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Dawn Phenomenon (probably AGAIN!)

etmsreec

etmsreec

Well-Known Member
Hiya,

I know this is discussed elsewhere, but this cold be a slightly different slant on the discussion.

Regimen: Novorapid, 1 unit per 10g CHO with meals
Levemir 8 units at 9am, 10 units at 9pm.

I'm finding that my morning blood sugars can vary but tend to be on the very high side before breakfast. I typically wake at about 7am and have breakfast at 9am. At waking, my blood sugar might be 7 or 9 but by breakfast time it's likely to have jumped to 17 or 19. The usual, "I ate nothing so why has my blood glucose jumped up?" question!
I was put onto a split Levemir dose to try and reduce the variability in my injection times which it has done. Rather than taking my Levemir at any time from 10.30pm to 3am, it's in a regular pattern of 9am/9pm. However, having gone from injecting 20units and having hypos if I was late getting up, I'm now going high every day.
I'm able to function down to about 3.9 on my AccuChek glucose meter which suggests to me that I'm not permanently high, otherwise I'd be getting hypo symptoms at higher and higher levels, wouldn't I?
Yesterday:
02:30 = 11.3
09:35 = 5.7
13:55 = 16.2
Last night/this morning:
20:50 = 12.5 (before evening meal)
00:34 = 11.2 (before bed)
05:55 = 17.3
09:49 = 17.4
Clearly, the only result within a normal range is the one at 09:35 yesterday morning which was before breakfast, shortly after waking up. Having started the day at the right level with the right level of carbs, my blood sugar then jumped.
So, the question:
Is this Dawn Phenomenon or is it rebound from hypos? I hadn't heard of DP until recently and attributed it to rebound from hypos.
Either way, should I increase the Levemir at 9pm? I don't want to go hypo overnight, but I want to get my control improved. It never seemed this bad when I was on a single shot of Levemir!
Thanks in advance
Steve
(Diabetic since 1981 and still fighting it every day!)
 
Hi Steve
It goes without saying really that your DSN will hopefully be the best person to try and unravel it all with you .
I think if I was looking at those numbers it would say to me DP...but also it will depend on what you are eating , even if your unit to carb ratio is good..I find mine does vary at certain times of the day,as does a lot of people's . Also if you are having a carb laden meal on an evening with a high level of fat included with it ..it can take such a long time for this to be digested and I used to find with this sort of meal I would just get a prolonged high...try and chase it down with insulin...then get that stacking up and hypo's :roll: It may not apply to you at all this but it is always worth IMO trying diet changes before dose changes..but that's just me.

I am on a split dose of Levemir, 12 Units AM and now 12 units PM, I was on 8 units PM but found to get to 5 mmols for my pre breakfast reading I had to increase it. I'm 8 1/2 stone female and very active...so maybe you really need to look at a good increase in your basal the night time dose, if it was me with those numbers that is what I would do.

Run this past your DSN and see what they say. I find when you get Levemir at the right dose it really will keep you steady and for me anyway it does not seem to drop me like a rocket as other insulins did in the past...it's a good slow burner for me :D

Hope things work out Steve and a happy new year
 
Re: Dawn Phenomenon (probably AGAIN!

This was my biguest challenge as a type 1 diabetic for many years until I too discovered the dp. The solution in the end was also one of the easiest. When I woke up a took a small amount of novo rapid which seemed crazy without food but worked a treat. Changing the levemir will cause hypo's.
 
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