Night and morning hyperglycemia

Hello again I have seen if you can help us because we are a little worried.
My girl has a few days (approximately 2 weeks) with quite pronounced hyperglycemia when measuring before breakfast (raising around 210).We thought it was due to a catarral episode, but being well of that infection, this situation is still maintained.
His doctor told him that it was good to measure some days at 4 in the morning to see what happened, two or three days that he has done 320. His dinners have not varied, sometimes he has sometimes dinner less than before.To which this nocturnal lack of control and hyperglycemia may be due.
Thank you very much for your help.

If the measurements at 4 in the morning are high, it lacks a little insulin at dinner.Check that so for several days in a row before making changes.

It can also influence what it ceases.The pasta and pizza give me some measurements the next day in 150, no matter how much I lie in 100-120 two hours after dinner.

Hi Nenito:
If you tell us what treatment we can take a hand: D

Well, its treatment is: Lantus (16 U) at 10pm.Apidra 8-6-6.
No Pizza Cena, or Pasta ...., the problem is that these high values ​​have begun to have them for 2 weeks having dinner at the same time before this happened.His dinner is normally a vegetable and a little cheese, or a vegetable and fish, that is, with few carbohydrates at dinner, and not even dinner much.There are times that at 2 hours of dinner it is 160 and when it is measured at 4 in the morning it is when it has risen to 320.
His nurse of the Health Center has told him that when he got up high, around 200 because he could be some rebound of night hypoglycemia, but when measured at 4 in the morning and having more than 300 they have told him that it can also be something called something"Phenomenon of dawn", until next month he has no review in the endocrine and is quite worried.

Hello!.It seems lack of the antus.Increase a unit and wait two days to see if it is enough.
S Alluds: d

I think how regina, I think Lantus lacks and what surprises me is that for dinner that hardly ingests hydrates, so many apidra units are put or varies depending on the rations of hydrates?

Thank you very much to everyone.The lack of Lantus was a thing that is contemplated but the doctor says that it is not likely because the lantus gets at 22 hours and the controls before the food (16.00 h) and before dinner (23.00 h) areBetween 120-130, the problem is dawn and dawn, when the Lantus is also supposed to take a lot of effect.Thanks for your help, we will continue trying to control this roller coaster.

I would try to correct that hyper raising Lantus and, if necessary, going down quickly for the day ...

You need yourself, "we will continue trying to control this roller coaster", if that happens, something fails in the pattern, do you control the diet by portions?It gives me the feeling that Lantus is missing and you have plenty of quick but with so few data is it difficult .... Do you know how many fast units need for each ration of hydrates?

Hello,
I think that the doctor's diagnosis is the successful: high basal values ​​are due to revives by norturian hypoglycemia.I explain myself: The hydrates of the dinner are in the blood two hours later and in the measurement of that glycemia it has 160 mg/dl (a good value), at that time or shortly after the lantus that has been injected to the22:00 (think that the lantus begins to take effect two hours after being injected and stops taking effect to twenty hours of being injected) and then produces hypoglycemia in another two hours more or less that implies a rebound that goes downSomething but not much until it gets up.The Alba phenomenon is discarded because it begins much later and can produce a light increase at dawn but not at 4:00.
My advice is that Lantus insulin is injected in the afternoon (about an hour and a half before dinner) and that it is more dating because it will be taking effect during dinner.Measure the glycemia before dinner, two hours after starting dinner, at dawn between 3:00 and 4:00 and in the morning.If the basal value is less than 70 mg/dl two days in a row in two units the Lantus and if it is greater than 140 mg/dl two days in a row you increase in two units.All this as long as at dawn and two hours after dinner has acceptable values ​​(around 180 mg/dl).
Greetings.

Well .. that of the Somogy effect (rebounds by nocturnal hypoglycemia), it seems that it is under discussion that exists.At least, I have never seen it in the 17 years of diabetes of my daughter.Whenever he wakes up, he has needed more insulin, no less.
Greetings :)

Regina,
When basal blood glucose is two days of more than 140 mg/dl, the insulin mustHe is questioning in recent years but in the bookThe blood glucose variations produced by this effect.In one of them it passes from 200 mg/dl at 00:00 to 60 mg/dl at 4:00 and from that time it increases up to 400 mg/dl at 10:00 and in the other the maximum values ​​still stillThey are higher.
Greetings.

