Insulin-related causes of hyperglycemia are often related to the basal insulin doses, so start with checking the pre-breakfast (fasting) glucose levels and go from there.
For each scenario, suggested management options are provided:
When the hypoglycaemic event was caused by insulin, reduce the dose immediately. Work out which insulin was active at that time and adjust that insulin.
During the day, hypoglycaemic events that occur within 3 hours of eating a meal are most likely due to the rapid-acting insulin. Hypoglycaemic events are due to the basal insulin when they occur during fasting or more than 4 hours after eating a meal.
Reduce the insulin dose if hypoglycemic events occur overnight, or if there is a regular pattern of daytime hypos.
Erratic glucose levels
Sometimes it seems like there is no pattern at all in the glucose levels that you see.
There are a number of reasons for this, and many of them lie in the non-insulin causes of hyper- and hypoglycemia: