Dawn Phenomenon??

[chimp]

For years I was taking varies forms of long acting insulin and it didn't work. So in order to combat the DP, I was giving myself a 20 unit jab to combat the rise that happened every morning. A diabetic nurse informed me that Levemir doesn't work, and I was given Lantus SolaStar. It worked straight away.

 

[Inka]

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.

First I’d try correcting as soon as you get up if you’re 10. You need to nip the rise in the bud. Leaving the 10 uncorrected could have contributed to your rise to 17.8.

Also, try having your basal earlier too so that can get going quicker.

Thirdly, get some breakfast in. Some of the rise could be your body pumping out extra glucose because you’ve had no food. You could have a small breakfast of say 20g plus a bolus. You might need a higher mealtime ratio for it, sometimes a lot higher.

Fourthly, in the circumstances you’ve described above, I wouldn’t have eaten at 12.15pm with a BG of 16.2. You’ll just be more insulin resistant and push your BG higher. It also means you’re unable to see if your 8.50am correction finally got you down.

Get the insulin in early. If you don’t, you’ll probably find it much harder to get back in range basically. You should also be upping your correction ratio if you’re above 12 or 13.

 

[KS76]

Thanks for your reply

First I’d try correcting as soon as you get up if you’re 10. You need to nip the rise in the bud. Leaving the 10 uncorrected could have contributed to your rise to 17.8.

Also, try having your basal earlier too so that can get going quicker.

Thirdly, get some breakfast in. Some of the rise could be your body pumping out extra glucose because you’ve had no food. You could have a small breakfast of say 20g plus a bolus. You might need a higher mealtime ratio for it, sometimes a lot higher.

Fourthly, in the circumstances you’ve described above, I wouldn’t have eaten at 12.15pm with a BG of 16.2. You’ll just be more insulin resistant and push your BG higher. It also means you’re unable to see if your 8.50am correction finally got you down.

Get the insulin in early. If you don’t, you’ll probably find it much harder to get back in range basically. You should also be upping your correction ratio if you’re above 12 or 13..

 

[KS76]

Thanks for your reply

I did another scan at 3pm and I was 3.7 so have come flying down so had something to eat.
Up and down today!! Bolus has worked eventually and the basal too!!!

 

[Inka]

I did another scan at 3pm and I was 3.7 so have come flying down so had something to eat.
Up and down today!! Bolus has worked eventually and the basal too!!!

Ok - so nipping the rise in the bud will hopefully help avoid dropping later too. Everyone varies slightly but I find I normally start dropping at 2hrs for a high that’s below 11 very approximately, but if I was say 15, it could be 3 hours plus before I see movement and it starts to drop.

So correcting your 10 would hopefully help stop this cycle of high-high-high-drop you’re having. If it helps you, you can get half unit pens so you can have a more accurate correction dose.

Another thought looking at what you described above is that your lunch contributed too and helped stop your body pumping out glucose. That is, the combo of food plus bolus was what helped.

 

[Jenny101]

I have been a type 1 diabetic for 47 years. I had been struggling with my sugar levels for decades until December 2018 when a new (wonderful) doctor allowed me to have the Libreview sensor which then led on to me have a pump. I had been constantly explaining that my sugar levels rose in the morning and fell dramatically in the afternoon but wasn't getting any helpful information. I discovered that my sugars naturally rose at approximately 5am (dawn phenomenon) and continued until approximately 11am. I injected fast acting insulin for breakfast at 6am and injected another correction dose about 9am every day. During the afternoon my sugars would drop very quickly between the hours of 3pm and 6pm. Now that I have a pump I can correct all this. I have more insulin (humalog) 4am - 9am and NO background basal insulin 11am - 5pm. Blood sugars are now really good. i hope this is of some help.

 

[KS76]

I have been a type 1 diabetic for 47 years. I had been struggling with my sugar levels for decades until December 2018 when a new (wonderful) doctor allowed me to have the Libreview sensor which then led on to me have a pump. I had been constantly explaining that my sugar levels rose in the morning and fell dramatically in the afternoon but wasn't getting any helpful information. I discovered that my sugars naturally rose at approximately 5am (dawn phenomenon) and continued until approximately 11am. I injected fast acting insulin for breakfast at 6am and injected another correction dose about 9am every day. During the afternoon my sugars would drop very quickly between the hours of 3pm and 6pm. Now that I have a pump I can correct all this. I have more insulin (humalog) 4am - 9am and NO background basal insulin 11am - 5pm. Blood sugars are now really good. i hope this is of some help.

Hi yes it has given me an insight into how you managed it. I'm on a waiting list for a pump and I do believe it will get me out this blood sugar mess. Luckily I'm on the Libre too so its easy to test all the time. I keep in touch with my DSN so I am pushing a lot to get the pump. I don't see why I need to keep waiting, I've been diabetic 35 years and running out of injection sites. It would also be nice to get a full night's sleep as I'm up at least twice dealing with sugar levels. I would like to have a day where I feel good as when I'm high I feel awful and with this happening so much I hate it.

 

[everydayupsanddowns]

DP and FHTF can be a frustrating runaround. Especially when Mr Liver suddenly decides to change the rules and not dump the ‘usual’ amount of glucose without warning!

 

[Ditto]

Hello and welcome to the forum @KS76 🙂