Dawn Phenomena

[Cyborg]

I'm a little confused as to what classifies as dawn phenomena. Does the rise in bg have to occur before you wake for it to be dawn phenomena? Is it dependent on the time you wake?

[JediSkipdogg]

http://www.diabetic-talk.org/dp.htm

[Cinnabon]

I had this for a real long time, till I got my pump.

[JediSkipdogg]

I had this for a real long time, till I got my pump.

I still have it on my pump. And I'm still trying to decide how I want to go about handling it long term. My problem is it lessons as the day goes on.

If I wake up and eat right away, I have to give basically a 1:6 carb ratio. If I wait say 2 hours and eat it's only 1:10. If I don't eat for about 4 hours after waking up, then it is normal at the 1:19 ratio that I'm on throughout the rest of the day. And during that whole time my BG levels never rise until I eat.

[Cyborg]

http://www.diabetic-talk.org/dp.htm

Thanks for the link, nice site. It does help explain the phenomena. I see where the page says it occurs overnight between 4am and 11am, I guess the "overnight" part, without the 4am - 11am part was misleading in everything else I read. Now I need to figure out if it's time dependent or dependent on me waking.

[JediSkipdogg]

The effect starts when you first sleep. And for some, it can occur with an afternoon nap as well. But you don't see any symptons of it till your body (not you) starts to wake.

[Cyborg]

Jedi, please let me know when you find a way to deal with it. I'll do the same... Thanks

[Cinnabon]

Well, Its pretty simple to determine this. If you go to bed with a normal BS level, dont have anything to eat, and wake with an elevated reading, then your liver is dumping.
There are a few that experience these small dumps later on in the day.

[JediSkipdogg]

Well, Its pretty simple to determine this. If you go to bed with a normal BS level, dont have anything to eat, and wake with an elevated reading, then your liver is dumping.
There are a few that experience these small dumps later on in the day.

Liver dump and dawn phenomenon are two different items. Waking to a high elevetated BG is a result of a liver dump known as the Somogyi Effect. Dawn phenomenon is simply a resistance to insulin in the morning after your body wakes up. Key word being AFTER.

[Cyborg]

Well, Its pretty simple to determine this. If you go to bed with a normal BS level, dont have anything to eat, and wake with an elevated reading, then your liver is dumping.
There are a few that experience these small dumps later on in the day.

I don't wake up with elevated sugars, unless you use Jedi's definition of waking up, in terms of "my body waking up". Perhaps I am getting these dumps later in the day.

(5 minutes passes)

Ok, I just tested both bg and ketones and I believe you are correct. My bg 2 hours ago, when I awoke, was 96. 1 hour ago it was 126 and now it is 145. I have not eaten anything. And I just checked for ketones and I am showing a small amount.

[JediSkipdogg]

Ok, I just tested both bg and ketones and I believe you are correct. My bg 2 hours ago, when I awoke, was 96. 1 hour ago it was 126 and now it is 145. I have not eaten anything. And I just checked for ketones and I am showing a small amount.

That is definitely the dawn phenomenon. And one way to control it is to eat. Basically you will continue to rise until you eat something so your body shuts down it's production of glucose. And when you eat something, you may need more insulin for your first meal of the day than any other meal of the day.

[Cyborg]

So perhaps I need to eat a nice healthy breakfast first thing upon waking in the morning? Or... Since I live in Florida, and we have the best oranges in the world, a glass of orange juice with a bolus!!! The sweat nectar of the gods, forbidden to only high bg for the last 6 years! :D

[JediSkipdogg]

So perhaps I need to eat a nice healthy breakfast first thing upon waking in the morning? Or... Since I live in Florida, and we have the best oranges in the world, a glass of orange juice with a bolus!!! The sweat nectar of the gods, forbidden to only high bg for the last 6 years! :D

Orange juice, the DP devil. You can try it, but usually the OJ will shoot you sky high (since it's mostly sugar) before the bolus insulin has time to take effect. It doesn't have to be anything big. Heck, I've found that eating just one piece of toast (9 grams of carbs) will shut the DP down for the day.

[Cyborg]

Ok, frown on my o.j. parade... :(

[duck]

Are you a "morning person"?

[Cyborg]

With 2 kids, you bet...

Even without the kids at home, I rarely sleep past 8. My internal alarm clock usually wakes me by 7.

I am curious about early morning bathroom breaks though. Wonder if those wake up the body and start the morning phenomena? I don't wake up nearly as much as when my diabetes when uncontrolled, but hey I am still human. :creep:

[duck]

With 2 kids, you bet...

