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Dawn phenomenon

ewoo42

ewoo42

Newbie
Messages
3
Type of diabetes
Type 1
Treatment type
Insulin
Hi,

I've been t1d for 15 years, recently I have noticed I am experiencing dawn phenomena. Every morning, around 4am by bg levels rise and are very difficult to get down. The rest of the day my levels are very stable, just seems to be the early morning. And I'm not sure what is causing this.

I have been on a low carb diet for a few months now. I don't eat carbohydrates like bread/pasta etc, but still eat non starchy veg most evenings for dinner. I have also started giving my long acting insulin (lantus) later (around 10pm) to see if this makes a difference.

My levels are usually very good after dinner and before bed but I'm still getting these highs in the early morning (up to 15mmol sometimes!) and it is really stressful trying to keep these under control. I've also started to slowly increase my lantus to see if that makes a difference, but I haven't noticed any changes.

Has anyone else experienced this or have any advice on how to improve my morning levels? Could changing my long acting insulin help? I'm currently waking up at 4am every day to do a correction dose, but would love to not have to do this.

Any recommendations would be appreciated!
 
Sorry to read you are struggling with DP.
Unless you are using an insulin pump, I would be very reluctant to raise my basal because it is likely to cause hypos earlier in the night.

I find my DP is much more pronounced when I do not exercise. If I have a good work out the day before, my levels are much flatter. I don't understand the biology behind it but it definitely keeps my graphs smoother (once I worked out how to avoid the hypos during exercise) and reduces my insulin needs.
 
Hi,

Thanks for responding!

I do walk about 8k every day, going 3 times per day (one long walk in the evening). This definitely helps smooth out my levels throughout the day.

I've read that low intensity exercise is good for BG levels, but I don't do anything high intensity so maybe I should try a more intense workout in the evening!

Thanks for the suggestion :)
 
I tried everything for DP. I was someone who couldn’t split my long acting dose as it made me hypo the entire night even on as little as 4 units. I would discuss some options with your diabetes team, I wouldn’t change anything insulin wise without talking to them first. I know some people find split dosing their long acting insulin helps. I’ve also heard Tresiba is a good long acting insulin although can’t comment on how good as I’ve never used it. Most people with DP do tend to be good candidates for an insulin pump though if that’s something you’re interested in and I would definitely bring it up if you are.

DP sucks and I sympathise completely. I was always high in the mornings because of it.
 
Hi Nicola,

Thanks for the suggestions.

Yes I've noticed I'll be down at around 4mmol during the night, and then as soon as 4am hits my levels sky rocket! So frustrating.

I've been struggling to get any regular appointments with my hospital team but I will try and make an appointment with the nurse to see what they suggest.

I've been thinking about getting a pump for a while so now might be the time!

Thank you!
 
I have it too..but for me the biggest rise appears when I wake up and get from sleep to active mode. Often I would be between 6-8 mmol when I wake up around 8 am. Then I take 2 mmol of fast insulin and 20 mmol of lantus, go to shower and my Libre will start beeping within 10 minutes because of high glucose around 10/11 mmol. After 20/30 minutes bg should be back at 8 in my case.

I completely skip breakfast, and at 12:00 I eat salad or low carb. A walk in the morning is also useful.

In perioods when I do less excersise, the rise in the morning is higher, so good suggestion to try some more intensive workout in the evenings.

Then I try not to eat a lot of slow carbs after dinner/before going to sleep, but of course - in combination with workout in the evening - one has to be careful with nightly hypo’s too.

I was in the same situation as you some years ago, when I had to set my alarm at 5am in order to take some insulin. I tried splitting the lantus, but didnt help in my case. And I dont really trust Lantus enough to take it before going to sleep. I think the excersise and low carb made a difference for me. (Of course I still have days and nights that I f* up btw..)
 
ewoo42 said:
Hi,

I've been t1d for 15 years, recently I have noticed I am experiencing dawn phenomena. Every morning, around 4am by bg levels rise and are very difficult to get down. The rest of the day my levels are very stable, just seems to be the early morning. And I'm not sure what is causing this.

I have been on a low carb diet for a few months now. I don't eat carbohydrates like bread/pasta etc, but still eat non starchy veg most evenings for dinner. I have also started giving my long acting insulin (lantus) later (around 10pm) to see if this makes a difference.

My levels are usually very good after dinner and before bed but I'm still getting these highs in the early morning (up to 15mmol sometimes!) and it is really stressful trying to keep these under control. I've also started to slowly increase my lantus to see if that makes a difference, but I haven't noticed any changes.

Has anyone else experienced this or have any advice on how to improve my morning levels? Could changing my long acting insulin help? I'm currently waking up at 4am every day to do a correction dose, but would love to not have to do this.

Any recommendations would be appreciated!
Click to expand...
My doctor suggested something with a little fat before bed. Examples were a slice of avocado or teaspoon of almond butter.
 
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