Just not understanding Dawn Phenomenon

[mikeyuk]

Hi all,

Another question about the dreaded DP.

I started to split my levemir insulin to try to get better coverage for dawn phenomenon, no more than 9 hours apart as dr bernstein recommends (10 units at 10pm, 20 at 6:30am when i get up). I thought I had it licked and seemed stable enough, today on rising (at 6:30) 5.5, by 9:30am at work before I had a peperammi, 7.1. No food in between, no stress, nothing else that would raise it.

Is it possible to control the DP by Levemir alone, or will I have to inject a small amount of novorapid each day? It doesn't even seem like the DP is particularly predictable, so how do all the people with hba1cs in the 4s and 5s actually deal with it?

Looking forward to your replies
Mike

 

[jopar]

I used to suffer the dreaded DP before I went on the insulin pump.

Normally when splitting Levemir it is split over a 12 hour period! But you do have to play around with timing a bit for best effect, I used to have my, at 11pm and 11.30 am…

If you look at the profile of Levimer, your breakfast jab if taken at 6.30am it isn’t going to kick in until around 1 hour after you’ve injected (7.30am) and full effect around the 4 hour mark and starts to tail off at the 5 to 6 hours…

If you are taking the correct amount of basal insulin your basal profile on fasting should remain +/- 2mmol/l ?