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Dawn Phenomenon??

KS76

Member
Relationship to Diabetes
Type 1
Most days I am having the same blood sugar problem. From about 7.30am I have a reading of about 10mmol going to around 14 at roughly 9 - 9.30am. By 11 - 12 lunch time I'm up to about 18mmol. I've eaten nothing since the night before and it was mentioned about this dawn phenomenon. Is this true it makes this rise happen? Ive tried many things to get my sugars steady by upping my Levemir and I am still having this surge in a morning. By mid afternoon it comes down to about 9 and usually by dinner time I'm 4 - 5mmol. Its a regular pattern and don't know how to prevent it from happening. Any help/suggestions would be much appreciated.
 

grovesy

Well-Known Member
Relationship to Diabetes
Type 2
Yes it is a thing, it has been discussed many times if you do a forum search you should find them.
 

Inka

Well-Known Member
Relationship to Diabetes
Type 1
Have you done a basal test @KS76 ? And when do you eat breakfast?

Are you on twice daily Levemir? Are you correcting when you get up? Are you sure your mealtime ratios are right?

If your blood sugar goes up in the early hours of the morning to get you ready for the day, then yes, that’s DP. There’s also ‘feet on the floor’ where getting up causes another rise. But your breakfast bolus (and basal) should get your blood sugar down. It shouldn’t stay high all day like that. That’s not DP as such.
 
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KS76

Member
Relationship to Diabetes
Type 1
Have you done a basal test @KS76 ? And when do you eat breakfast?

Are you on twice daily Levemir? Are you correcting when you get up? Are you sure your mealtime ratios are right?

If your blood sugar goes up in the early hours of the morning to get you ready for the day, then yes, that’s DP. There’s also ‘feet on the floor’ where getting up causes another rise. But your breakfast bolus (and basal) should get your blood sugar down. It shouldn’t stay high all day like that. That’s not DP as such.
I don't eat breakfast I have Levemir twice daily. I usually end up correcting as it goes higher and higher. I have been putting my morning Levemir up over the past 2 weeks but still getting this problem. It happens most days but not everyday which is weird. Wondering whether I need to look at changing from Levemir to something else perhaps????
 

Inka

Well-Known Member
Relationship to Diabetes
Type 1
Perhaps the lack of breakfast is contributing too? I find if I get up and eat my breakfast late my blood sugar will go up even though I haven’t yet eaten. I think it’s my body pumping out glucose in the absence of breakfast. I deal with that by having a small bolus (without food). You could try experimenting carefully with that maybe? Or even just have a small breakfast and bolus for it.

So your corrections aren’t working? I mean if you’re going up and up despite them?
 

KS76

Member
Relationship to Diabetes
Type 1
Perhaps the lack of breakfast is contributing too? I find if I get up and eat my breakfast late my blood sugar will go up even though I haven’t yet eaten. I think it’s my body pumping out glucose in the absence of breakfast. I deal with that by having a small bolus (without food). You could try experimenting carefully with that maybe? Or even just have a small breakfast and bolus for it.

So your corrections aren’t working? I mean if you’re going up and up despite them?
Maybe not having breakfast is causing a problem!! I have my Levemir and take some Novorapid at the same time as I'm going high. Most times it does absolutely nothing and 2 hours later I've gone up 5mmol, just don't get it.
Might have to speak to my diabetic nurse again and see what she suggests as last time she told me to up the daytime Levemir and that's not worked so need to find out whats going on!! Never had problems like this, on the whole I have very good control. Been type 1 for 35 years!!! Maybe a pumps the way forward
 

rebrascora

Well-Known Member
Relationship to Diabetes
Type 1
Hi and welcome

How long have you been diagnosed and is this something that has just started happening recently?
When do you inject your Levemir ie what times of day?
What sort of fasting readings do you usually get and how do they compare to your bedtime readings?
Could it be that the mornings when it doesn't happen are following a particularly active day or a day when you did significantly more exercise. The effects of exercise are usually seen up top 48hours afterwards.

I get "Foot on the Floor" rather than DP which is much more convenient and I just inject 1.5-2 units of bolus insulin as soon as I get out of bed to cover it.

The fact that yours continues to rise throughout the day until after lunch suggests it might be a shortage of basal insulin as well as DP or FOTF
 

rebrascora

Well-Known Member
Relationship to Diabetes
Type 1
Sorry, I see you answered my query about how long you have been diagnosed whilst I was typing.