If it were rebound caused by excess of Lantus or by the Pico de la Lantus, at 3 in the morning it would have a championship hypo, which seems not to happen ...

Before touching the Lantus (injection time or dose), you have to examine what is done with dinner and food.
Hydrates and fast insulin adjustment at the main meals, presence/absence Physical exercise in the afternoon, presence/absence of infections or other symptoms (rule, medications ....)

The "observation period" to modify Lantus is at least 1 week, when changing the doses or schedule its effect is not immediate but takes several days to check the effect.That is why it is better to adjust all the remaining parameters and then adjust the basal insulin.

Returning to the theme of the graphics of the book that I have told you, the blood glucose after the minimum value rises very quickly, in a couple of hours it passes from the 60 mg/dl to 280 mg/dl and then it still goes up more.Perhaps the hypoglycemia that Nenito has occurred between 2:00 and 3:00 and when measured at 4:00 it has already risen up to 320 mg/dl.Perhaps it would be a good idea to advance the time of night measurement.
Regarding the modification in the Lantus, all the endocrine that I have had in recent years (several for change of address) have told me that with two values ​​greater than 140 mg/dl or less than 70 mg/dl of basal blood glucose, andWe had to modify up or down the units that inject myself.
Greetings.

Nenito, try to put the lantus before dinner, while the fast, to start acting before.If you see that this is how high dinner comes, then it will be needed to go up to Lantus.

Greetings :)

I do not think it is hypoglycemia, if you are high before and then it is missing insulin.My mother was very scared that hyper fura because I had hypoglycemia at night and slowly insulin (before I wore NPH) and in the end I ended an elegant ketosis ... Look several hours at night, but it is quite a lotOf course, lack of insulin.We have to try to spend the night with the very tight glycemia, because it is many hours ...

Thank you very much guys for your advice, the truth is that we went to the header, since I had an appointment with the endocrine yesterday, and in the report he put "Valuar to climb Lantus".The doctor confirmed that we had to upload it and now we are little by little, climbing the basal lantus.This morning apparently has gone well, so to continue with this streak, hopefully.Dinner even scarce, is still a bad dinner, and eats quite well, control and that.They said that the hydrates are essential, so maintenance will have to be done so that the peaks do not return.

How to walk

nenito said:
hello again walk here, to see if you can help us because we are a bit worried.
My girl has a few days (approximately 2 weeks) with quite pronounced hyperglycemia when measuring before breakfast (raising around 210).We thought it was due to a catarral episode, but being well of that infection, this situation is still maintained.
His doctor told him that it was good to measure some days at 4 in the morning to see what happened, two or three days that he has done 320. His dinners have not varied, sometimes he has sometimes dinner less than before.To which this nocturnal lack of control and hyperglycemia may be due.
Thank you very much for your help.

Thank you very much for your comments.As Nenito commented a couple of weeks ago that the same thing has begun to happen to me.Without changing my dinners, I have gone from having values ​​around 80-90 on an empty stomach to be around 180-200.I inject 4 Lantus units at breakfast and I am considering spending them at night to see how.At the moment I do not get fast and my values ​​after all meals (even breakfast) are less than 180. These last days I am drinking a glass of milk before going to sleep because it is about the rebound effect by hypoglycemia, butI have not achieved that fasting values ​​fall.

nenito said:
Thank you very much to all for your advice, the truth is that we went to the head doctor, since I had an appointment with the endocrine yesterday, and in the report he put "ValueLantus ".The doctor confirmed that we had to upload it and now we are little by little, climbing the basal lantus.This morning apparently has gone well, so to continue with this streak, hopefully.Dinner even scarce, is still a bad dinner, and eats quite well, control and that.They said that the hydrates are essential, so you will have to do maintenance so that the peaks do not return.

To me in pharmacoliseum I was very recommended that I take some vitamins so that I would not upload the issue of insulin so much and the truth is that nothing has gone to meevil.Right now I don't remember the boat they gave me but I notice more straight and I took the day with many more desire!