Ask the Diabetes Educator Archive

9/16/03

Q:
I am a type 1 diabetic and over the last couple of years I have had a problem with my morning sugars. I usually run between 200 and 300 when I wake up. I take humalog with each meal and I take humulin at bedtime. I am 29 years old and I have 2 kids. I can't figure out what is causing this because my sugars are good before I go to bed. My Dr. has been adjusting my medicines but it doesn't seem to work. I also have developed a thyroid condition within the last couple of years. I started out as overactive thyroid but now I am underactive.

A:
Without more information, it is difficult to give a very specific answer. What you may know is that you have a Dawn Phenomenon at work, the result of nocturnal hormonal activity. Your thyroid condition can also be upsetting the balance; other medications that you may be on can be affecting also, particularly if they are newly started. Have you tested your blood sugars at 2-3 AM to see if they are low before going high? This would be a step for adjusting bedtime insulin. A few general suggestions would include the possibility of switching to Lantus insulin or an insulin pump. If you are not being managed by an endocrinologist or one who thoroughly understands diabetes, then you may want another opinion.



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