Even without the kids at home, I rarely sleep past 8. My internal alarm clock usually wakes me by 7.

I am curious about early morning bathroom breaks though. Wonder if those wake up the body and start the morning phenomena? I don't wake up nearly as much as when my diabetes when uncontrolled, but hey I am still human. :creep:

The reason I ask is because I am NOT a morning person...I could sleep til noon and still feel like I could use more sleep. But I can stay up all night like there is no tomorrow...

People here who are "morning people", the ones who wake up at the ***-crack of dawn ready to take on the world, seem to be the ones who suffer from DP--That's just my casual observation, and to wit I know of no exceptions. Apparently dumping all that glucose into your system is part of the wake-up process for morning people.

So, are you the kind of person who wakes up refreshed, ready to go, the world is yours...or could you sleep a little more and a little more and little more?

[Cyborg]

I don't jump up outta bed if that's what you mean. I might go back to sleep for a half hour occasionally, but that's about it unless I took a sleeping pill the night before. I do tend to stay up too late, usually between 12 and 1 am weekdays. But I can't sleep in till noon even if I wanted to, my brain just won't let me - always too much to do.

You sound like my current and ex wives, both of which have no problem sleeping into till noon or later. Maybe that's why I get up so early, somebody's gotta take care of the kids (guess I'm in the doghouse tonight if she reads this forum).

[hlchilders]

I am not a morning person by choice, but I have to be at work by 7 so I am forced into this unnatural way of life. If I am understanding this correctly, then I think I have "liver dump" instead of "dawn phoenomenon". When I get up, my bg is high, but the longer I am up before I eat, the lower it goes. On a non-working day when I can sleep in till 9 or 10, my bg is almost in the normal range. If I wait a couple hours before I eat, it goes down even further. So is that "dawn phoenomon" or "liver dump"? Either way, how do I fix it? I got a few ideas and will try those.

[Cinnabon]

I think there is a bit of confusion here, please read...
http://www.diabetic-talk.org/dp.htm

[Cyborg]

Woke up this morning at 7:20 am with a 95 bg. Immediately ate a small can of lite peaches (13 g carbs) and bolused. Thought I'd try to nip the DP in the bud.

No such luck... I was 143 at 8:41 and 165 at 9:35. I'll try eating something different tomorrow to see if that helps, perhaps something with a lower glycemic index.

I'll talk to my trainer tomorrow about adjusting the basal rate to try and compensate for it since I wake at approx the same time. If I have to, I'll set an alarm on the pump to wake myself and kick in the DP on purpose to coincide with the increased basal. Gotta outsmart this thing!

[JediSkipdogg]

Test in 4 hours. 2 hours after eating won't prove if you nailed it or not. At that point the insulin is not even 50% finished working and the food is still working.

[Georgia]

I seem to suffer from DP but as I'm still on the horrible pre-mix insulin (at the moment) it's harder to control as I end up with a hypo if I increase my dose :hmmmm:

[Simon]

Just a thought but when do you take your basal? Could it be running out in the morning?
I'm not a morning person and I have the opposite problem. Need less bolus for breakfast. I wonder if there's a Phd project for someone there...

[Cyborg]

I'm on the pump, so I get my basal all the time. But I will talk to my trainer about switching basal rates around 4 am to a higher rate. Right now I'm switching to a higher rate at 7 am, which is too late in my opinion.

[Cyborg]

IMHO, I should be able to skip breakfast!!!

[Cyborg]

I found this on the net. Maybe this is what is happening:

Dawn Phenomenon -- A precipitous rise in bloodsugar in the hours after waking. Dawn Phenomenon is caused by glucose production in the liver.
Sentence: I am irritated that my basal rate nearly doubles between 6 am and 9 am because of dawn phenomenon.

Sleep-eating -- The act of rising from a sound sleep, proceeding to the kitchen and eating anything you can find. A diabetic often wakes up while in the process of sleep-eating without being able to figure out how they got to the kitchen or why there is ice cream (or other food substance) all over their fingers and face.
Sentence: Last night, my boyfriend found me sleep-eating again; when he was able to rouse me, I was mortified to find I had eaten a 1/2 gallon of chocolate ice cream.

Maybe I'm Sleep-eating :vollkomme

[Simon]

Well I tested this morning when I first got up and I was 6.1. 25 minutes later without eating it was 8.3! I guess the thing to do is have breakfast in bed. :)

[Cyborg]

Good luck, didn't work for me. But I tried something with a rather high glycemic index (small can of light peaches). Last night I tried 15 grams of peanut butter before going to bed, no success.

