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Dawn Phenomenon

linda_b

Active Member
Messages
42
Location
UK
Type of diabetes
Type 1
Treatment type
Insulin
Hi all,

So for the past three weeks I have not had a waking blood glucose reading below 13.
Looking at my Libre I can see exactly where the spikes happen. Every night I have a steady line until about 3am and between 3 and 5am is where they start to peak. I wake at 5:30 every weekday for work so I can correct pretty quickly.
I know this has probably been asked countless times but is there any tips to prevent this happening?
I don't eat any carbs past 7pm. I inject my Levemir at 7pm I have read that moving this to when I go to bed could help but this is obviously something I will discuss with my DSN before I do anything.
It's just so frausting. Wish bloody Dawn would do one!
 
Hello @linda_b,

To keep this brief, the answer is no. As far as we currently know, there is nothing that can prevent the dawn phenomenon from raising BG. The best we can do is to either wake and bolus a correction in anticipation for the rise, or programme a pump to deliver more insulin at the right time.

I, like you, have a a similar situation regarding DP and its a ******* nightmare. Vinegar tablets, fat before bed, protein before bed, exercise, etc have had zero impact on it...
 

Thanks you your reply! It's such a pain in the ar$e isn't it!?
I've suffered from them for 20 odd years but this is the first time where it has happened every morning for three weeks.
I'll keep going as I am and you never know it might get the hint and sod off!
 
Big time...

I was 17.5mmol/l this morning and that's because I had a lie in till 0930.
 

If you use the search bar in the top right corner you'll find many threads on the subject. Have a read around, what doesn't work for others might work for you.

https://www.diabetesdaily.com/learn...ng-high-morning-blood-sugars-dawn-phenomenon/

http://www.diabetes.co.uk/blood-glucose/dawn-phenomenon.html
 
I moved my lantus from 6 pm to 10 pm and it helped. I also HAVE to eat something immediately upon rising or o go up very fast. It needs to just be mostly fat. So avocado it is.

If I do sleep longer, I do wake up higher. It sure is a pain!!
 
ok -- the bad news has already been delivered -- you can't prevent it.

you can set an alarm at 3am , test , and inject a correction . ( totally totally inconvenient )

I would definitely discuss with your DSN and possibly drop a line into the conversation about how it is affecting your life and what are the prospects of a pump ?
( if you are inclined ) ....... just putting it out there for you to think about.
 
As already stated, DP is a complete pain in the ar*e.
I do have a method that seems to give favourable results maybe 80% of the time.
It all depends what my BS is before bedtime.
Everything is based on a 1:1 bolus ratio.
If I'm a bit high 10ish, then I'll have 10g carbs ( slice brown bread, piece malt loaf ) and bolus 2 units.
If I'm in range 7 ish then I'll have about 20/30 g carbs ( banana and peanut butter ) and bolus 2/3 units as required.
If I'm low 4 ish then it's 20/30 g carbs ( banana and p/b or oats ) but no bolus.
This tends to work more often than not but does obviously involve eating before bed which always isn't ideal.
I also split my basal and have moved the 10pm injection to 6 pm which also seems to keep things a little smoother.
After saying all this I'll probably get up tomorrow morning and be 15+.
 
I have an awful time with DP, but for some reason mine appears to be due to environment? Does anyone else have this? I never used to suffer from it, but about a year ago I moved from the UK to Costa Rica for work, and since then I rarely wake up with a sugar below 10. I have tried a lot of things (eating/not eating/increasing insulin/decreasing insulin) and nothing works. BUT when I visit the UK (e.g. at christmas) I have no problems with DP! I do not eat anything really different here compared to the UK (same amount of carbs etc) so I am pretty stumped. I am on injections and the thought of getting up every day at 3am kills me. Something that has helped slightly is to go to bed with a sugar level of 8 or so (which is high for me). In this case I usually wake up with sugars around 12-15 rather than higher but this does not always work and is totally trial and error!!
 
I've been experiencing DP now I've been on a keto diet. Beforehand I would get up and eat some mini-shredded wheat, and take some bolus to counter the carbs. My BS would always rise due to the breakfast, but I guess I wasn't also taking into account the DP too.

