Bolus And Dawn Dump

[SueJB]

Can I have some thoughts on whether people bolus for the dawn dump please?
I woke at 4am with 7.2 then at 7.30 my BG was 8.8. I'm just about to drive and it's 9.4
No food just black coffee

 

[Rokaab]

For myself it depends on what level it's got to, for instance if it had gone from 7.2 to 8.8 for me I wouldn't add a correction dose to breakfast - noting that I always have a carby breakfast - I can't think straight before I eat, however I know earlier in the week it went from 6 to 18! (my libre showed me it started going up at about 2:30am and by 6:30 it was 18 - helpful huh!) so I did take a correction dose for it with breakfast.

 

[Fairygodmother]

It can be a difficult one. If I wake early enough to go back to sleep again and the libre trend shows that the dump’s started then I definitely bolus for it. The morning’s much easier after that. If it’s already risen when I wake and I have to drive soon then a bolus can lead to lower BG than expected.

 

[Deleted Account]

My philosophy is whatever time I take a BG reading, I correct it.
Unless I was doing a basal test, the only reason I would take a reading would be to check and adjust if necessary.
So, if I awake in the night and my BG is high, I will correct (if I wake in the night, my BG is usually high or low); if I take a BG reading before breakfast (or any other meal) and it is high, I will correct and take bolus for my food; if I take a reading before driving and it is high (although my target is slightly higher than usual), I will correct; ...

 

[Knikki]

If I wake up at stupid o'clock and I am running high then usually it is because of something I have eaten the night before, then I am in the land of Hyper (which I hate) so I will correct to bring it down.

However, I have never deliberately set and alarm to wake up to deal with a dawn dump unless I have to like going on holiday then that is different.

 

[Juicyj]

I am on the same mindset at @helensaramay on this - if I have no quick acting insulin on board and I test and i'm high then I correct for it, however if I have quick acting on board then i'd wait till this has depleted before doing another correction.

Personally I find the easiest way to manage the DP is to eat and take insulin first thing so generally have about 10g of carbs upon waking and take my correction and bolus in one, then test again 3 hours later to ensure i've come down.

 

[SueJB]

It's now 11am and it's gone down from 9.4 (I corrected it at 8.30 but only 1 unit of novorapid as I was driving) to 7.1. I've still not eaten anything and just wondering if I should have done 2 units.
I'm going to leave it alone but thanks everyone for your thoughts

 

[porl69]

It's now 11am and it's gone down from 9.4 (I corrected it at 8.30 but only 1 unit of novorapid as I was driving) to 7.1. I've still not eaten anything and just wondering if I should have done 2 units.
I'm going to leave it alone but thanks everyone for your thoughts

How tight do you want your control to be? I would be so happy at 7.1 and would have thought that the correction before hand was a winner and correct. 2 units may have take you below 5 and not be able to drive. I think you made the right choice
I always correct with breakfast (IF the DP has decided to show its head (on the Libre)) as I eat breakfast 10 mins after waking and getting ready for work...

 

[Bluey1]

I bolus as I go up. I'm on a pump so it's easy. It doesn't matter when I wake up, as soon as I do I start rising for about 3hrs, so I just keep bolusing as required.

 

[scotteric]

Yes, absolutely. I take 1 unit of NovoRapid the minute I get out of bed unless I am low. If I am low though I often won't treat it, I would just take my normal breakfast bolus or do nothing at all because my blood sugar will rise on its own just from getting out of bed. There are times I take too much to counteract the dawn phenomenon and go low, but this bothers me less than not taking enough and spiking.