Do you have type 1 diabetes? Managing blood sugar levels is challenging, but when you have the right information and training, you can manage T1D with more ease, I promise!
I’ve lived with T1D for over 40 years and have helped hundreds of T1Ds around the world get better BGs and live with more ease. You can too.
Let’s start with understanding three possible causes for high blood sugar levels in the morning…
#1 – Your background insulin is too low
A perfectly set long-acting dose (for those on shots) or basal rate (for those on a pump) should keep your blood sugar nice and steady as you sleep, assuming you have no rapid insulin on board and no food digesting at bedtime. If your background insulin is set correctly, going to bed high would likely be due to under-dosing at dinner time. If you go to bed high, it’s NOT your basal rate’s job to lower you. The basal insulin is meant to keep BG flat. If you don’t have enough of it on board while you sleep, you’ll be high throughout the night.
Getting your background insulin/basal rate set correctly is an essential step in having a healthy A1c. Every type 1 should know how to do this. If you’d like to learn the simple steps, check out this course: How to Avoid the Blood Sugar Roller Coaster.
#2 – You didn’t dose enough at dinner
The second reason to consider is that you didn’t dose enough insulin for your dinner. This can be true even if you went to bed with a normal blood sugar. Imagine your BG slowly rises up after you fall asleep. This could be because your dinnertime insulin is wearing out but your food is still digesting. This is especially true with big meals, high protein meals and high-fat meals. They can digest for hours and hours. Want to learn how to avoid those post-meal highs? Check out this course: Proper Mealtime Dosing & Why Carb Counting is Not Enough.
#3 – Morning Hormones
The third reason why you could be high in the morning is due to normal morning hormones. Let’s say your BG stayed nice and flat for most of the night but then a few hours before waking, your BG started to climb. This is likely due to the normal, early morning rise in a hormone called cortisol. When cortisol is released, it tells the liver to put extra glucose into the bloodstream.
Our hormones have their own kind of agenda if you will and it’s very normal for the body to have this output of glucose in the morning. For us with type 1, this morning rise is called the Dawn Phenomenon, i.e. the phenomenon where BG rises in the morning for no apparent reason. A variation of this is when BG spikes within the first hour of waking up. This is called ‘Feet on The Floor,’ and it is also caused by cortisol telling your body that you need some extra fuel to get your day going. Although the body is trying to help us, it can be aggravating if you don’t know how to adjust your insulin to avoid the spike.
For me, the slow rise happens almost everyday, but sometimes not. Same is true for the feet on the floor…sometimes I have it and sometimes I don’t. Most of my patients experience this inconsistency, which can be very frustrating, but there are ways to deal with it.
Now, there could be even more reasons, such as your insulin has gone bad, you injected your long-acting into scar tissue, something has gone bad with insulin delivery from your pump, and so on and so on.
We actually just discussed this topic last month in my T1D monthly education program called The T1D CREW. If you are looking to improve your blood sugars and/or you’d just like to be part of a positive-minded T1D community, you’ll love The T1D Crew! And we’d love to have you! Click here to learn more: www.DrJodyND.com.