Today I adjusted my basal rate bumped it up .3 units/hr on the pump 1 hour before waking. We'll see if that has an effect. Will report later...

[duck]

Woke up this morning at 7:20 am with a 95 bg. Immediately ate a small can of lite peaches (13 g carbs) and bolused. Thought I'd try to nip the DP in the bud.

No such luck... I was 143 at 8:41 and 165 at 9:35. I'll try eating something different tomorrow to see if that helps, perhaps something with a lower glycemic index.

I'll talk to my trainer tomorrow about adjusting the basal rate to try and compensate for it since I wake at approx the same time. If I have to, I'll set an alarm on the pump to wake myself and kick in the DP on purpose to coincide with the increased basal. Gotta outsmart this thing!

Dude...I don't see where there's a "problem"?

[Cyborg]

Dude...I don't see where there's a "problem"?


I tend to like by bg below 100...

[duck]

I tend to like by bg below 100...

A whole hour after eating? :questionm

[MarkMunday]

Woke up this morning at 7:20 am with a 95 bg. Immediately ate a small can of lite peaches (13 g carbs) and bolused. Thought I'd try to nip the DP in the bud.

No such luck... I was 143 at 8:41 and 165 at 9:35. I'll try eating something different tomorrow to see if that helps, perhaps something with a lower glycemic index.
I thought a major advantage of a pump was that you can program the basal rate to deal with the dawn phenomenon. I can see how eating can help avoid the rebound effect. But I don't see how it can stop the DP. The DP starts to kick in at like 3 am!

The flat action profile of Lantus is a double edged sword. It doesn't cause lows like NPH. But it doesn't cope with the DP either. I inject NPH the night before to compensate for the DP. And it works very well.

Cheers,

Mark

[Cinnabon]

Thats the only way I beat it, adjusting my basals from 4:30am-7 am.

[Cyborg]

No, I don't expect to keep the bg below 100 immediately after eating. But the experiment was an attempt to stop the DP. And eating only 13 grams of carbs did not do it. My bg rises the same due to the DP with or without the food in the two experiments (one eating immediately upon waking and one eating something high in fat and protein, peanut butter, before bedtime).

I'm trying the early morning change in basal tomorrow as seems to work for Cinnabon... My trainer wanted the basal change to occur at 7 am, I wanted 5 am, so we compromised on 6 am, but I think it will end up closer to 5 in the end... Will report tomorrow.

[duck]

Can you repost your basal rates as they are now? I'm not arguing with you (you'd know better than I would if you were having DP) but your numbers look too good to be DP. Typically, the afflicted here end up much higher than what you are showing. You may indeed have something of a waking liver dump that some of us suffer from, but it's milder than DP...

[MarkMunday]

No, I don't expect to keep the bg below 100 immediately after eating. But the experiment was an attempt to stop the DP. And eating only 13 grams of carbs did not do it. My bg rises the same due to the DP with or without the food in the two experiments (one eating immediately upon waking and one eating something high in fat and protein, peanut butter, before bedtime).

I'm trying the early morning change in basal tomorrow as seems to work for Cinnabon... My trainer wanted the basal change to occur at 7 am, I wanted 5 am, so we compromised on 6 am, but I think it will end up closer to 5 in the end... Will report tomorrow.
When I used the CGMS, we could see that the DP started increasing the blood sugar at about 3am. But then we are all a bit different. It may be worth your while getting hooked up to a CGMS for a few days to find exactly how you work ...

Mark

[Cyborg]

When I used the CGMS, we could see that the DP started increasing the blood sugar at about 3am. But then we are all a bit different. It may be worth your while getting hooked up to a CGMS for a few days to find exactly how you work ...

Mark

I was reluctantly thinking about asking the endo next week about it. Wasn't too excited reading about some of the other posts. It doesn't sound like it's very comfortable, but if it provides useful data, I suppose it's worth it.

[Cyborg]

Can you repost your basal rates as they are now? I'm not arguing with you (you'd know better than I would if you were having DP) but your numbers look too good to be DP. Typically, the afflicted here end up much higher than what you are showing. You may indeed have something of a waking liver dump that some of us suffer from, but it's milder than DP...

Duck, do you want to see basal rates, or morning bg values?

[duck]

Duck, do you want to see basal rates, or morning bg values?

