Dawn Phenomenon - help needed

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rachelha

rachelha

Well-Known Member
Relationship to Diabetes
Type 1
Hello all

Sorry to drag this old topic up again but I really need some advice.

My blood sugar at 2:00am was at 7.2, and I woke up at 7:00am at 15.7!!!! :(
I am pretty certain this was DP not a hypo rebound as I actually felt quite well rested for once.

Does anyone have any advice on how I can stop this. My only thought is setting an alarm for 5:30 or 6:00am and having 1 or 2 units of humalog, then going back to sleep. I normally get up at some point between 7:30 and 8:00am.

Please don't tell me I need a pump as I am not going to get one until August, and I need to do something about this now. I have just contacted my DSN to see if they have any advice, however last time I saw the consultant all he said to me was - "when you get the pump that will sort it. ARGHHHH!!!!

Rachel
 
After trying CGMS and various different dosing regimes, I was put on a pump, This has cured it once and for all, But I would ask your team what different approaches you could take.
 
I have just heard back from my DSN who spoke to the consultant, and they agreed that I should try waking up and having a shot of humalog. AARRGHHH!!!
I was really hoping they would have some other wonderful idea which did not involve disturbing my sleep so much. Oh well I guess it will be worth it in the long run.

:(:(:(
 
rachelha said:
I have just heard back from my DSN who spoke to the consultant, and they agreed that I should try waking up and having a shot of humalog. AARRGHHH!!!
I was really hoping they would have some other wonderful idea which did not involve disturbing my sleep so much. Oh well I guess it will be worth it in the long run.

:(:(:(
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Oh man, that sucks! :( Is there nothing they can do with some of the other insulins? I know there are some that have a longer peak than the short acting insulins - I think insulatard is one of them - and I've heard of people taking a couple of units of that before bed. I had a similar problem to you, and my DSN got me to take a couple of units of levemir before bed, in addition to my lantus, and that seemed to help. Would any of these be an option with your DSN?
 
randomange said:
Oh man, that sucks! :( Is there nothing they can do with some of the other insulins? I know there are some that have a longer peak than the short acting insulins - I think insulatard is one of them - and I've heard of people taking a couple of units of that before bed. I had a similar problem to you, and my DSN got me to take a couple of units of levemir before bed, in addition to my lantus, and that seemed to help. Would any of these be an option with your DSN?
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Ramdonange - thanks for your reply.
I asked my consultant about different insulin last time I saw him, but he said I should stay on the current regime, which is 10u levemir at 7:30am and 5u levemar at 7:30pm. The problem is I am also prone to night time hypos so I can not up the evening dose any futher or I have bad hypos at about 3am, and the associated rebound.
 
rachelha said:
Ramdonange - thanks for your reply.
I asked my consultant about different insulin last time I saw him, but he said I should stay on the current regime, which is 10u levemir at 7:30am and 5u levemar at 7:30pm. The problem is I am also prone to night time hypos so I can not up the evening dose any futher or I have bad hypos at about 3am, and the associated rebound.
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Ah yeah, I feel your pain, I have that problem too. It's taken a lot of playing around with doses and times and insulins before I finally was able to settle on something that (most of the time!) doesn't cause me to go low in the night, but doesn't make me rise too much either. I hope the extra shot helps! At least it should make you feel better not waking up high in the morning, and in six months time you can use your pump to sort it out! 🙂
 
randomange said:
Ah yeah, I feel your pain, I have that problem too. It's taken a lot of playing around with doses and times and insulins before I finally was able to settle on something that (most of the time!) doesn't cause me to go low in the night, but doesn't make me rise too much either. I hope the extra shot helps! At least it should make you feel better not waking up high in the morning, and in six months time you can use your pump to sort it out! 🙂
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Randomage - fingers crossed in 6 months time, i will be 7 months pregnant 🙂, so the pump will have to go on hold for a while longer
 
rachelha said:
Randomage - fingers crossed in 6 months time, i will be 7 months pregnant 🙂, so the pump will have to go on hold for a while longer
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Congratulations Rachel 🙂. Do you think this may be the reason - your hormones must be going through a big change at the moment with the resultant effect on your insulin needs.
 
Jules A said:
Congratulations Rachel 🙂. Do you think this may be the reason - your hormones must be going through a big change at the moment with the resultant effect on your insulin needs.
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No unfortunately I have always had problems, with DP, night time hypos and generally erratic blood sugars, which is why I have been approved for a pump. I expect things will just get worse in the next 9 months though.
 
sofaraway said:
Do you find the levemir has any kind of peak for you? If so I wonder if moving it to a bit later would help?
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Nikki - Thanks alot for that comment. I am not sure if it gives me a peak or not. I used to have both injections at 8am and 8pm, but thought getting the morning shot into me earlier might help, so moved them to 7. It is not really helping though. I had not thought of trying it later. I will ask the DSN about that.

I think I will try the early morning injection for the next couple of days and see how that goes.
 
I don't know if it was clear but I meant moving the evening levemir to later.
I know that they like to start a split with the doses 12 hours apart but mine are rarely that. My evening lantus is 9pm, and my morning lantus is around 6-7am.

Will be interested to hear how the early humalog works
 
sofaraway said:
I don't know if it was clear but I meant moving the evening levemir to later.
I know that they like to start a split with the doses 12 hours apart but mine are rarely that. My evening lantus is 9pm, and my morning lantus is around 6-7am.

Will be interested to hear how the early humalog works
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Ah, no I did not pick that up correctly, I thought they had to be 12 hours apart. That would make sense though as there would be no way the evening one could be tailing off if I have it later on. Not sure which to try first now? I guess I should do what the nurse says.
 
rachelha said:
Randomage - fingers crossed in 6 months time, i will be 7 months pregnant 🙂, so the pump will have to go on hold for a while longer
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Ah, congratulations! :D I've just realised that August, as you put in your original post, is actually eight months away and not six. My ability to count has gone out the window...😱 😉
 
Please speak to your nurse first and go with what she and you think is best. I was just thinking of some possibilities that may or may not be useful to you.

Hope that you can get the levels down
 
It worked!!!

My bloodsugar was 11.7 when I went to bed so I had one unit correction. I awoke at 3am and was at 4.7 so had 2 glucotabs as I knew I would not get back to sleep otherwise. The alarm went off at 6am, I was at 7.2 and had 1 unit humalog. Then when I got up at 7:30 I was at 7.4🙂🙂

I was really worried I would hypo in the morning but it was all fine. My hubby did not get back to sleep at all though. Apparently he was so worried I would hypo and go into a coma that he kept rolling over to make sure I reacted and was not unconcious. What a sweetie. Hopefully if it is ok again tonight, he will realise he can go back to sleep without worrying.

Now I just need a method of getting rid of the post meal spikes.
 
Excellent Rachel! Feel sorry for hubby though, it really must be harder for partners sometimes than it is for us.
 
I really, really admire and salute your dedication to getting your morning numbers down. Fantastic that this solution works! I really hope you don't need to keep it up for 8 months though -- erk, sounds so hard.

What a good OH. I hope my son finds someone as caring someday...

All best.
 
Patricia said:
I really, really admire and salute your dedication to getting your morning numbers down. Fantastic that this solution works! I really hope you don't need to keep it up for 8 months though -- erk, sounds so hard.

What a good OH. I hope my son finds someone as caring someday...

All best.
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Patricia - thank you.

It is hard for O/H. I am going to try and get him to come along to the next shootuporputup meet, so that he can meet some other O/Hs of diabetics. I think he could probably do with a forum like this to let off steam too aswell.
 
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