Dawn Phenomenon again I'm sure

[CrazyGramma]

I am one of the new kids on the block from Canada. Joined today. Looks like a good place to be! Pumping for 20 years and would be interested in basal rates to combat dawn phenomenon. Have know about it for years. My endo is fabulous and has for 22 years always given me the info and let me run with it. He feels that I am currently using too much insulin. He has challenged me to prove him wrong. (smart man - has prompted me to research like crazy). It has been 2 weeks and I already know he is right - lowered the basal across the board by a wee bit, reset carb ratio and correction (psychologically very hard to do) and voila! feeling incredibly better. Still having trouble with the dawn phenomenon though. I normally just throw lots of insulin at it which isnt that good an idea as it turns out. Looking forward to some great ideas!

[BlueSky]

... Still having trouble with the dawn phenomenon though. I normally just throw lots of insulin at it which isnt that good an idea as it turns out. ...
I am curious. Why is throwing insulin at the dawn phenomenon not a good idea?

[Emm]

It is a good idea to throw insulin at DP!
It's not a good idea to overdo it :D

Are you increasing your basal just before the DP hits? (Have you tested repeatedly overnight to see what time it hits?) And then decreased it again whenever you need to (more testing) in the morning?

You'll probably find that just increasing your basal by a tiny dribble somewhere around 5am (depends on your schedule of course) is all it takes. BUT... we're all so different. And I'm not a pumper, so I'm not talking from experience - although I really wish I was!

Tell us what you already do, that may help us offer advice :)

And welcome to DF!! Great to have you here. Sounds like you have a great endo!

[Gary_W]

Even the low carb folks here (such as BlueSky) seem to take more insulin in the morning due to DP, so either your doctor has some odd ideas or there has been a slight misunderstanding. Some pump manufacturers have parts of their marketing literature that is directly aimed at those of us who get DP and tells us that a pump is a very effective way of combatting it purely because you can run at a low basal for the early hours of the morning (when most people's requirements are at their lowest) and then ramp it up as appropriate as dawn approaches.

I have yet to pump (fingers crossed as I type, which makes it difficult!) but I am led to believe that altering the basal an hour or two BEFORE the change in your body's requirements is the way to do it with pumping. I'm obviously speaking as an outsider who hasn't yet done it in anger, so this is pure hearsay on my part :)

Gary

[Clint]

In order to effectively combat DP, you need to figure out when your body starts this process. Then and only then can you correct it. For me personally, I start raising my basal @ 3am slowly until 6am and then I back off @ 7am.. Once you know when your BS starts to rise, you will know when to start increasing your rate to fight it. my 2 cents ;)

[Jan B]

Here's what I do to combat DP & it works great.

I eat low-carb, pump, and my TDD (total daily dose) is about 18

My current basals are a little pyramid (I had more before Spring came):

12a - .6
5a - .65
6:30a - .7
9a - .65
2p - .6

[Cyborg]

My DP kicks off when I wake-up. I have 2 basal profiles set. One for waking early during weekdays, etc., and one for when I'm going to sleep in. In both cases, I have bolus reminder alarms set to go off to awaken me. My basal is increased and lowered as follows:

work days:

12.00 - 1.525
5.30 - 3.000
6.30 - 3.500
8.30 - 1.750
11.00- 1.575

I usually sleep in an extra 1.5 hours on weekends, so the start time is shifted by that much. I also slightly lower my midnight basal and my 8 am basal in case I want to sleep in even later. This gives me a little buffer to sleep later and a small bolus in the morning (if needed) will quickly bring my bg back down.

week ends:

12.00 - 1.500
7.00 - 3.000
8.00 - 3.400
10.00 - 1.750
12.30 - 1.575

If I have alcohol the night before, I simply switch to another basal profile that is set a constant 1.5, my lowest setting. Alcohol stops my DP from occurring so the extra insulin is not required. I simply switch back to the correct profile for the day sometime before noon, the exact time depending on how much I had and what time I woke...


:vroam:

[CrazyGramma]

I just did a reply and lost it somehow. so here we go again. Wow. This is the place to be. Have gained a lot of weight, been super tired, crabby and intolerant with too many lows around 5pm. Feeling like I have a wet blanket on. Looks like I have my basal set too hi too early in the morning. Been searching for the time the DP hits, I need to get the basal lowered so I can see the pattern. Here is two weeks ago Midnight .6 4am 1.85 8am.45 2pm .4 7pm.5. This would still result in 6am to noon rises. I have worked it down to this over two weeks. Midnight .35 3am.95 5am1.3 noon .5 10pm .35. Have been seeing improvement in bg's over the last two weeks so I'm sure its the way to go. My target daily insulin is 30-32 units and am actually using avg 36. I have gotten quite lazy over time. Have been cultured to fear hi bg's thus have been correction bolus crazy and have neglected the lo thus rebounding probably around midnight. So testing at 9pm, 12 mid, 3am, 8am should allow me to catch the start of the DP. It is very interesting to me that lowering my insulin across the board has improved things greatly. I feel like I should know better being at this for so long. But wait we have lives too right?

[CrazyGramma]

It never occured to me that the DP could actually start on waking. Geez I'm so behind.

[CrazyGramma]

What's a type 1.5

[Jan B]

Keeping it simple . . . . Type 1.5 is basically a Type 1, who got diabetes after they were an adult. They were very often misdiagnosed as a Type 2 because of their age. Someone will come along and be more precise I'm sure!

[CrazyGramma]

Thanks much for the info. Feeling much more focused as it is a comfort to know that many of you work at good control and that DP can be managed with especially seeing a few different profiles. Great to be here!

[Glucoweb]

After reading this post, I made some adjustments to my pump's early morning programming and this morning has slightly better numbers for my first BG test. I apln to keep tweaking it a little more and see what happens, My issue is I sleep so deeply, that checking my BG if I wake up at night would be hilarious to watch. I am soooo groggy. Even opening my eyes feels like a monumental task.

[morrisma]

Someone on another DP thread mentioned having a glass of wine before bed to keep the liver busy and thereby lessening dawn phenomenon issues. Been getting up with 200+ readings way too often and a glass of wine sounds promising on many levels so I tried it the last 2 nights and...

...two great sub-120 mornings. :D I'll continue the experiments and keep you posted.
Mike

[xMenace]

I'm only going to say this once:

BASAL TEST !!!

Your basal rates should keep you flat without food. Mine do:
1am 0.70
2 0.70
3 0.70
4 0.70
5 1.30
6 1.85
7 1.85
8 1.85
9 1.15
10 0.60
11 0.45
12pm 0.45

[palefacegirl03]

I'm only going to say this once:

BASAL TEST !!!





Yes SIR !!!!!!

My numbers have been creeping up for the last week or so, I am going to try and test my basals this weekend and see what is going on. I dont like how my mornings are going.
Takes all day to get right again and then it starts over.

[CrazyGramma]

I get it and will shout to the hilltops as soon as my bg's are flat without food.

Do you know the calculation to conver mmol to dl ie I run in mmol. I know that 6.7 is 120. Easier to talk bgs if I can understand both.

[CrazyGramma]

I dont know about the whole alcohol thing but I'm a newbie so maybe better not to be too opininated.

[xMenace]

I get it and will shout to the hilltops as soon as my bg's are flat without food.

Do you know the calculation to conver mmol to dl ie I run in mmol. I know that 6.7 is 120. Easier to talk bgs if I can understand both.

18 ;)


BTW what part of the tundra do you live on?