Rising morning BG knowing the 'Dawn' Phenomenon is not present

Hi Everyone

I have recently been doing throught the night and early morning BG tests and have discovered that a rising morning blood sugar after morning Lantus at 7.30 am and before breakfast at 10.00am ish not due to our friend 'Dawn'. Can anyone explain what else it might be, if all other areas seem ok, ie. ratios, morning Lantus checked with CHO free lunch etc.

Thanks in advance.

Tracey x

tracy,
Why are you so sure its not 'Dawn' ? Its effects are not necessarily text book and as you would expect. As I understand it ( and i'm NOT a HCP), 'dawn' is basically your body releasing hormones to get you moving in the mornings its effects can vary and can last right through the moring not just literally at dawn. I'm not suggesting it IS 'dawn', I just wanted to be clear why you are sure its not.

Marke, you are quite right, the release of hormones at 2-3 am will start glucose rising at about 4-5 but this effect will last into the day, which is why people who get up at the weekend note that their glucose often goes higher even if they miss breakfast. Add to this that bedtime long-acting insulin, particularly isophane insulins such as Humulin I and Insulatard are running out then it is not surprising that a high blood glucose on waking up is such a common problem for people with Type 1 diabetes. Simon

Im no HCP, but I can say it is Dawn.......

Its a pain in the bum but I think the earlier you get up the quicker you catch the rise.........ie monday to friday working.....

Ultimately for me the few hours of rising sugars dont have a long term (2-3 months) effect.

I have also moved onto Humilin I to try and combat it, its starts working in 2 hours then peaks 2 hours later, this has helped me drive them down slightly in the morning, still double figures though

This is one of the problems that sometimes can be fixed by replacing Humulin I by long acting insulin analogues such as Levemir or glargine. more long acting and less likely to cause hypoglycaemia in the middle of the night. Usually need to be given twice daily though just like Humulin I or Insulatard. Simon

I was on Levemir twice a day, and it worked to some extent, its just was not lasting long enough, and increasing the doses was not really an option as I wanted to drive my intake down from what is was before dafne.

Everything is working as it should for now, but what I do believe is that could change throughout my life as lifestyles change and my body

Not wanting tut the cat amongst the proverbial pigeons, but I'm often -  OK always - up til stupid o'clock and up again quite early. At my DAFNE course they said the dawn effect still comes around the same time regardless. From some of my results this does seem to make sense.

I'd been doing my long acting twice a day, once at 2-4pm and again at 4-5pm. I set an alarm on my phone recently to do them at 1.30am and 1.30pm. I'm still spotting or at least trying to spot patterns and changes from the previous set up. If anything my overall sugars are up throughout the day. 

Before I did DAFNE I was on a 26u and 12u. They dropped me to 6 & 6 but it seems to be climbing again. I've had some really bad morning hypos and worry about having more if I up the late one. My mam and dad worry even more than me. Heheh!

Forgive mentor droning on but the point I wanted to get to is that I was thinking whether or not taking 3 pops of slow acting a day might have a better smoother effect. Has anyone tried this? If so how did you get on?

Cheers folks!

Actually there is some evidence that multiple small doses of an insulin such as Humulin I or Insulatard with each meal alongside quick acting insulin does work pretty well but it does involve free mixing of insulin in syringes so not terribly practical. on the basis that an insulin pump replaces background insulin most effectively then probably for those who are prepared to be pushing the envelope in terms of glucose control and effective self management, this is probably the best solution, that is if a pump is acceptable. Simon

what do you mean by free mixing of insulin??

Sorry about the jargon, it means using a traditional syringe and needle (not many people using disposable syringes any more) and drawing up the two different insulins from vials. very complicated and old fashioned and impractical.