Dusk phenomenon

[itconor]

Hi All, I Was on DAFNE Last week and i must say it has been life changing! my blood Sugars have never been this good consistently on target, the DSN and the Doctor were both pretty impressed and interested on the Libre i had on my arm, i was even given the code to enable my Ratios and change it from grams of carbs to CPS which is handy.

however the Doctor noticed quite quickly on it that not only do i seem to suffer from Dawn phenomenon but also Dusk phenomenon.

about 9:30 at night my blood glucose starts to rise, id always assumed this was a delayed reaction from maybe fatty foods at dinner, Although the worst thing i have is oven chips. but apparently it is this which i have never heard of before, the only times my glucose has been out of range seems to be at bed in the morning, i tweaked my evening dose of levmir a little and this seems to have helped a bit, but every night before bed im having to take correction doses. since Dafne, my Morning blood Glucose tends to be around 10-12mmol, i can see on my libre that i sit fine all night till about 6 am then start to spike up, if i dont get up around 7/8am i have gone as high as 20mmol.

What is the best way to deal with this, id like to be in target for bed/be able to lye in somtimes in the morning.

 

[noblehead]

I'd try a change of basal insulin if you've tried split-dosing and increasing your dose to no avail, better still would be to ask your Consultant if you can be considered for pump.

The CP's on Dafne I couldn't get away with, soon went back to grams

 

[tim2000s]

This sounds like a classic dual dose levemir reaction. I don't know what dose you are taking, But I find that my overnight dose taken at 9.30pm (which is around 50% of my daily dose at 8iu) runs out from about 8am-8.30am, which isn't an issue generally because my breakfast short acting has a slightly larger dose than needed for the carbs to counter this. My morning dose (which is 14-16iu) generally runs through 12 hours from 9.30am-9.30pm without issue.

If I split the dose 50-50, my daytime dose runs out at around 7.30pm and my overnight dose pushes me low from around 3am, so I find the 35-65 split to be much more effective.

 

[Diamattic]

I did not know there was such a thing! But if there is, then I am certainly experiencing it as well.

All day long sugars are perfect. Come 9-10pm they just start soaring upwards! I know its not a food issue because the first thing tried was no eating past 4pm, and it still remains unchanged.

The strange thing is that this NEVER happened when i was on Lantus. Now that I am on a pump i find that i have to crank my basal starting at around 8pm until 2am, and then raise it even more at 2am to fight dawn phenomenon.

When i WASN'T on a pump, i never once had any issues with either of these.. so its a bit strange..

 

[itconor]

Yes I'm on dual dose levmir. 18 in the evening 12 in the morning. Thing is blood sugars are tight in the afternoon. I'd end up low of I increased morning levmir . Doc suggested the pump was the answer