Dawn phenomenon

[manda pops]

Hi guys is anyonr suffering from this i jus cant control it go to bed between 5 or 6 and wake up about 9 but take a dose of fast acting and it still rises sometimes. Im on levemir anf if i take extra im hypo around 12.30 am then still 9ish around 7.30 am but sometimes it rises for another hour or so until its haulted then fast actig will bring my sugar down this has me in tears everyday because all i have tried to do is control my diabtes for the last 2 years and it shoukdnt be as hard as this. Im now pregnant and extremly worried. Any advise please and thanks x

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[noblehead]

This is one that is frustrating, I believe DP can take place between the hours of 3 - 8am and I know mine kicks-in slowly after 7am and rises fast after 8am, so to avoid this I normally eat breakfast around 6.30am weekdays and no later than 7am on weekends.

It's a pain in the butt DP and I have read on the forum that some people wake, inject, eat and then go back to bed to avoid it, I don't know what to suggest Manda except to say have a chat with your DSN about it.

 

[iHs]

Hi Manda

Try to get up in the night and do some bg testing and then you'll find out what time yr bg level starts to change.
Next bit is to probably change the timing of the levemir so that it tackles the rise up in the bg in the night. What time are you injecting it at the moment. I suspect you are injecting it at yr eve meal so if thats the case, if you increase it, it will cause you to go much lower at midnight, whereas if you leave the jab until bedtime, its effect will hit the rise up in bg due to DP. Presuming the rise up is about 4am, you could have a go at changing the timing of the basal.

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[novorapidboi26]

everyone's DP will start at different times, according to their body clock.......

it will usually start a few hours before you wake.......

the process can be stopped and/or slowed by eating something...

the liver dump happens because you have had no food digesting for many hours during sleep, so getting the digestive juices flowing will alert the brain, then liver to stop as its not needed......this will stop the continuing rise after you wake...

trying to catch the initial process can be difficult if not impossible, trying to get up as early as you can and eat something was my tactic....

others have used things like alcohol and/or having a slow acting carb before bed like toast and peanut butter, these might work, but they might not...

if your in tears by this and its effecting your lifestyle and especially now your pregnant, you will qualify for a pump.....

 

[manda pops]

Thanks for all you replies. I take my levemir at 7.30 along with qa and breakfast. Levemir at night is around 9 as im scared the morninh one is running out so try to take it asap. Wheb would u suggest u do this? Around i think my dp happend from 5 am onwards and today i never had breakfast i was sitting at 9 so took some quick acting and was sitting around 10 nearly 2 hours later. It really is horrible. What doese are everyonr else on im 18 at nite and 13 am which seems strange to me. Altho i am staying more stable during the day and not huge peaks between meals compared to humulin i. Hopefully i will get there i go to dsn every week so hopefully my baby is safe and not under too much danger x

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[novorapidboi26]

I am pumping now, but was on 32 in the morning and something like 56 at night, so a lot more insulin and spread differently from you..........

its wise to try and take your PM dose of Levemir immediately before bed, this will create an overlap of the AM and PM dose throughout the next morning, which will also help with the DP.

As you pointed out, this means that your AM dose will likely have ran out and you will notice a rise towards bedtime........

however you can compensate with a higher insulin/carb ratio at dinner in order to get the benefit of the overlap, a small price to pay I think.....

my DP was bad, I was waking at 15 - 19, felt really bad and really struggled to function and get to work...

 

[manda pops]

AWW THANKS. SO WHAT TIME WOUKD YOU SUGGEST TAKING LEVEMIR AT IN THE MORNING GUYS? I go to bed around 1o x

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[novorapidboi26]

just as soon as your officially up and about really, you don't need to wait till breakfast.........

but as i mentioned, its best to get something in your stomach as soon possible, just to get the liver to stop dumping glucose........

when do you currently give your dose......?

 

[manda pops]

I have been taking ut around 7.30 am but think i start to rise after 5x

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[manda pops]

Also has anyone ever tried the vinegar tablets i hears they can reduce dp x

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[novorapidboi26]

if your up at 5 every morning, your body clock will have calibrated to that time, meaning any dawn phenomenon response will occur a couple of hours before that, obviously everyone's clock is different and response time from the hormone release....

a good way of finding out your actual rise time is to test overnight, or at 3 am at least, if your within 1-2 mmol of your bedtime result, and you have had no food or quick acting insulin at bedtime, then you can be confident your PM Levemir dose is right and that the DP starts sometime after that...

as your injecting the 3 am test is good as you can still establish the right PM background dose even with the DP....

 

[manda pops]

Yea i get up around 7 ish and alot of the time im still the same around 3 am. Rise keeps going till after 8 what time would be best for breakie and also to take both levemir injections do u know?

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[Russ]

Also has anyone ever tried the vinegar tablets i hears they can reduce dp x

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I still take them but am not sure they work as well as the PICKLED VEGETABLES, I eat the night before. I'm doing a trial and it looks like this works.

Russ

 

[Nyxks]

@MANDA have you thought about Lantus? its like the one your on but for some people it works better with their body and they have better luck with their numbers thought the night n day in some cases .. you could always ask if a change in type might be of benefit to your control (n if they say no can always ask why not = as in why one not the other might give you an idea as to why they prefer you use one over the other if you've not already been told).

 

[drahawkins_1973]

Hi manda. I share your pain, it's really frustrating isn't it. I usually rise about 3-4mmol so even if I'm well in range to go to bed I'm always high in the morning.
My DP kicks in at about 4 am and I've just got into the habit of getting up, testing and taking my QA before doing anything else. Doesn't solve the problem but it shortens the time I'm higher than I'd like. I also need to take much more insulin than other times in the day. I have to do a ratio of 1:3 in the morning compared to 1:12 during the day or otherwise like you my sugars rise til about 10 am. I take my levemir before bed but as I only take 3 units I don't really have the option of splitting like others suggest.
Good luck, hope you get it sorted
Andrea


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[sammyc123]

Hello. I am recently diagnosed (end of April 2014) however, I have managed to get and hba1c of 4.4%. I use Lantus and as another poster has suggested I definitely think it is worth trying. My diabetic nurses and consultants suggested I take one shot of Lantus daily however, I find that if I take one shot at bed and one shot first thing in the morning I am able to maintain my target range all the time! I tend to have very tight control (consultant is concerned it is too tight ) however, I test BG at least 8 times daily...sometimes as much as 14 times (yes I OCD).