Dawn phenomenon

Samantha1308

Member
Messages
14
Type of diabetes
Type 1
Treatment type
Insulin
Hi everyone. I will have been type 1 for 5 years this coming July. It has taken all this time to get as best control as I can. My big problem is I am affected by dawn phenomenon. My bm before bed is usually no higher than 8 but on waking it is 16+

What I have been doing is taking a large bolus and having a carb free breakfast which brings me to my normal range in a couple of hours.

I take novorapid then levimer 18 units daily around 6pm

Has anyone any better tips on how to manage this?
 

caretaker

Well-Known Member
Messages
276
Type of diabetes
Type 1
Treatment type
Pump
Hi everyone. I will have been type 1 for 5 years this coming July. It has taken all this time to get as best control as I can. My big problem is I am affected by dawn phenomenon. My bm before bed is usually no higher than 8 but on waking it is 16+

What I have been doing is taking a large bolus and having a carb free breakfast which brings me to my normal range in a couple of hours.

I take novorapid then levimer 18 units daily around 6pm

Has anyone any better tips on how to manage this?
Hi Sam
I am just the same and i now take 40 unit of levimer in the morning and 45 at night .
if a go to bed with BG below 7 i will hypo in the night .
i am now getting an insulin pump witch should sort this out
i start on a trail next week.
this might be a option for you as it sounds like you meet the criteria .As you have only been type 1 for 5 years getting a good control will make all the differences when you get older.
i've been type 1 for over 40 years.
 

Samantha1308

Member
Messages
14
Type of diabetes
Type 1
Treatment type
Insulin
That's just the time they started me on the levimer and I've never known if or how to change
 

himtoo

Well-Known Member
Retired Moderator
Messages
4,805
Type of diabetes
Type 1
Treatment type
Pump
Dislikes
mean people , gardening , dishonest people , and war.
why can't everyone get on........
The idea of the levemir ( basal) is to keep your blood glucose stable whether or not you eat.
if you are experiencing this large rise every morning the first thing to look at is the basal.
a link was left above for how to test to see if your basal is right for you.

the large correction and no carb brekkie is ok as a short term solution but you really need to get the basal right
 

caretaker

Well-Known Member
Messages
276
Type of diabetes
Type 1
Treatment type
Pump
Change the time...try before you go to bed
i agree 6 o'clock far to early. it would be on its way out by the morning. and your levemir should be split 50/50 morning and night.
i would suggest this to your diabetes nurse or doctor before taking anyone's advice as we don't no your history .
 
  • Like
Reactions: 2 people

JRW

Well-Known Member
Messages
275
Type of diabetes
Type 1
Treatment type
Insulin
Hi Sam
I am just the same and i now take 40 unit of levimer in the morning and 45 at night .
if a go to bed with BG below 7 i will hypo in the night .
i am now getting an insulin pump witch should sort this out
i start on a trail next week.
this might be a option for you as it sounds like you meet the criteria .As you have only been type 1 for 5 years getting a good control will make all the differences when you get older.
i've been type 1 for over 40 years.


Out of interest have you always taken that amount of levemir? Curious as I take much less, but have only been diagnosed as diabetic/T1 for 26 months.
 

caretaker

Well-Known Member
Messages
276
Type of diabetes
Type 1
Treatment type
Pump
No
i use be on lantus and only took 32 units once a day.
but after going on a dafne course 6 months ago i was put on leverir this made things worse but it did stop my night time hypos i was told to increase at 2 unit increments and now i'm up to this.and have a Hbc1 8
i could have tried metformin but the best way to get this sorted is with a pump where i can set different basal rates to cope with my dawn phenomenon
 

catriona92

Member
Messages
10
Type of diabetes
Type 1
Treatment type
Insulin
Hi Sam
I am just the same and i now take 40 unit of levimer in the morning and 45 at night .
if a go to bed with BG below 7 i will hypo in the night .
i am now getting an insulin pump witch should sort this out
i start on a trail next week.
this might be a option for you as it sounds like you meet the criteria .As you have only been type 1 for 5 years getting a good control will make all the differences when you get older.
i've been type 1 for over 40 years.

