Dawn Phenomenon

Hi Guys
Just wondering if anyone has any advice on the dawn phenomenon,when the morning glucose is higher than expected.I am sure I have this,as my Bg's are high at 730am,but normal to reasonable at 3am.I have increased my BI and am now on a 3:1 ratio at breakfast but still have a morning rise.Do I still have to keep increasing my BI until I get a good result at 730am.Or do I leave it alone as I only have the 2 abnormal results normally.

I too suffer from this and for a long time stopped increasing my BI as I thought it was not making a difference.....

If you do get persistently high readings in the morning then you should keep upping the dose, say by 2 each time, at 22:00. I would also offer the consideration of moving your evening BI dose to a later time, this will mean there will be more BI in your system by the time 4:00am comes, the likely time your liver releases it glucagon.

I see you take your evening BI dose at bed time, moving it to later time might be difficult then if you are in the land of nod...........I personally take my morning dose at 6:30 with breakfast and used to take the PM dose at 5:00-6:00, I moved it forward to 22:00, it helped a lot....

The first thing to do would be to increase the dose though, each time doing some 3am to make sure you are not going too low overnight.

Thanks for that novorapidboi.Was unsure as I have now increased my evening BI from 20 to 36 since starting dafne.Although this is still roughly half the evening dose I used to take,was still kind of wary about the increase.As you will see from todays results I seem to have no grip on it yet,plan to go carb free at supper tonight to see what kind of results I get from that.Thanks for the input.

The figures do not look that bad but you may be seeking perfection, your biggest intake of carbs are before bed at 22:00 plus you throw in the BI & QA at the same time and I have to presume you have caluclated the carbs spot on. The answers would lie in the profiles of you QA & BI plus the release of the CP's while in the horizontal mode, a touch more QA is not going to do any harm and I would try based on your own assessment of things of the day in hand I say this because you have not gone hypo mid morning and are not waking up with a headache.

On a less serious note if you intend to make a habit of getting up at 3am simply inject 1 UNIT of QA and the problem has gone, simple.

Good Luck

I amdit to being a bit greedy at 10 at night,but always match my carb to QA correctly.I may very well just inject 1 unit of QA at 3am if it stops me feeling so shitty on wakening.Am sure i'm not hypoing during night so will take the extra to see if it helps.Am now up to 40 units of BI at 10pm with no improvement.Cheers for your advice.

Think of it as this scenario pretend it is 2 armies going to battle CP's against QA&BI commecing at 22:00. The QA & BI are going to come on strong before levelling off during the early hours the CP's have seen it all before they will send in the fast acting soldiers i.e sugars and starches then the older guys slow acting CP's will kick in hours later because they seen it all before and they know "daviebear" does not send in enough troops and like to get you outside dafne target for your morning test.

That is one of a multitude of scenarios that may question you to look at different strategys if it's one that continues to persit and do not forget it's a manual system we operate so it's never without minor problems.

The other point is if your not waking up hypo the question you may have to ask are you bothered about the 3am test dipping, just a touch more QA might do the trick to bring you in target for breakfast and if you are not hypo in the early hours why worry.


Keep at it.

Hi

My name is Derek, from Edinburgh. Diabetic for 17 years.
Should probably have introduced myself in the new users topic.
Just completed my DAFNE last week.
I was never told about CPs or ratios, just had to guess. Was on umalog and Humilkin I at teatime. I too for years had a high blood sugar in the morning.
Doctor just told me to keep increasing my Humiilin I. I always eat a supper so would inject what I normally would for what I was eating and always woke up high.
Sometimes I would wake up at 4:30- 5:00 hypo, take my sugar and couple of biscuits and then wake up high!!

It wasn't until a few months ago a nurse told me about the "Peak" Isophane has between 4 - 6 hrs. So if I'm injecting at 6pm and having supper at say 11pm there's the
Isophane peak plus my fast acting kicking in. I reduced my fast acting dramatically, never believed I could get away with taking so little, 14-16 down to 2 units and I was amazed to see I was normal in the morning. My supper was mostly no carb so don't follow my injections, but you could maybe try rreduciing your ratio to a 1:1?

Then again I am no expert and don't know what insulin you take, it was what worked for me.


Derek

My neice has been having highs in the morning with good readings at 3am. My sister decided to try a CGMS to see if there was anything going on - turned out she was hypoing at 4am so they were missing it with the 3am test. Do you have the option for a CGMS - if only for a week, it can give you some fantastic feedback and provide patterns you might otherwise miss.
Trudi

I was the same and just would put my BI up to try to bring BGs down in the mornings tests at 3.00 were fine. Got the use of a CGMS and found out that I was hypoing at the 4.00. I have now drooped my BG down from 20 to 10 and if I am high through night then I give a extra QA things still not quite right yet but getting better. Would never have known about the night hypos if it haddent been gor the CGM so if you can get one for a week take it. I am on a 3.5 to1 ratio in the mornings but at dinner time just 0.5.

Thanks Trudi and grandma carol.Am fairly sure I'm not hypoing at 4am.But may ask for the CGMS,I have the first follow up to dafne on wednesday,so will give it a shot.Grandma Carol,you have answered another query I was going to put up here.I hypo evry working day(not on days off as ratio is different then),at 2pm then again at 4pm.I have reduced my BI and am on a 1to 1 ratio at lunchtime.I was going to ask if you could do a 0.5 to 1 ratio.Seeing as you're doing it,I will go ahead and do it too,and agin let them know on wednesday.That's been a great help.Thanks a lot.