(Almost) perfect solution to Dawn Phenomenon

[DeusXM]

I think I've cracked the key element of dawn phenomenon - at least, in my case anyway.

At the start of the year, I was working a job from 12pm to 8pm. I'd usually get up around 10ish, not have breakfast and then have lunch around 1ish. I always used to have high BGs in the morning - anything from 9-12mmol/l.

Then when I started a new job, I was working 9-5 hours, getting up around 7am. I was still waking up with high BGs, so I was told by my dietician to start eating breakfast. After a couple of weeks, I was waking up with BGs rigidly between 4-5.

For the last couple of months I've been skipping breakfast and my morning BGs have been steadily creeping up. So starting tomorrow, I'm going to start having breakfast again. It might be that you're able to offset DP too - logically, if your body is expecting some carbs first thing in the morning, it won't feel quite so obliged to provide you with some itself!

[corwin]

That's interesting, I was told before by my endo that I should eat breakfast to avoid DP. I figured that when I'll start having DP I'll start having breakfast and it never happened. What I generally do is have coffee first thing in the morning, with just enough sugar to bring me to about 100-110. If I go by your theory, maybe this tiny amount of sugar is enough to avoid DP.

[Stuboy]

i've only started eating breakfast sinse diagnosis and my morning BG's in the past couple of weeks (sinse i dropped my insulin to 12, not 10 units) have been between 4 and 6 mostly. If only they'd stay that way throughout the day! lol

[mg_2204]

I'm glad you've found a way that works for you :) :) :)

Only as a teenager (when dinosaurs roamed!) did I skip breakfast. I always have breakfast (my fav meal of the day!) but I suffer from DP anyway. Only when I eat a small protein before bed DP seems to be less worse. But I still have mornings when BG is up in the curtains. I hate DP. With a passion.

Keep us posted how it goes.

[ProudNanaof5]

I used to experience DP until endo put me on Lantus and Symlin. Don't know which one helped but something did. I no longer have DP. :hmmmm2:

[Penny]

I have always eaten breakfast. The only way I can avoid DP, is to get up between 2 or 3 hours earlier than normal, eat and inject some Novlog. I am going through a really bad spell with DP, anywhere from 160 to 200. Then from about lunch on, I have really good levels. Makes me mad, too. I work so hard to keep my levels good!

[spike]

The solution for my DP of 18 years was to go on a pump. :)

[rchabot]

I have always had a problem with dp, mroning bg 135-155. since getting diabetes I now eat breakfast, never did before. I finally got my early morning bg down under 100 by eating early somewhat light dinner of mostly protein and or salad, very little or no carbs. I too hate dp. Thank you for the thread

[DeusXM]

It's not a perfect solution - obviously if you're already eating breakfast, it's not going to help you. However if you don't eat breakfast, you're basically encouraging your liver to chuck out glucose to give you energy - and unfortunately you can't control how much or when your liver gets excitable. But if you eat a regular breakfast, you can control that, and it gives your liver a rest.

[Clint]

for me, my DP starts while I am still asleep...

[spike]

for me, my DP starts while I am still asleep...

Mine starts around 3 AM, no matter if I'm asleep or have gotten up early for an early-start road trip.

[Clint]

min is around 4-5am or so...

[Lynne1]

Mine starts around 3 AM, no matter if I'm asleep or have gotten up early for an early-start road trip.
How many hours before the start of dp do you increase your basal? 1 1/2 hours? I think I read that in PI.

[DeusXM]

for me, my DP starts while I am still asleep...

Presumably so did mine too - I woke up with high BG. The point I'm making is that if you eat breakfast in the morning, your liver is less likely to think 'Oh, he's getting up in a few hours. Better start pumping out the sugar because the lazy sod certainly won't be feeding us when he gets up.'

[JasonJayhawk]

That's interesting.

Has anyone found the DP to be related to the meal they have the evening before bed? I've found that slower digesting meals seem to cause my morning hyperglycemia, but never considered looking back on breakfast from the day before.

If I test immediately out of bed and 30 minutes out of bed, I usually rise 40 to 60 mg/dl. A couple units of fast-acting are pretty much always required to halt the rise. I find it somewhat of a fun challenge to beat it by injecting those units before I'm even standing up to catch that peak as it's happening.