I would take about 18-20 bolus for the breakfast. Now I don't have breakfast, or I have a bulletproof coffee, and I now have to take about 6-8 units to counter the DP.

I guess the Liver simply gives out the glucose, but doesn't care or regulate the quantity. That would be the pancreas and insulin's job. So we have to med up to counter this. Biology, eh? Pain the the butt.
 
I had the DP for years, and as yours is my blood sugars rose at 3am, if I woke with a blood sugar of 13 or less I would be amazed. My diabetic clinic referred me to go on to a pump (because of the DP) and I was so unsure about It I actually considered it for about a year. What a waste of a year, I can honestly say the insulin pump 'for me' has been perfect. I would say my average reading in the morning is now 6.7 ish. If you get the opportunity to go on a pump, I would go for it.
 
I was put on a pump for Dawn Phenomenon.......it made every day a struggle.....was so tired in the morning.....

I can still wake up high but only if i eat a certain amount of carbs before bed...

Splitting your basal and moving it to immediately before bed and on waking should help.....

And I suppose a longer term solution would be to cut your carb intake, this should eventually decrease the DP severity.....as it never ever goes away, just can go unnoticed for some people....
 
Have read anecdotal reports that a low GI or protein based snack before bed helps some people. Can't say I've done any testing myself, and seems counter-intuitive - unless it somehow regulates the liver?
 
A FEW macadamia nuts help me but no carbs and very little protein if any. Just something to keep my liver busy- fat
 
I have chronic Phenomens!! I have to wake at 4am each morning for my firstshot of insulatard. Again at 8am I have another shot of Insulatard with a getting up correction as well at 8am.
If I dont do this I can go from 5 to 20 in 3-6 hours. My rise starts 4 hours before I get up and continues to midday, no matter what.
Then in the evening at 5.30pm I have a shot of tresiba. The tresiba keeps me level but cant cope with my rises in mornings or late afternoons.

I cant see an easy andwer for you to be honest. I tried levemir and lantus at different times.

The only thing that did work for me was a pump for 5 years, but then my body decided to reject cannulas... so had to go back to MDI.

If this continues I would really consider a pump...
 
It didnt!! My body rejected them as soon as put in. No insulin would get through for up to 15 hours.. didnt matter what corrections were done and boy, did I do a lot!! Nothing worked. Had to try going back to pump with two more different hospitals including a different pump.. 3 hospitalisations before my tertiary care clinic agreed that my body all of a sudden in 2015 started disliking cannulas. Even after gaining two stone from my worst times of being thin did not allow my skin to accept cannulas.
I only drastically lost weight for 12 months from 2015 to 2017 due to other stomach condition. Even with weight before and after nothing persuaded skin to accept.

Also I have large amounts o intolerances and due to this the doc and I had considered a diaport but it was definitely a no as I know from other going ons that my body would definitely not accept a permanent tube in me feeding insulin.. and thats why I didnt go for reconstruction with breast cancer. Even dressings for plasters etc, certain ones are really bad. Ie had a dressing on for last mastectomy and I coukdnt tolerate that. So no options but to wake at 4 am each day currently...
 
In my experience liver dump isn't managed by my basal.
Liver dump is from your food intake.

If I eat fatty protein before bed it lasts til 3am+ The fat delays its digestion. Protein give a kick not a huge spike.

So if before bed you're 6mmol/l ideally you should wake on less than 8mmol/l.
If your not maintaining 6mmol/ls before bed or throughout your day the basal may need adjusting.
 
Do you take metformin @Lord Midas ?
 
I went through a period a couple of months back where I'd wake up with figures over 10+ every morning.

I think I identified my problem was that I'd have my evening meal 6 hours before I went to sleep so I was without food for 14 hours which intensified the dawn phenomenon effect in the morning.

What worked for me was eating 40g carbs 2 hours before I go to sleep. I use 2 hours since that's how long it takes my insulin to wear off and I don't like going to sleep with active fast acting insulin. Since then I am waking up between 4 and 6.5.

I don't know how well this would work for other people though, maybe only consider it if you have a big gap between your meals like I did.
 
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