This seems like an awful lot to me :s I was told by my dsn that no one should really be on more than 24 units a day, 1 unit for each hour as I'm on 30 and she's looking to bring that Down. I suffer from the dawn phenomenon and it was explained to me as my levels are dipping during the night, and our natural hormone balances it's self out in the early morning which can make my sugars high when I get up, so my basal is actually too high.

I don't think this helps but this is just how things have been explained to me
 

nigelho

Well-Known Member
Messages
227
Type of diabetes
Type 1
Treatment type
Insulin
That's just the time they started me on the levimer and I've never known if or how to change
Sam, I'd strongly consider doing the DAFNE course. I've been diagnosed type 1 now 6 year when I was 60. It only AFTER I did DAFNE I found out that I'd bee given wrong info from my ex-consultant and DSN. DAFNE looked at everything and I've now got the knowledge to sort most things out myself. I use the help of a DAFNE nurse whenever I need extra help. One way round the DAWN PHEN is to do a 2-3am test. If you're high I do a correction aiming for 5 mmols. Try splitting the levemir to breakfast time and do your night injection at a later time. You must try different times to see what suits YOU. Do you keep a record for your readings and food etc???
 
  • Like
Reactions: 2 people

Samantha1308

Member
Messages
14
Type of diabetes
Type 1
Treatment type
Insulin
Thanks all. I'm seeing the clinic next Thurs so hope to get on top of this once and for all!
 

Type1Bri

Well-Known Member
Messages
881
Type of diabetes
Type 1
Treatment type
Pump
Dislikes
Highs and lows
Do you rotate your injection sites
 

Type1Bri

Well-Known Member
Messages
881
Type of diabetes
Type 1
Treatment type
Pump
Dislikes
Highs and lows
It is not wrong but you need to be careful you not got lipo happening, lumps under the skin where you always inject there. If you have this can stop the insulin working properly/getting into your system
 
  • Like
Reactions: 2 people

caretaker

Well-Known Member
Messages
276
Type of diabetes
Type 1
Treatment type
Pump
i treat my tummy like a clock face and inject 12 o'clock 2 o'clock 4 o'clock 8 o'clock 10 o'clock just try to very. theres sites on Google that shows you all the others.are
thighs are always good for a change but the tummy is the recomended
 

smidge

Well-Known Member
Messages
1,761
Type of diabetes
LADA
Treatment type
Insulin
Hi everyone. I will have been type 1 for 5 years this coming July. It has taken all this time to get as best control as I can. My big problem is I am affected by dawn phenomenon. My bm before bed is usually no higher than 8 but on waking it is 16+

What I have been doing is taking a large bolus and having a carb free breakfast which brings me to my normal range in a couple of hours.

I take novorapid then levimer 18 units daily around 6pm

Has anyone any better tips on how to manage this?

Hi Sam,

I'd definitely split the Levemir dose as a first step in sorting this out. It doesn't last 24 hours at the smallish dose you're on. I used to take 15 units daily split 7 morning and 8 evening. 6am and 6pm. I've been diagnosed similar amount of time to you and also struggle with DP. I found Levemir pretty poor for me - it seems to work better and for a longer duration at larger doses. I have now come off the evening dose ad changed to Insuman basal at 10pm. This is an older insulin with pronounced peak at about 4 to 6hours, so I time its peak to hit at the some time as my DP. This is working better for me. I think the newer Tresiba insulin might be better but it's difficult to get them to prescribe that until you've exhausted all other options.

Take care

Smidge
 

tim2000s

Expert
Retired Moderator
Messages
8,934
Type of diabetes
Type 1
Treatment type
Other
I'd also suggest that you don't need to split the levemir dose 50/50. Mine is split 33/66 as I don't eat carbs overnight and run at a lower basal. Effectively by splitting it I am running two separate basal insulins, much like smidge, and I have a 12 hour gap between injections. They just happen to both be levemir.