[DeusXM]

Has anyone found the DP to be related to the meal they have the evening before bed? I've found that slower digesting meals seem to cause my morning hyperglycemia, but never considered looking back on breakfast from the day before.

Ah, well that's probably not DP then - that's simply the carbs from the meal you ate earlier eventually getting into your system, as opposed to your liver getting all excited.

[spike]

Ah, well that's probably not DP then - that's simply the carbs from the meal you ate earlier eventually getting into your system, as opposed to your liver getting all excited.

Good point. anyone with gastroparesis also will have more of an issue with such delayed bg increases.

[Lynne1]

That's interesting.

Has anyone found the DP to be related to the meal they have the evening before bed?

Happens to me all the time. If I eat a lowish fat and carb meal around 6pm I wake up w/ok #s. If I eat later than 6pm or eat a larger or fattier meal I have to correct several times during the night to get my numbers back down. I even have a problem if I have a fatty snack in the afternoon. I love cheezits but they don't like me. However, if I have fruit, all's well. I think the fats cause increased insulin resistance during the evening hours for me and it messes w/my am numbers.

[Clint]

DP happens to me no matter what I eat or dont eat... I wish it didnt but it does...

[Lynne1]

DP happens to me no matter what I eat or dont eat... I wish it didnt but it does...
Me 2, but it can be worse depending on what I've eaten.

[JasonJayhawk]

Happens to me all the time. If I eat a lowish fat and carb meal around 6pm I wake up w/ok #s. If I eat later than 6pm or eat a larger or fattier meal I have to correct several times during the night to get my numbers back down. I even have a problem if I have a fatty snack in the afternoon. I love cheezits but they don't like me. However, if I have fruit, all's well. I think the fats cause increased insulin resistance during the evening hours for me and it messes w/my am numbers.

Good to know I'm not the only one with this issue. I've only been T1 since March '04, and my A1c's have always been below 6%, so I didn't think gastroparesis to be a factor, though it made me wonder.

You must have smelled Cheezits in the air! I was just munching down a quarter of a box of them. I get the newer "Reduced Fat" Cheez-Its, although I have to practice proportion control.

I do best with a "high carb", very low fat, and low to moderate protein dinner. Ice cream in front of the TV is an invitation to wake up at 1 to 3 AM feeling yucky.

[JasonJayhawk]

DP happens to me no matter what I eat or dont eat... I wish it didnt but it does...

What kind of basal insulin are you on, and have you played with the doses to fight it off?

I might have it, but wouldn't know unless I lowered my basal dose. :ridinghor

[ProudNanaof5]

I think my Symlin at Supper meal has helped my DP most likely. It slows the digestion of food down and doesn't allow the sudden spike I used to have. I do believe the combo of the Lantus I take in a.m. and the Symlin I take with each meal has taken care of my DP. My DP in the morn used to be in the 200's and now I am having 90 - 100 when I first wake up. :dontknow: Something is working

[JasonJayhawk]

When I tried Symlin for two months, I found that it delayed my digestion even longer. My boluses were smaller, but I had to increase my basal to cover the slower digestion. In the end, I was using the same amount of insulin per carbohydrate injested.

[Pattyh]

That is very interesting. My son has DP and has since diagnosis. He's 14 now and on a pump. It has aleviated some of it, but it's creeping up again, and I'll be spending sleepless nights checking sugars at 2:30 am and 4:30 am again until we can get it back under control. I'm going to make him eat breakfast, he's a teen and on a pump he doesn't eat breakfast. Good to know, I'm going to try it, I'll let you know how it works. Thanks

[mg_2204]

Has anyone found the DP to be related to the meal they have the evening before bed?

I would be tempted to say it's not true in my case. Sometimes fasting sugars are low (below 6 mmolL) after a lasagna with plenty of garlic bread... and sometimes they're up in the curtains.

That's what I find most frustrating about DP. Even if I do all the right things, it's always a gamble. Can be high. Can be low. I never know what to expect. I have noticed that with a small protein before bed it makes DP less worse (fasting sugars can go as high as 12 mmolL without) but I still have the odd morning at 8.5 or 9 mmolL. Must depend on phases of the moon...

:)