Treating Dawn Phenomenon

[Hellybell80]

Morning all. Type 2
Over the last few weeks I've been getting high sugar levels from 2am onwards. Up to 16mmol. Waking up on a high.
I eat about 6pm. Take my nova rapid and go to bed normally on about 7mmol. Take my lantus before I go to bed.
I've been prescribed libre 2 for the last few months which has been great to help me monitor my sugar levels. Helps me see what's going on through the night.
I go to bed by by 9pm and get out of bed between 3.30am and 6am.
My sugars surge around any time between 12am and 3am. Quite a steep incline and stays there till about 6am and comes down to about 7-10mmol.
I did try to up my lantus but it affected my daytime sugars making my base levels too low. I'm not an eater I have 2 latte coffees in the morning then don't really eat till 3pm.
So that's all the the basic info
So the question is how do I combat this high sugar levels through the night? It's making me sleep badly and sweating profusely through the night. Not pleasant. Plus I've had good control over the last 8-9 months and my lasts HBA1C was 50. When before it was 98
I've read that using long acting insulin dosnt really work to crease out that jump.
Also I know the best way is to counteract it is by using a pump. But I guess as a type 2 that pumps are not given. Is that correct?

 

[Inka]

You could try having your Lantus a little earlier @Hellybell80 That might help a bit. Yes, you’re right that a pump helps but they’re not available to Type 2s. Another thing you could try is a different basal - one with a more pronounced peak of action. Your DP could be so pronounced because you’re having to get up so early, so my final (and not joking) solution is to consider looking for a new job.

 

[Hellybell80]

You could try having your Lantus a little earlier @Hellybell80 That might help a bit. Yes, you’re right that a pump helps but they’re not available to Type 2s. Another thing you could try is a different basal - one with a more pronounced peak of action. Your DP could be so pronounced because you’re having to get up so early, so my final (and not joking) solution is to consider looking for a new job.

Ha my job doesn't get me up early. It's just a natural waking response for me. I'm just weired lol.
I'll try taking it earlier to see if it helps. If it doesn't help I'll see if I can try a different basal.
Does it matter if I take my nova and my lantus at the same time?

 

[Hellybell80]

Plus it's about 6-8 hours after taking my lantus. Would this really not be working enough to combat this by then?
I'm aware it's up to a 24 hour dose. But surely at 6-8 hours it should be about right.

 

[Inka]

Ha my job doesn't get me up early. It's just a natural waking response for me. I'm just weired lol.
I'll try taking it earlier to see if it helps. If it doesn't help I'll see if I can try a different basal.
Does it matter if I take my nova and my lantus at the same time?

Oh! Well, in a way that makes it easier (never fun job-searching!). Could you try moving your sleep times later gradually? That might help you over all too as I believe night shifts/poor sleep is associated with a higher risk of Type 2.

No, it doesn’t matter if you take the Novorapid and Lantus at the same time. Just don’t inject them in the same place.

 

[helli]

Hi @Hellybell80
Sorry to read about your experiences with an annoying DP.
Sadly, many of us have to manage it and some find it more pronounced than others.
I have a few thoughts based on my experience
- despite what it says on the "tin", the profile of Lantus is not completely flat for 24 hours. For many of us has a small peak after 5 hours and does not last the full 24 hours. Whilst not ideal, this may give you the opportunity to exploit its imperfections. If you take your Lantus later, the 5 hour peak may coincide close to the time when your BG starts rising. And, because it does not lats the full 24 hours, some people benefit from splitting the dose so you can have slightly less in the morning for the day. This is not as flexible as Levemir which lasts about 12 hours but could be worthwhile experimenting if you feel able.
- whilst the rise at 2am is most likely to be due to DP, if you eat higher carb and high fat foods for evening meal such as a curry or pizza, the BG rising affect can last many hours into the early hours of the morning. I am not suggesting you are feasting on pizza and curry every night but wondered if a low carb evening meal may help.
- I am pretty active and do a lot of exercise. I find my DP is more pronounced when I have not been able to get to the gym. I think this is due to the exercise using up some of my glucose reserves so my liver has less available to dump in the morning on days after exercise. So my suggestion would be to try some exercise most days. This does not have to be running a marathon but something which raises your heart rate.

I hope this helps.