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Hi all

T

Type1Ron

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5
There's so much info here, I'm not sure where to start, so thought it's best to say hi / introduce.

I'm type one. Late diagnosis. Around age 30 and now I'm pushing 40.

I have a thing called dawn phenomenon, otherwise known as liver dump, basically the natural and even none diabetic process that releases glucose in your sleep, to help humans wake up. In my case, it releases far too much, so that even on fasting I will wake up at around 15mmol every morning. Its rubbish, I have to over compensate every morning with around 10-15 units of insulin to bring it back down. The issue with this is it causes me to have a hypo so often as it's a guessing game. I have now waited for over 2 years for a pump, to be told that I am not high priority / coatings mean i need to wait more. Anyway without ranting any more, hello and thanks for reading I guess. Hoping to find a bit more info on here as there seems to be so much that GPs dont understand.
 
Hello and welcome @Type1Ron :)

We’ve all experienced this to some degree, my best tip is to eat as soon as you wake, so something easy on the carbs like plain yoghurt or omelette - to trick the liver into thinking there’s another source of energy and to take a small bolus shot at this point, although we are all uniquely different so how much you correct upon waking and bolus only for protein is something you can work on and tweak, however eating first thing works for me.
 
@Type1Ron . Welcome to the forum.
Dawn phenomenon :banghead::banghead::banghead::banghead:. The bane of many of our lives.
Perhaps you could give us a bit of insight into your insulin type and injecting routines.
Some one might be able to offer a different approach to doing things.
 
I'm currently on levemir (slow insulin) and Fiasp (Fast insulin), I've forgot the acronym lol). I was on novorapid for fast, the docs advised to switch to Fiasp but I'm wondering if that was down to cost.

Levemir (background /Slow) I'm on 20 unit in AM and 20 in PM)
Fiasp (fast, food time insulin), 12 units + 2x 10 carbs
Midday 1.5 x 10 carbs
Evening 1x1 carbs

Sometimes a variable in between if I eat anything carby
 
@Type1Ron . You appear to be on the ball with everything. Injecting Levemir/ basal insulin twice daily is probably your best option.
Have you got anyway of monitoring when your BS rises? A libre or CGM ( continuous glucose monitor) can be very useful.
Are you actually waking with elevated levels or does your BS rise shortly after you rise out of bed?
Dawn phenomenon usually kicks in around 3 a.m whilst we sleep and raises BS before we wake.
Feet on floor is a different problem. BS is generally good on waking but rises rapidly once we get out of bed.
There are different things to try depending on the problem you have.
Your post suggests that you are experiencing dawn phenomenon. Would this be correct?
 
Type1Ron said:
the docs advised to switch to Fiasp but I'm wondering if that was down to cost.
Click to expand...
Fiasp is faster than Novorapid (I know I changed to Fiasp because I was finding Novorapid a long long way from rapid), in my area at least the cost is exactly the same.
 
Type1Ron said:
In my case, it releases far too much, so that even on fasting I will wake up at around 15mmol every morning. Its rubbish, I have to over compensate every morning with around 10-15 units of insulin to bring it back down
Click to expand...
Just out of curiosity do you definitely know its dawn phenomenon, or could it just be rising all night? If its just steadily rising through the night you may just need more basal overnight, if it is DP its trickier
I ask because I know I get DP as it shows on my libre, most evenings its flat, maybe going down slightly til 3-4am at which point it can start going up like a rocket, are you using a CGM, or are you just testing through the night every so often, or are you just assuming it's DP; due to my DP I've actually been approved for a pump, though it did take about 2 years to get to this point and I still haven't started on a pump.

But yes I know the problem of hypoing some point in the morning due to overdoing the correction because it doesn't seem consistent
 
I was paying for a while to use the Libre arm thing (I done a few months at a time for about 1.5 years) glucose could be 6-8 at bed time, dip a bit (not to low levels although there was the odd time), then raise from around 3-5am to high levels. So it's not due to not enough BI (I was crept up to 28 BI on the PM but it wasn't working and my doc told me my total was just well beyond normal daily use)

I'm 99.9% sure its dawn phenomenon, hence me wanting a pump. Only other option seems to be to wake up at 3 or 4am every night to inject some fast acting.
 
I guess my biggest gripe is that I was told I do need one, by the NHS consultant, but there is another 40 people that are higher priority (and something about staffing levels to maintain the service in the county). Anyway, sorry, off on a rant there. Lol
 
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