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What Causes Hyperglycemia In The Morning Despite Taking Medication?
Question: I am having pe2 since 1987 and using 20,24,22 units of slow acting insulin before breakfast , lunch and dinner and using 70 units of long acting insulin at bedtime-and metformin 1000 beforebreakfast and night dinner. But my morning readings are very high as 160 now a dayseven though I increased the intake of long acting insulin from 42 units to 70
Brief Answer:
As advised below
Detailed Answer:
Hello.
Thanks for writing to HCM.
Noted your concern. You are on a sufficiently good dose of insulin as per the basal bolus regimen. Your sugars in the morning are definitely out of the required range as you mentioned. There could be various reasons for that. Most commonly, it could be mean that you need additional insulin. However even after such a huge increase in dose your sugars are high. Hence, few things need to be done. Please check the site of your injection. If there are lumps avoid the site and inject elsewhere and rotate your shots in the site.
Do you take a late night snack? If you do you may need to keep it light.
Thirdly, it would be good to check your sugars at 4 am in the morning. Sometimes people can have hypoglycemia during sleep which will go largely unnoticed and you can have a rebound hyperglycemia in the morning.
Fourthly, have you been started on any new drug? If all of the above is normal, then you can consider adding the dose of insulin and/or add a tablet of a DPP-IV inhibitor like sitagliptin 100 mg once a day.
I will be glad to answer if you have any more queries.
Warm regards.
Dr Praveen
As advised below
Detailed Answer:
Hello.
Thanks for writing to HCM.
Noted your concern. You are on a sufficiently good dose of insulin as per the basal bolus regimen. Your sugars in the morning are definitely out of the required range as you mentioned. There could be various reasons for that. Most commonly, it could be mean that you need additional insulin. However even after such a huge increase in dose your sugars are high. Hence, few things need to be done. Please check the site of your injection. If there are lumps avoid the site and inject elsewhere and rotate your shots in the site.
Do you take a late night snack? If you do you may need to keep it light.
Thirdly, it would be good to check your sugars at 4 am in the morning. Sometimes people can have hypoglycemia during sleep which will go largely unnoticed and you can have a rebound hyperglycemia in the morning.
Fourthly, have you been started on any new drug? If all of the above is normal, then you can consider adding the dose of insulin and/or add a tablet of a DPP-IV inhibitor like sitagliptin 100 mg once a day.
I will be glad to answer if you have any more queries.
Warm regards.
Dr Praveen
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Answered by
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