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Old 10-11-2004, 02:34 PM
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Waking up

I was wondering if anyone else has the same problem I'm having here.

I have notice that after I wake up, my bg spikes in less than 2 hours. I will wake up with a 100 at 5:15am and by 7am I will be at 280. Then I have to correct all morning to bring it back down to normal. Same thing happens on the weekend but different times. I sleep in until 7.
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Old 10-11-2004, 02:51 PM
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I have had problems like this at times. I can eat just a small amount of food for breakfast and my blood sugar will aim for the stratosphere. I'm taking NPH in the evening so I don't know if it is part of the problem or not.
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Old 10-11-2004, 02:55 PM
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Sounds very familiar. Some of us suffer from a far more pronounced Dawn Phenomenon effect than others. I deal with it by injecting a large correction bolus as soon as I wake up. I do it even if my bg is at the bottom of the target range. Because I know that my bg will rise sharply while I am in tyhe shower and getting dressed. 45-60 minutes after the first shot, I have a somewhat smaller pre-breakfast bolus.

Doing this sort of flattens things out. But timing is critical and you have to make sure that you take into account the overlapping effect of two shots so close together. I find that doing this is the only way I can avoid playing "chase the tiger" for the rest of the day.

Cheers,

Mark
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Old 10-11-2004, 03:27 PM
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This won't be helpful to those of you on insulin, but it might be worth a try if you're on medications. My late husband (also diabetic) had dawn phenomenon problems and, after a lot of experimenting, we found that what worked best was for him to wake up when I got up at 6:30 for work (he was retired), do a blood test (it would usually be around 4.5 to 5.0 (81 to 90), have his pills, and go back to bed. Just before I left for work at 8 o'clock, I'd wake him. He would do another blood test (still low) and then have his breakfast. If we slept in on a weekend, and he didn't have his meds till a couple of hours later, it had started to climb and he'd have trouble with it all day. The same thing would happen if he had his meds at 6:30 and then went back to sleep for more than 2 hours before he had breakfast. So it seemed that his dawn phenomenon started just after 6:30 and if he could catch it by then, he'd be fine for the rest of the day.

Karen
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Old 10-11-2004, 04:26 PM
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My 5am to 9am basal rate is much higher than my 3am to 5am, so in essence, I think I am doing the same thing as Mark. Sometimes around 9 or 10am I have to bolus. Btw, I rarely eat breakfast.
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Old 10-11-2004, 05:23 PM
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Tony are you a pumper or not? Am guessing not with the dawn phenomena problems.

My endo told me to keep the body busy all nite digesting carbs before bed by eating quick and complex carbs. I used to have
1/2 of a zone bar with some juice. Zone bars have 40/30/30
for carbs/fat/prot. My body was busy all nite but my morning
dawn phenomenas disappeared also.

This was not the way I wanted to live my life as I like my body
to be getting rid of wastes and toxins in the middle of the nite -not digesting carbs. I also want to pump so lost another reason
for docs to write the letter.

Anyhow, try something like this and see if it flattens out your bgs.
Trial and error!!<smile>

Tony you might be more ahead by having hormones other
than Growth Hormone active at that time of the morning.*g*

SunniD
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Old 10-11-2004, 05:32 PM
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Tony I have had this problem and it is all in adjusting the pump to different rates at different times. The CGMS helped me with this but I am sure you are working on it my checking your levels lots each day and all the fun stuff that goes with it.
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Old 10-11-2004, 06:57 PM
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Tony,

This sounds very similar to a problem I have been having for a while now. I can wake up in normal range and no matter what I eat for breakfast, I will be in the 200 range 2 hours later. It's so frustrating and aggravating . Then I also have a heck of a time trying to bring my numbers down . This period of time in the morning seems to be when I need the most insulin too, which I don't like, but I guess that's really the only way to handle this. Unfortunately, I haven't been able to get those numbers down, but I know from speaking to my Endo. that at that point in the morning is when the release of cortisol is at it's highest and that's also not working in my favor.

Sorry I couldn't offer you any real advice or suggestions. I just wanted to let you know that I feel your pain, so to speak I guess all we can do is keep monitoring our blood sugar levels and adjusting our insulin doses. Hopefully, eventually we'll figure it out
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Old 10-11-2004, 06:57 PM
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Tony,

I often have the reverse circumstance. I normally awaken with a level between 89 and 110. I have breakfast, get ready for work and have a hypo before leaving the house. I tried reducing my insulin dose, but that leaves me with a high later in the day. For me, the simplest answer is let the hypo come and deal with it. My lows aren't particularly severe, just somewhat irritating.

Travis
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Old 10-11-2004, 09:25 PM
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This morning I got up at 2.30am ( i do shift work) got ready and checked my bgl was 6.5. I had breakfast at 7.00am and it was 15.9. I had one egg and 5 units of insulin checked it at 12.00 and it was 16.9. I don't know whats going on.
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Old 10-12-2004, 04:53 PM
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So it's not just me. That is the first.

This is something new for me. I never had this problem before and just notice last week thanks to my best friend. She has me testing alot. Good thing I'm on the pump. She had me setup a 4am-9am basal rate. That has helped a little. I will have to up that rate some more.
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Old 10-12-2004, 05:27 PM
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Quote:
Originally posted by Tony
So it's not just me. That is the first.

This is something new for me. I never had this problem before and just notice last week thanks to my best friend. She has me testing alot. Good thing I'm on the pump. She had me setup a 4am-9am basal rate. That has helped a little. I will have to up that rate some more.
No it is not just you but you are unique in your own way!!!!! Yep sounds like your friend has you on the right track....better listen to her.
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Old 10-12-2004, 05:38 PM
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Quote:
Originally posted by Belinda
you are unique in your own way!!!!!
Thats what she says!
Quote:
Yep sounds like your friend has you on the right track....better listen to her.
No worries there, I do listen. She does have me on a road of recovery!!
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Old 10-12-2004, 05:44 PM
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[quote]Originally posted by Tony
[b]Thats what she says!


Hmmm sounds like great minds think alike!
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Old 10-12-2004, 05:45 PM
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I used to have a big problem with dawn phenomenon when I was on NPH. Either that, or I would have the Somogyi effect - a low in the middle of the night (without waking) and a rebound high in the morning. Sometimes I wasn't sure which process was taking place!

With lantus my bsl usually stays the same overnight or drops slightly (or a LOT if I have been very active that day). The rise doesn't come until after I wake up, so I bolus almost as soon as I get up, as Mark mentioned. For me it only takes one unit of humalog to keep my bsl steady if I don't eat breakfast. I take lantus AM and PM. When I took lantus at bedtime only, I would go low during the night and be high by 6:00 PM.

Hope this information helps someone else.
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