Recent Posts - DAFNE Online

Dec 1, 2021

Muriel McCul... 3 posts

Topic: Carbohydrate Counting / Dawn Phenomenon

Thanks
I’ll give that a go. I did try increasing my nighttime BI by one but was going low around 5-6 am. I hadn’t decreased my morning dose though, so worth a try.
I’ll let you know how it goes Smile

Dec 1, 2021

Warwick 425 posts

Topic: Carbohydrate Counting / Dawn Phenomenon

Hello Muriel,

Lantus and Levemir are both basal insulins, so the same advice should apply. Their behaviour differs - I find that changes made to Lantus doses can take 2 to 3 days to show a difference in BGLs, whereas changes to doses of Levemir are much more responsive. Also Lantus can continue to work up to 18-24 hours after injection whereas Levemir almost always stops acting 18 hours after injecting which is why it is good to be on a split dose for Levemir.

I think that with Levemir, you would actually be in a better position to try decreasing your morning dose and increasing your evening dose by the same amount and see if that makes any difference. It is more responsive than Lantus, so you will see if this works sooner. Just drop one unit from the morning dose and add one, leave for a few days and see if there is an improvement. If so, then you can consider whether to repeat that.

Feel free to post your diary to this thread. It's always easier to give advice when looking at a few days worth of your readings and doses.

Dec 1, 2021

Muriel McCul... 3 posts

Topic: Carbohydrate Counting / Dawn Phenomenon

I’m experiencing something similar, on split dose of Levimir.
Would the same thing work for me?

Nov 30, 2021

Warwick 425 posts

Topic: Carbohydrate Counting / Dawn Phenomenon

Hello Joan,

What I have found helpful with dawn phenomenon is to add a third insulin to my QA and BI. I use Humalin NPH. Its action kind of sits between QA and BI with a peak around 6-8 hours after injection. I find if I inject it around 9 pm, then it covers the DP period of 3-5 am without inducing too many highs or lows and is largely finished by the time I wake around 7 am.

It sounds like you are on quite low amounts of insulin, so with this, you'd probably only need to inject 1 or 2 units of NPH to go with your injection of 4 units of Lantus at night.

What does the rest of your insulin regime look like?

From what you have said it sounds like you are taking a split dose of Lantus - once in the morning and once in the evening? If so, it may be that your morning basal insulin is running out (for some people, Lantus only lasts around 18 hours), in which case you could consider slowly adjusting your basal insulin injections so that you inject a little less in the morning and the equivalent amount extra in the evening.

If you are comfortable sharing your diary with this thread, then we can probably offer more tailored advice.

Thanks,
Warwick.

Nov 27, 2021

joan013 1 post

Topic: Carbohydrate Counting / Dawn Phenomenon

Hi, I'm being driven crazy with Dawn Phenomenon and trying to stop it or at least ease it. I have tried reducing my night-time dose of Lantus by 1 unit to 4 but find my bloods really high in the morning, and yet when I take 5 units of Lantus I am prone to go low over night. I can spend the following morning chasing the high with my correction and it's driving me crazy! Anyone been able to crack the phenomenon???


Dec 1, 2021 Muriel McCul... 3 posts	Topic: Carbohydrate Counting / Dawn Phenomenon Thanks I’ll give that a go. I did try increasing my nighttime BI by one but was going low around 5-6 am. I hadn’t decreased my morning dose though, so worth a try. I’ll let you know how it goes

Dec 1, 2021 Warwick 425 posts	Topic: Carbohydrate Counting / Dawn Phenomenon Hello Muriel, Lantus and Levemir are both basal insulins, so the same advice should apply. Their behaviour differs - I find that changes made to Lantus doses can take 2 to 3 days to show a difference in BGLs, whereas changes to doses of Levemir are much more responsive. Also Lantus can continue to work up to 18-24 hours after injection whereas Levemir almost always stops acting 18 hours after injecting which is why it is good to be on a split dose for Levemir. I think that with Levemir, you would actually be in a better position to try decreasing your morning dose and increasing your evening dose by the same amount and see if that makes any difference. It is more responsive than Lantus, so you will see if this works sooner. Just drop one unit from the morning dose and add one, leave for a few days and see if there is an improvement. If so, then you can consider whether to repeat that. Feel free to post your diary to this thread. It's always easier to give advice when looking at a few days worth of your readings and doses.

Dec 1, 2021 Muriel McCul... 3 posts	Topic: Carbohydrate Counting / Dawn Phenomenon I’m experiencing something similar, on split dose of Levimir. Would the same thing work for me?

Nov 30, 2021 Warwick 425 posts	Topic: Carbohydrate Counting / Dawn Phenomenon Hello Joan, What I have found helpful with dawn phenomenon is to add a third insulin to my QA and BI. I use Humalin NPH. Its action kind of sits between QA and BI with a peak around 6-8 hours after injection. I find if I inject it around 9 pm, then it covers the DP period of 3-5 am without inducing too many highs or lows and is largely finished by the time I wake around 7 am. It sounds like you are on quite low amounts of insulin, so with this, you'd probably only need to inject 1 or 2 units of NPH to go with your injection of 4 units of Lantus at night. What does the rest of your insulin regime look like? From what you have said it sounds like you are taking a split dose of Lantus - once in the morning and once in the evening? If so, it may be that your morning basal insulin is running out (for some people, Lantus only lasts around 18 hours), in which case you could consider slowly adjusting your basal insulin injections so that you inject a little less in the morning and the equivalent amount extra in the evening. If you are comfortable sharing your diary with this thread, then we can probably offer more tailored advice. Thanks, Warwick.

Nov 27, 2021 joan013 1 post	Topic: Carbohydrate Counting / Dawn Phenomenon Hi, I'm being driven crazy with Dawn Phenomenon and trying to stop it or at least ease it. I have tried reducing my night-time dose of Lantus by 1 unit to 4 but find my bloods really high in the morning, and yet when I take 5 units of Lantus I am prone to go low over night. I can spend the following morning chasing the high with my correction and it's driving me crazy! Anyone been able to crack the phenomenon???