Breakfast ratio to counteract dawn phenomenon

[RobynBeiers]

I usually have about 20g carbs for breakfast and I’ve found that a 1:5 insulin to carb ratio works to counteract the dawn phenomenon (I take 1:7-1:9 at other times of day). But on the rare occasion when I have about double the amount of carbs for breakfast, 1:5 and around double the insulin dose results in massive hypos.

My theory is that instead of changing the whole ratio for breakfast, the dawn phenomenon means that I need an extra 1-2 units of carbs, then I should use my normal insulin to carb ratio on top of that. Has anyone tried calculating breakfast doses like this?

I have similar problems at different times of the month (hypo) and when I’m sick (high). Do you think it’s better to change the whole ratio or add/remove a few units from the overall dose?

 

[kitedoc]

Hi @RobynBeires, From my experience as a diabetic, not as professional advice or opinion.
I think you really need to speak with your DSN or doctor about any dosage changes.
To help with this encounter maybe setting the alarm and doing some finger prick BSL readings say from 3 am, hourly through to breakfast time on one or two occasions would help.
It may be that the DP you are experiencing might be starting earlier than your breakfast time. All taking extra insulin at breakfast might be doing is correcting the blood sugar rise after the event.
And whilst correcting a high BSL is fine, at least seeing if something can be done to prevent the BSL rise is at least a thought. Some people actually wake at 4 5 am and take small doses of insulin, others exercise on waking, other have food late evening/early morning. On an insulin pump, any rise in BSL in the early hours can be countered by the programme of insulin released during the early morning.
So lots to think about!! Best Wishes. Also please see the Home section and look for Dawn Phenomenon under one of the headings ? Type 1, I think.

 

[etmsreec]

I can't tick the original posting enough! I'm not convinced that it's dawn phenomenon in my case, but my blood glucose seems to rise on working days when I need to get up, and not on non-working days when I don't. If I were to increase my ratio to 1u to 5g carbs, I'd go hypo, so it tends to be 1 or 2 units added on to the 1:10g ratio.

 

[NicoleC1971]

I think we are confusing a correction dose to get you back into range versus a carb:insulin ratio to be taken once you've corrected. The risk of doing both things simultaneously is that you end up stacking doses together so get advice but if self experimenting be cautious because your dose will still be working at 3-4 hours after your meal.
DP happens when our bodies need to a surge of energy from the liver to get you up and out bringing home the bacon (so the stress of the alarm clock could be activating that physiological process).
Pumps are really useful for correcting this and for having different basal rates for different times of the month and different carb/insulin ratios for specific circumstances (stress, pmt, exercise, illness).
They also 'know' how much insulin is already in your system because of your dose history and use that to calculate the bolus.
The only injection option I can think of to counteract DP with a basal/bolus regime would be splitting a basal dose and giving more of it in the evening but your DSN should be the expert on tweaking with that and also the person to ask about getting a pump.

 

[ickihun]

I usually have about 20g carbs for breakfast and I’ve found that a 1:5 insulin to carb ratio works to counteract the dawn phenomenon (I take 1:7-1:9 at other times of day). But on the rare occasion when I have about double the amount of carbs for breakfast, 1:5 and around double the insulin dose results in massive hypos.

My theory is that instead of changing the whole ratio for breakfast, the dawn phenomenon means that I need an extra 1-2 units of carbs, then I should use my normal insulin to carb ratio on top of that. Has anyone tried calculating breakfast doses like this?

I have similar problems at different times of the month (hypo) and when I’m sick (high). Do you think it’s better to change the whole ratio or add/remove a few units from the overall dose?

If you want to beat Dawn phenomenon just eat fatty protein before bed which due to being fatty it slowly digests through the night and counteracts the 3am (rough time) liver dumping of glucose. Also a similiar one to eat immediately once you open your eyes and before your feet has touch the floor. Both with not increased insulin units. But with your normal insulin units for fatty proteins?