Dawn phenomenon

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MichelleF78

MichelleF78

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Relationship to Diabetes
Type 1.5 LADA
Morning everyone,

Can I ask please how many of you suffer from DP.

Feel like I’m never going to get it under control.

Thanks M
 
I do @MichelleF78 I have a pump, which helps, but on injections I found I needed between half and one unit on rising to stop the DP. Eating soon after getting up helps a lot too. In fact, I’d say that was one of the most helpful things actually.
 
Thanks @Inka it’s bloody murder. Go to bed about 6 and it just keeps going. I have been taking my corrections I soon as I get up and my breakfast bolus but I need about an hour until it comes down to 6. Hope you are well 🙂
 
Have you tried eating when you’re slightly higher than you’d like - ie not waiting until you come down into range? If I wake at say 10.5 and correct and wait to eat, my blood sugar stays around 10 and can stay that way for ages. However, if I bolus for my food and then eat (even though I’m 10.5), it kind of kickstarts things and I’ll be back in range sooner.
 
Yes, I get it, from about 4am usually. Except when I don’t. I tend not to get it if I've done a lot of exercise the day before (more than usual for me, I mean) or when I’ve had a couple of glasses of red wine the evening before.
I drop a lot during the first part of the night, though, so it's useless to increase my basal overnight, I just hypo at 3am.

I factor in a couple of extra units of Novorapid with my breakfast bolus as soon as I wake up, ie, 2 for Dawn and 3 for my oats, if I'm having a carby breakfast, and just 2 units if I’m having eggs and don’t need a bolus.
I usually start eating a carby breakfast as soon as I see the Libre graph start to make a downwards turn, which can be around 45 minutes after injecting, then I get a flat line through breakfast and a gentle fall back down to normal levels.
If I'm going out straight way and can’t wait for the fall to start before breakfast, that’s when I have eggs, or a protein bar, so I won’t add any fuel to an already increasing line.
 
No @Inka I have been advised to be at target to eat which is taking over an hour on Fiasp. I am starving in morning! I don’t eat past 7pm. I will maybe try it tomorrow, thank you 🙂
 
MichelleF78 said:
Thanks @Inka it’s bloody murder. Go to bed about 6 and it just keeps going. I have been taking my corrections I soon as I get up and my breakfast bolus but I need about an hour until it comes down to 6. Hope you are well 🙂
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Don't know how long you've been type 1, if it's been while then push for a pump as this with deal with things like DP much easier.
 
Inka said:
Have you tried eating when you’re slightly higher than you’d like - ie not waiting until you come down into range? If I wake at say 10.5 and correct and wait to eat, my blood sugar stays around 10 and can stay that way for ages. However, if I bolus for my food and then eat (even though I’m 10.5), it kind of kickstarts things and I’ll be back in range sooner.
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@Inka yes I agree mines the same takes forever to budge. I was scared to eat at 9 or 10 incase I rocket. My time in range gets to me. Can I ask if you eat at 10 what you would go up to?
 
As you already know from conversations we have had, I do the same as @Robin and that works great for me. And certainly agree that exercise the day before stops it for me too. Oddly alcohol doesn't work for me though.

No reason why you couldn't have a scrambled egg or some meat or cheese if you are starving and to try to stop the liver dump, but will be interested to hear how you get on with @Inka's suggestion. We are all different and what works for me may not be the answer for you, so always good to try out different options and see how your body responds.
 
Robin said:
Yes, I get it, from about 4am usually. Except when I don’t. I tend not to get it if I've done a lot of exercise the day before (more than usual for me, I mean) or when I’ve had a couple of glasses of red wine the evening before.
I drop a lot during the first part of the night, though, so it's useless to increase my basal overnight, I just hypo at 3am.

I factor in a couple of extra units of Novorapid with my breakfast bolus as soon as I wake up, ie, 2 for Dawn and 3 for my oats, if I'm having a carby breakfast, and just 2 units if I’m having eggs and don’t need a bolus.
I usually start eating a carby breakfast as soon as I see the Libre graph start to make a downwards turn, which can be around 45 minutes after injecting, then I get a flat line through breakfast and a gentle fall back down to normal levels.
If I'm going out straight way and can’t wait for the fall to start before breakfast, that’s when I have eggs, or a protein bar, so I won’t add any fuel to an already increasing line.
Click to expand...
Thanks @Robin it’s a bugger for sure. I have been waiting to come down in range before I eat but I wonder if I didn’t wait what I would go to.
 
rebrascora said:
As you already know from conversations we have had, I do the same as @Robin and that works great for me. And certainly agree that exercise the day before stops it for me too. Oddly alcohol doesn't work for me though.

No reason why you couldn't have a scrambled egg or some meat or cheese if you are starving and to try to stop the liver dump, but will be interested to hear how you get on with @Inka's suggestion. We are all different and what works for me may not be the answer for you, so always good to try out different options and see how your body responds.
Click to expand...
Yes Barbara I might try it 🙂
 
Can you post your graph for today Michelle?
Just wondering how big a challenge you are facing and when it starts..... I know your predisposition to worry about things that really aren't a significant problem... 🙄😉
Something simple like a half unit pen for your Levemir might be all that is required.
 
So that dip just after 6am is where your morning Fiasp is kicking in and then your breakfast spike after that, so there is only very minimal and steady DP showing on that graph, more of a steady increase through the night which would suggest a little bit more Levemir might give you a nice horizontal line. Is it a clear pattern every night? If so, then then you could either increase the Levemir OR go to bed a little lower than your current target. Not both or you risk a hypo.
 
Can be worse than that. I don’t have half units on my pen and I’m already taking 28 units at night, woukd I better trying 1 more unit? @rebrascora
 
That graph only shows you hitting 10 after breakfast which is just your breakfast spike and is absolutely fine, however there is a steady rise overnight which indicates to me you need more evening Levemir to level it out, rather than an obvious DP.
 
That’s weird as my reader showed 12.2. Can they vary? I sometimes find the graph when I scan shows a higher reading. Dots above where the graph goes. Pic attached
 

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Yes, that happens due to the algorithm using previous readings to extrapolate to get the current reading but as you get towards the top of the peak, the rate of rise slows down and then changes direction but it takes 15 mins or so for the Libre to recognize that levels are peaking, so it is predicting that your levels are still rising when they may have levelled out and be starting to drop back down. If you scan when levels are changing you get that inflated extrapolated prediction like your 12.2, but as the levels start to come back down, the algorithm realizes that that prediction was incorrect and adjusts the graph so that it doesn't go through that point. I always think about it as cheating. It tells you one thing and then when it realizes it got it wrong it tries to cover it's mistake. o_O 🙄 It is just part of the limitations or quirks of Libre and to a certain extent CGM in general, due to the difference between blood and interstitial fluid. Personally I wonder if we might not be better off without the algorithm and just learning to manage our interstitial fluid levels instead of blood glucose levels, rather than trying to bridge the gap poorly.
 
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