s not just me. I start slowly climbing around 1AM and usually jump up around 3AM. I’m a pumper (Omni Pod) so I’ve been adjusting my basal rates a little every week but it hasn’t made much of a difference. Knowing yours is almost double during those hours makes me feel a lot better about maybe upping my rates a bit more. I’ve always been really insulin resistant (my carb ratio and correction factors are way different than all of my diabetic friends) so I guess I was just baffled that it might actually take THAT much insulin to get me where I need to be. Thank you!
=) a couple other thoughts. alcohol has a way of slowly increasing bs at night (that’s why many people who drink wine wake up suddenly at 2AMish) basal changes are typically made slow, you really don’t want ot go low at night. the starting point for a basal change is 45 minutes before you see a bs rise on your cgm. good luck!