Could this be Dawn Phenomenon?

[**shell**]

Hello!
I am after people's thoughts on this...

I have found myself waking up on a morning, with my alarm, feeling awful. Splitting head, groggy and even more tired than when I went to bed.
My bloods are at about 5mmol and the same when I wake up (about 7.5hrs) later if not slightly raised by 1 or 2. I'm having a late tea at around 20:30, usually about two hours before bed.
Could this be Dawn Phenomenon? If so should I be looking at testing every hour or two and for how many days? I work full time so an interrupted night sleep (for me or the BF) is never fun.
Suggestions etc are most appreciated.

xoxox

 

[azure]

Could you be sleeping through a hypo? That would give you a headache.

DP usually causes a rise in BS from early morning (eg 4am or around there)

 

[GrantGam]

A freestyle Libre sensor would help your to ascertain whether you're having overnight hypos. They're not cheap, but would mean an undisturbed sleep.

If you were to have dawn phenomenon then you'd almost definitely be waking up with BG's well over 5mmol/l-7mmol/l and would need to correct the high with rapid acting insulin.

 

[catinahat]

Hi shell
Sounds like the Somogyi effect to me http://www.webmd.com/diabetes/tc/dawn-phenomenon-and-the-somogyi-effect-

 

[ickihun]

Could be suffering after the somogyi phenomena effect?
Although it's noted that you normally wake on a higher bg than going to bed, you could have court it just before the rise had finished.
Only way to know would be to monitor through the night.
Maybe set alarm for 3am and test?

 

[**shell**]

Thanks guys!!!
Just thinking about it further ...
I tend to get to work and have breakfast there (3 hours after my alarm clock) and my bloods have usually increased to 9s 10s so I have been altering my basal rate (I'm on a pump) to manage the higher lev. I had also thought the higher bloods around 9am might be related to being disconnected from the pump whilst I showered.

I'm definitely checking though the night now!

xoxox

 

[azure]

@**shell** That sounds like a Waking Rise. If I get up and delay breakfast my levels go up too. So I either take a tiny bolus without food on waking or eat a small amount and bolus.

 

[noblehead]

I had also thought the higher bloods around 9am might be related to being disconnected from the pump whilst I showered.

Quite possibly, but I tend to find if I miss breakfast my bg levels will be in double figures within an hour or two (if I don't take insulin to counteract the rise).

As a suggestion maybe try having a small snack before you leave home (you'll still need to bolus) and then have your breakfast later when you get to work, I think eating upon waking shuts off the waking rise as a result of the overnight fast. Good luck.

 

[ickihun]

Now that part could be a glucose dump. Mine normally increases by 2-3mmol/l although I am type2 on insulin and extremely insulin resistant.
Some of us are eating a protein immediately on rising to prevent this increase which reflects on our hba1c.
I'm not sure if type1s find this a solution too?

 

[noblehead]

I'm not sure if type1s find this a solution too?

Personally it would add to the bg rise if I didn't bolus for it @ickihun

 

[azure]

You could try eating your breakfast soon after waking to see if that helps. I think it might well

 

[Odin004]

Hi @**shell** - I agree wtih @azure and @noblehead - I use the Dexcom G5, so I can see exactly what my sugars are doing - for me, the very act of getting out of bed and moving around causes my sugars to rise noticeably; I need about 2 units to counteract this; and this does seem to "reset" things somewhat. Perhaps a small meal on waking (with insulin) would be a good idea, just to see if it changes anything?

As for the feelings of grogginess when you wake up, this doesn't sound like the Dawn Phenomenon - but as @azure says, it's possible you're experiencing hypos during the night - the Libre would be a great idea to get to grips with this and find out what's going on (even if you only use it for a short time).

In the mean time, you say your sugars are around 5 before bed - personally, I feel this is a bit on the low side before sleeping; just as an experiment, why don't you try going to bed with sugars of around 7 or 8, just for a couple of nights - and see if you still feel groggy in the morning? This way, even if your sugars are dropping overnight (before coming back up in the morning) this may avoid you actually going hypo while you sleep - and if you find that you feel fine in the mornings, it's a fair bet that hypos were the culprit! You also say you eat late - so, could I also suggest ensuring that your meal-time insulin is out of your system before you sleep - just in case this is contributing to low sugars overnight. Hope this helps!