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Dawn phenomenon strikes again

Discussion in 'Type 1 Diabetes' started by Kiarna96H, May 8, 2022.

  1. Kiarna96H

    Kiarna96H · Member

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    Hello everyone,

    I hope you have all had a lovely weekend and enjoying the warm weather!

    I struggled with the dawn phenomenon before but changed my evening dose of basal to just before bed to 10pm instead of at dinner time at 6pm. This helped massively but after a while I noticed my basal wasn't quite getting me through the day and would randomly spike around 9pm before my basal dose.

    I spoke to my DNS and she recommended to move my evening basal forward to counteract the spike which helped for quite a while but now in doing so I'm now experiencing the dawn phenomenon again... Can't bloody win!

    So has anyone had any experience with split dosing their evening basal dose? Or could anyone recommend anything I can try or whether I need to increase my evening basal.

    I have tried contacting my DNS but have had no reply for 2 weeks and not sure what to do as it's making it hard to have breakfast in the morning at the moment.

    Take care,

    Ki x
     
  2. StewM

    StewM Type 1 · Well-Known Member

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    Have you tried a higher dose of the Basal? Sometimes a Basal running out can be a sign that your dosage is too low. You obviously have to be wary of Lows, if that's not the case.
     
  3. In Response

    In Response Type 1 · Well-Known Member

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    I used to find my basal didn’t quite last 24 hours.
    I changed the timing to after tea and increased my dose with tea to cover the missing couple of hours.

    Another option could be to split your basal and take two doses per day about 12 hours apart.

    I would be very wary of increasing basal dose if it keeps me stable most of the day. I would be too concerned by the risk of night time hypos.
     
  4. Kiarna96H

    Kiarna96H · Member

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    I take morning and night time doses so 7units in the morning at 8am and then 10units at 9pm.

    I adjust my basal accordingly depending on if I see a trend over a few days.

    I've tried increasing my night basal before and ended up in hypo throughout the night. I might try increasing it again and see what will happen.

    Has anyone tried doing a split night dose so as I'm on 10 units, do 5 at say 8pm and then another 5 at 10pm?

    I've tried increasing my dinner ratio but I just end up in hypo afterwards as I have dinner around 6/6.30. where as the night time spike if I moved my evening dose back to 10pm would be around 9ish... Type one is so very confusing
     
  5. Yaya10_10

    Yaya10_10 Type 1 · Well-Known Member

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    it is hard I know

    have u consider lower carb in your night meal,


    or carb in the day before to see how it goes?
     
  6. StewM

    StewM Type 1 · Well-Known Member

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    I did try and triple split for awhile and I could never make it work, which I guess is why the vast majority of people don’t do it.

    I know some people essentially give a Dawn Phenomenon dose of Bolus to counteract its effects. Because Dawn Phenomenon activates early in the morning that would mean taking a Bolus at those hours to, which… doesn’t suit everyone’s lifestyle. It also relies on said Bolus not sending you later once the Phenomenon’s past.
     
  7. chrisbug

    chrisbug Type 1 · Well-Known Member

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    Hi,
    I've had to do some trial and error to get my night-time routine down.
    I normally creep up at about 2-3 am. This could be to do with my sleep pattern, I'm often on call for work and have disruptive sleep.

    And the only way that I can make it work for me is to take 2 units of bolus at bedtime in addition with my basal.
    This does depend on my BG at bedtime, if my BG is around 5mmol/L, I'll set an alarm for 1-2 hours time.
    The occasions I haven't followed this routine I'll wake with a BG above 10mmol/L.

    If I up my basal by as little as half a unit, I have too many lows during the day.

    It's a bit of a pain, but it works for me.

    I hope you find a system that works for you.
     
  8. derivadow

    derivadow Type 1 · Well-Known Member

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    I’ve not tried splitting may basal evening insulin dose but I have tried shifting the gap between and timing of my basal doses to match up with my body ie working out where / how the activation curves of the two doses overlap so that I didn’t go low in the afternoon but had enough for the rest of the day.

    I improved things a bit but in the end I needed to go onto a pump (I was waking up every night at 3am to correct) :(
     
  9. StewM

    StewM Type 1 · Well-Known Member

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    Yeah this isn’t faraway from what happened to me (with the same end result of going on the Pump).
     
  10. becca59

    becca59 Type 1 · Well-Known Member

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    Hi @Kiarna96H you mention random spikes about 9pm. As you don’t eat til late it could also be due to a spike from foods eaten. Depending on meal contents, spikes can occur much later. Perhaps look at what you are eating in the evening also. It may be nothing to do with it but worth a look.
     
  11. Soplewis12

    Soplewis12 Type 1 · Well-Known Member

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    Have you tried increasing your morning basal? I know it sounds strange but when I was using pens and experiencing hypos about 3-5am my consultant told my to reduce my morning basal & it worked for quite a long period of time. Opposite of what you're experiencing but maybe worth a try. I was on lantus
     
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