Sounds like you need to increase the daytime Levemir a bit more or perhaps alter the time you take it if that is convenient... and maybe reduce your lunchtime ratio if you are low by tea time
 

stephknits

Well-Known Member
Relationship to Diabetes
Type 1
I found a pump really helped with my Dawn phenomenon. I have set my basal rate to have more insulin about an hour before I usually get up and for about 2 hours after. Lowest amount is set from 2-4 in morning and now most nights I have a nice steady line. Might be worth a look if you can't sort it with MDI.
 

SB2015

Forum Host
Relationship to Diabetes
Type 1
Welcome to the forum @KS76

Dawn phenomenon is indeed a thing and a bit of a pest. It is the release of cortisol to get us going that then causes us to release some glucose. I do find injecting early for my breakfast before I even let my feet touch the floor helps. Timing of this took a bit of trial and improvement.

You mention that you are on Levemir. When I was on injections I found it useful to split my Levemir to do a morning and evening dose. That way I was able to adjust the morning one for what I had planned for the day, without impacting my nighttime dose.

There are other suggestions on here, and you can tap into them using the search facility for Dawn Phenomenon.

I hope that helps
 

KS76

Member
Relationship to Diabetes
Type 1
Perhaps the lack of breakfast is contributing too? I find if I get up and eat my breakfast late my blood sugar will go up even though I haven’t yet eaten. I think it’s my body pumping out glucose in the absence of breakfast. I deal with that by having a small bolus (without food). You could try experimenting carefully with that maybe? Or even just have a small breakfast and bolus for it.

So your corrections aren’t working? I mean if you’re going up and up despite them?
Maybe not having breakfast is causing a problem!! I have my Levemir and take some Novorapid at the same time as I'm going high. Most times it does absolutely nothing and 2 hours later I've gone up 5mmol, just don't get it.
Might have to speak to my diabetic nurse again and see what she suggests as last time she told me to up the daytime Levemir and that's not worked so need to find out whats going on!! Never had problems like this, on the whole I have very good control. Been type 1 for 35 years!!! Maybe a pumps the way forward
Hi and welcome

How long have you been diagnosed and is this something that has just started happening recently?
When do you inject your Levemir ie what times of day?
What sort of fasting readings do you usually get and how do they compare to your bedtime readings?
Could it be that the mornings when it doesn't happen are following a particularly active day or a day when you did significantly more exercise. The effects of exercise are usually seen up top 48hours afterwards.

I get "Foot on the Floor" rather than DP which is much more convenient and I just inject 1.5-2 units of bolus insulin as soon as I get out of bed to cover it.

The fact that yours continues to rise throughout the day until after lunch suggests it might be a shortage of basal insulin as well as DP or FOTF
Been type 1 for 35 years. I do Levemir twice daily 9am and 9pm.
I don't do any significant exercise to change blood sugar. The most I do is walking. I've been advised already by diabetic nurse to up Levemir which I've done a couple of units over the past 2 weeks, not done anything really.
On the whole I've had good control over the years so I'm just not getting whats happening these last few weeks.
 

KS76

Member
Relationship to Diabetes
Type 1
Welcome to the forum @KS76

Dawn phenomenon is indeed a thing and a bit of a pest. It is the release of cortisol to get us going that then causes us to release some glucose. I do find injecting early for my breakfast before I even let my feet touch the floor helps. Timing of this took a bit of trial and improvement.

You mention that you are on Levemir. When I was on injections I found it useful to split my Levemir to do a morning and evening dose. That way I was able to adjust the morning one for what I had planned for the day, without impacting my nighttime dose.

There are other suggestions on here, and you can tap into them using the search facility for Dawn Phenomenon.

I hope that helps
I do split the Levemir to morning and evening. So do you take different amounts for different days? Didn't know you could fluctuate it daily.
I will look at the search facility...thanks
 

rebrascora

Well-Known Member
Relationship to Diabetes
Type 1
Have you had a Covid vaccination recently? That has been cause for higher levels and spikes for no good reason for some of us.
 

SB2015

Forum Host
Relationship to Diabetes
Type 1
I am now on a pump, but when I was on injections, if I had an active day ahead I used to adjust my Levemir. I had different rates for work days and for weekends. I suggest you ask your DSN about adjustments.

