Is this dawn phenomenon?

[firemangtp]

I have always had good control of my diabetes, (atleast when eating and reading corectly)

Im on the minimed pump, novolog...


4 days ago I noticed my sugar went from 180 prebed to 400 at waking!

So the next night I was very careful on snacks etc, had no food 2 hours before bed... BGL went from 120 before bed to 280 in the morning,

Then day 3 and 4 even more stringent on the late day carbs, went from 100's at bed and woke just 3-4 hours into sleeping and it was mid 300's! Bolused correction and still had 180-190 in the a.m. :confused:


A week ago I could fast for hours and sleep all night with almost NO change.

What could be causing this? It's SO agrivating!

I cant think of anything that had changed n my diet, habits etc. either.

Thanks to anyone who can help!:(

[UpNorth]

Sounds like you might need to take a look at your night basals.
How long have you had diabetes? How long pumping?

[morrisma]

Certainly check your basals. This happened to me when I adjusted the time on my pump and switched am to pm by mistake. That was a wild few days.

Dawn Phenomenon is best confirmed by waking halfway thru the night to see if you are roughly where you started at bedtime or quite a bit lower. If you are stable thru the first half of the sleep cycle, it is probably a dawn phenom. If you have dropped it's a Somogyi Effect which causes you do drop low during the night and experience a liver dump as a result.

Both have you high in the morning but are corrected differently.

[firemangtp]

Thanks guys,

Been a diabetic for 19yrs, I have been on the pump about 10.

My night time basal is .9/hr it was around .7 to .8 but I upped it a few weeks ago because my am BGL was always around 160.

That worked great until this happened. Before that change, I have been on the same basal for almost 10 years with very little need to alter it.

I actually HAVE woke up 1/2 way through the night and my sugar was already in the 300's! :(

Because the numbers jump so crazy, it seems different than the usual "high" associated with DP. Every time I hear about that, (DP) it seems to be 180-ish to low 200's, not 400's or 300's half way through the night like me.

[Glucoweb]

Sounds like you might need to test at some intervals through the evening, I know it stinks, but needed to determine when your dawn phenomenon might be occuring. I suggest 3 and 5 at least that is what helped me out.

[xMenace]

I'm not a big believer in Symogi effects, but supposedly it happens.

Things change as we age. Perhaps it has just caught up with you.

It is also possible something else is going on such as an infection. You may want to get chacked out. If you raise your basals to accomodate this, pay close attention to them.

Have your sleep patterns changed?

[xMenace]

Sounds like you might need to test at some intervals through the evening, I know it stinks, but needed to determine when your dawn phenomenon might be occuring. I suggest 3 and 5 at least that is what helped me out.

I even pulled an all-nighter once, testing every 30 minutes.

[firemangtp]

Hmm,

No, no change in sleep.

I am afraid to raise the basal (it would be nearly double to correct it by the recent changes!) ...Of course in baby steps.

But the a.m. correction is like 10 units, thats about what I get over night now (actually, less!)

Anyway, for this to come on so fast, I would fear it could also stop, and leave me VERY low.
This would cost me my job as a fireifhgter if they found me out cold at work one night. (not so good)

So the only alternative other than upping the basal is to continue to monitor and hope I see a pattern.

A coworker is also diabetic and recomender getting my doc to put me on a 24hr BGL monitor that can give him my hourly sugar levels.

I will be calling the Dr Monday if this pattern continues over the next few days.


Thanks again for all the input!

[firemangtp]

Quick note...

Last night was 100 before bed, no meals, etc in 3+ hours,

Woke @ 5:00 with it at 289. Atleast not in the 300's this time.

[morrisma]

If you can, get the cgms loaner from the doc. You can sleep while it measures. Medtronic has one my doc uses for all his pump patients to get basals better.

[xMenace]

Hmm,

No, no change in sleep.

I am afraid to raise the basal (it would be nearly double to correct it by the recent changes!) ...Of course in baby steps.

But the a.m. correction is like 10 units, thats about what I get over night now (actually, less!)

Anyway, for this to come on so fast, I would fear it could also stop, and leave me VERY low.
This would cost me my job as a fireifhgter if they found me out cold at work one night. (not so good)

So the only alternative other than upping the basal is to continue to monitor and hope I see a pattern.

A coworker is also diabetic and recomender getting my doc to put me on a 24hr BGL monitor that can give him my hourly sugar levels.

I will be calling the Dr Monday if this pattern continues over the next few days.


Thanks again for all the input!

I don't promote doing what others do, but if it helps, I tend to bottom out around 2am and stay low. I then skyrocket at dawn.

My basals go like this

12am .7
1am .7
2am .7
3am .7
4am .7
5am 1.3
6am 1.85
7am 1.85
8am 1.85
9am 1.15
10am .6
11am .45

Where your job depends on it, I think I'd definately consult with your endo to try and find an explanation.

As a firefighter, do you work shifts? Has the pattern changed?

Have you had a weight or activity change?

:stupido:

[firemangtp]

So I'm "normal" again! :D

After ANOTHER high night I was about to increase my sleeping basal rate and I realized somthing pretty wierd about the basal settings on my pump...

"00:00 to 08:00 : 0 U/hr"

My brain instantly shot back to last week when a was bumbling through the menus trying to give a bolus and accidently got into the basal menu, backed out without changing anything (or so i thought) and went on my merry way.

So today i fixed it back to the 0.8 U/hr that I was supposed to be on. Im sure I'll be fine now.

Thanks so much for the ideas everyone! Sorry to waist your time with my idiotic fat fingering. :o

This website is SO great! Even though this time it didnt "solve" my issue, its such a great feeling knowing there are others out there that I can bounce ideas and questions off of. :)

[xMenace]

So I'm "normal" again! :D

After ANOTHER high night I was about to increase my sleeping basal rate and I realized somthing pretty wierd about the basal settings on my pump...

"00:00 to 08:00 : 0 U/hr"

My brain instantly shot back to last week when a was bumbling through the menus trying to give a bolus and accidently got into the basal menu, backed out without changing anything (or so i thought) and went on my merry way.

So today i fixed it back to the 0.8 U/hr that I was supposed to be on. Im sure I'll be fine now.

Thanks so much for the ideas everyone! Sorry to waist your time with my idiotic fat fingering. :o

This website is SO great! Even though this time it didnt "solve" my issue, its such a great feeling knowing there are others out there that I can bounce ideas and questions off of. :)


I never would have considered that. Wow. I guess it's a good idea to review our rates directly on the pump whenever things get screwy.