Dawn phenomenon

Hello, I’ve just finished my DAFNE course and over the week I’ve upped my BI in the evening to a total of 40% because of the patterns. I have just done a 3am and 5am test as I was dubious that I had the dawn phenomenon. My blood was high before bed at 16.7 stayed stable at 3am however has risen to 22 at 5am?

Is there any thing other diabetics have done to counteract dawn phenomenon?, if so what works?

Amylouise x

I found the abbott freestyle libre invaluable in understanding my readings which go up from about 0600 and trough at about 0100. Giving BI later the night before or increasing BI has no effect for me just made me more likely to hypo overnight. I just give 1.5 units when I wake to correct for dawn and do BI calculations based on my pre 0600 - even if I have not woken to test I just take from meter record.

Did you correct the 16.7?

If you are rising up without any food and your BG at 3am is close to what it was before bed, then the dawn phenomenon is present....

Things that I tried with varying success were taking the evening BI dose immediately before bed, allowing there to be a stronger dose in my system by the time the DP started. Also getting food in and digesting as quickly as possible helped stop the continuous rise throughout the morning....

what you cant do is stop the DP though....it happens in everybody, its just its more severe in some......

reduce your carb intake should also help reduce the severity of the rise....

One suggestion i would have, that's not easy, is to try to get referred for a pump. I had very similar issues and diagnosed it as suggested with a freestyle libre. I took the reports it produced to my consultant who agreed it was DP and referred me for a pump. Since I have been in the pump it's all but disappeared. One of the reasons for this is the slow drop feed of insulin that absorbs more evenly and makes life a lot easier in all respects not just DP. I would still raise it with your consultant even without the freestyle if you don't have one, they should recognise the issue and recommend a pump.

Personally I don't experience DP in daily life but as soon as I go on holiday I wake up with extremely high BGLs. I suspect it is because I don't exercise much on holiday whereas in my usual daily life I am a cycle commuter, regularly run and play basketball once a week.

Weirdly, I actually find I am most sensitive to insulin in the mornings and need to have a lower insulin:carb ratio then than for the rest of the day. My DAFNE educator during the course didn't understand that and asked me to inject the same ratio as for other meals. I spent 75 minutes on day 2 of the course swallowing high-carb products in an attempt to get out of hypoland and after that we all agreed to keep me on a low dose of insulin in the mornings