I had big problems with DP and also needed a variable basal rate overnight to avoid night time hypos. That was what drove me to ask for a pump. With this I am able to adjust my basal insulin hour by hour to match what I need. This also helped me sort the DP as I was able to up my basal insulin a couple hours before I got up.
 

rebrascora

Well-Known Member
Relationship to Diabetes
Type 1
I do split the Levemir to morning and evening. So do you take different amounts for different days? Didn't know you could fluctuate it daily.
I will look at the search facility...thanks
I alter my evening Levemir on an almost daily basis depending upon what I have been doing through the day. A brisk walk will cause my night time levels to drop dramatically unless I reduce my evening dose although my daytime needs stay pretty stable. I am currently using 17 in the morning and just 3 at night but sometimes I have to reduce my evening dose to zero otherwise I hypo. That is the great thing about Levemir in that you can adjust it and get almost immediate results, whereas some other basal insulins take 3 days for any changes to have the full effect.
 

KS76

Member
Relationship to Diabetes
Type 1
Have you had a Covid vaccination recently? That has been cause for higher levels and spikes for no good reason for some of us.
Yes I had the jab 2 weeks ago, so maybe it has got something to do with the high readings. However it was happening just before the vaccine was given.
 

KS76

Member
Relationship to Diabetes
Type 1
I alter my evening Levemir on an almost daily basis depending upon what I have been doing through the day. A brisk walk will cause my night time levels to drop dramatically unless I reduce my evening dose although my daytime needs stay pretty stable. I am currently using 17 in the morning and just 3 at night but sometimes I have to reduce my evening dose to zero otherwise I hypo. That is the great thing about Levemir in that you can adjust it and get almost immediate results, whereas some other basal insulins take 3 days for any changes to have the full effect.
Thats really interesting to hear. I'm on 18 in the morning and 3 at night. I do tend to hypo at night so knowing I can adjust it daily is really good to know. I thought it took about 3 days to take effect so thanks for that, I might be able to sort out my blood sugars a bit easier now.
 

KS76

Member
Relationship to Diabetes
Type 1
I am now on a pump, but when I was on injections, if I had an active day ahead I used to adjust my Levemir. I had different rates for work days and for weekends. I suggest you ask your DSN about adjustments.

I had big problems with DP and also needed a variable basal rate overnight to avoid night time hypos. That was what drove me to ask for a pump. With this I am able to adjust my basal insulin hour by hour to match what I need. This also helped me sort the DP as I was able to up my basal insulin a couple hours before I got up.
Thanks for your response. I will speak to the diabetic nurse and look into a basal injection before I get up and get that high surge!! I might push for a pump a bit quicker too with the issues I'm currently having. Thanks again for the info.
 

Freddie1966

Well-Known Member
Relationship to Diabetes
Type 1
Hi and welcome

How long have you been diagnosed and is this something that has just started happening recently?
When do you inject your Levemir ie what times of day?
What sort of fasting readings do you usually get and how do they compare to your bedtime readings?
Could it be that the mornings when it doesn't happen are following a particularly active day or a day when you did significantly more exercise. The effects of exercise are usually seen up top 48hours afterwards.

I get "Foot on the Floor" rather than DP which is much more convenient and I just inject 1.5-2 units of bolus insulin as soon as I get out of bed to cover it.

The fact that yours continues to rise throughout the day until after lunch suggests it might be a shortage of basal insulin as well as DP or FOTF
This is what I do after trial and error this works for me as well
 

KS76

Member
Relationship to Diabetes
Type 1
Hi everyone. I just wanted to keep you up to date after speaking to DSN. I'm having too many hypos during the night so this could be affecting the morning highs. I'm speaking to them again on Tuesday to look at few days of readings (On Libre 2) However I've not had a hypo in the night and today and my readings so far are:
7.40am 10.3
8.50am 17.8 (gave 4 bolus to correct + 17 basal)
10.15am 19.7
12.15pm 16.2 (gave 6 bolus, had lunch 40g)

Given extra insulin with lunch as still high. The 17 basal has come down because DSN said I was on too much (19) and was low in evenings.
Why has the bolus not brought me down from such a high reading? What is this all about??
Please can anyone suggest something that may help.
 
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