A client called me the morning after... she was frustrated being woken at 280 mg/dL (10.0 mmol/l), not knowing how much insulin to safely dose before going back to sleep.
Her question couldn't have been timelier, my husband and I just got home from church, and all morning my glucose was stuck around 225 mg/dL. The difference was, I was up and going and could safely make the decision on how much to dose and get me back on track.
High blood sugars that catch us when we're asleep and more vulnerable can be scary. She is new to diabetes and still learning how her body responds and utilize her insulin pump integrated with her CGM (continuous glucose monitor).
No matter what time of day or night, you need to consider everything you know at the time and make the safest decision. I always caution to take a lower dose and to be willing to set an alarm to recheck your glucose again before waking up. The built in alarms that these CGM systems have is another layer of help to lean on.
So, my decision on what to do and dose for my sticky high blood sugar played out like this.
It was close to lunch time, getting hungry, but wanted to wait until sugar dropped before eating. So frustrating, but I followed the advice I often give and drank lots of water, dosed 2 units of Novolog short acting insulin.
My husband David and I, a fellow T1D took advantage of a beautiful day knowing exercise was going to help us both …physically and mentally! We packed a light lunch and sugar tabs preparing for what I'd need after riding for a few hours., and eventually dropping to a normal glucose level.
Many factors play into why we run high, it doesn’t always make sense and the anxiety we feel produces more stress hormone cortisol and can shoot blood sugar even higher.
First consider if any of these factors may be affecting how efficient your insulin is working or how your body is functioning:
✔️ Illness or Infection
✔️ Chronis stress
✔️ Pump site not delivering
✔️ Expired insulin
✔️ Scar tissue builds up around site injection area, reducing insulin sensitivity
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Still not sure why, here’s a few tricks to better handle those sticky high blood sugars…
Move your body - Steady state exercise is the best way to naturally utilize glucose for energy and to lower your numbers.
Insulin - Obviously your body needs more insulin to get sugar back down. Whether you’re on a pump or MDI. factor your current number into your system, Inpen and if you wear a CGM (continuous glucose monitor). See what calculated dose it suggests. *Remember to start small, as It’s easy to overdose insulin and drop to quickly and then you’re treating a low.
Drink water - Hydration helps the kidneys flush out extra glucose through urine and helps you from overeating…as hunger is a common side effect of high sugar.
Deep breathing - something attainable and easy to do, will calm your senses when high blood sugar is stressing you out. Practice the 4-7-8 breathing technique, the method is described as a ‘natural tranquilizer for the nervous system’ helping to reduce tension in the body.
Time and patience - When your number just doesn't make sense and waiting is the hardest part…But give yourself time and grace.
*Be sure to seek medical advice when these tips are not helping bring blood sugar back down.
My client, who was trending with higher glucose starting in the early morning, which is referred to as the dawn phenomenon. Read more about this topic and factors that contribute to high blood sugar right after waking up from nighttime sleep. This period usually starts around 4 AM and lasts until around 8:00 AM.
Managing blood sugar doesn't always make sense and feels overwhelming when all your efforts don't add up. But with support, encouragement and sound advice from someone like me who understands...you can make thriving with diabetes more attainable.
If stubborn high sugar is an obstacle, you need help with comment below and share.
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