How about both? :wink:

[Cyborg]

Ok, for those that are interested, as of today my basals are set at:

12:00 am - 1.1 u/hr
06:00 am - 1.4 u/hr
01:00 pm - 1.1 u/hr

Before today the basals were set at:

12:00 am - 1.1 u/hr
09:00 am - 1.2 u/hr
01:00 pm - 1.1 u/hr

Last 3 morning bg readings

I've listed when I've eaten and when I've bolused...

02/21/06 (I fasted as I had to do blood work)

01:00 am - bg = 65 (16 grams peanut butter taken)
04:09 am - bg = 73
07:22 am - bg = 87
10:13 am - bg = 116
10:15 - Bolus Taken

02/20/06

07:20 am - bg = 95 (ate 13 grams lite peaches and bolused)
08:41 am - bg = 143
09:35 am - bg = 165 (bolus taken)

02/19/06

01:52 am - bg = 92
07:17 am - bg = 96
08:20 am - bg = 126
09:18 am - bg = 145 (bolus taken)

[duck]

Personally (and this is NOT a criticism but a voiced concern), I think your numbers looked VERY good before today, and I think you are trying to do too much too soon. There are members here who have been on a pump for a while who do not have blood sugar readings this good, and yet within a week of going on a pump, you're trying to get readings better than that of a non-diabetic? I think you're being too aggressive...(I'm worried about hypos down the road).

Okay, let me back up and come from a different angle: What are your goals? Specifically, what do you expect your 1, 2 and 4 hour-post meal readings to be? My goals are based on 2 and 4 hour-post meal readings, and those are (2 hours) less than 140, greater than 120, and 4 hour to be about 120 (in theory, I should have been 120 or so before I ate, but there are variables that I will accept).

[duck]

Oh, I meant to say that you may want to decrease the basal rate between 11PM and say 2AM from the two readings you were able to collect at the 1AM hour.

[Cinnabon]

I agree with Duck about wanting to tighten too fast, too soon. You will go through some time till your body gets used to all this. Its not that high of a rise you are having. The last thing you want is to go low on a pump. (I did, NO FUN!)

[Cyborg]

Oh, I meant to say that you may want to decrease the basal rate between 11PM and say 2AM from the two readings you were able to collect at the 1AM hour.

I had fairly good control of my diabetes before moving to the pump. I was not running a daily 300 like alot of pre-pumpers. My problem on MDI was that I was getting too many spikes and lows. That said, right now I'm concentrating on getting the settings for the pump fine tuned. Specifically, I'm currently working on find a way to deal with the dawn phenomena.

My goal is to be able to skip breakfast if I have to and not have my bg go up to 160 or higher, but stay near or below 100. I am determined to find a way to do so. I consider the pump a powerful tool that is as close to an artificial pancreas as exists today. It is a tool that requires much interaction and requires much testing and experimentation to personalize, just as any diabetes treatment.

Yesterday my numbers were running a little low and I'm not sure why. They were running low the latter part of the day and through the evening. But since being on the pump, I've been testing very frequently. I may go ahead and ask for the CGMS when I see the endo next week.

Right now it's dawn phenomena time. I can't agree with you about my morning numbers looking good. Look at 2/19... I awoke around 7 and 2 hours later with no food at all my bg rose 50 points. Uncontrolled, it would have gone higher and I would have started dumping glucose in the urine. This is not new to me and has been occuring for a long time. This is not how I want to live my life as a diabetic. This is another reason why I moved to the pump to deal with issues like the dawn phenomena.

[duck]

Maybe I am misunderstanding what DP is, but again, as far as I can recall (and unless someone corrects me), DP occurs EARLY in the morning (ie, 3AM and goes on until "waking time", around 6AM), while you are asleep. It's a pronounced increase in blood sugar, not a 50 point spike but in excess of 100 points. If I remember right, most sufferers end up with waking blood sugars in the upper 200's/lower 300's.

What's happening to you is a bit different. On both 2/19 and 2/20, your blood sugar increased between 7AM and 9AM. I've said this to other members here so it needs to be said to you: two days is not a pattern. My endo made me record two weeks worth of numbers (I was so annoyed by the time I was done), and there are points in my day where my basal is higher than others as the result of that data collection. It could be that for you, you have a higher need between 7AM and 9AM for whatever reason (CGMS should be a great insight into that). I wish you could sleep in until about 9AM AND still take readings (CGMS?) to see if this has anything to do with your waking time or not...Or get up REAL early (5AM) and see if the pattern follows your waking time or sticks to the 7-9AM window.

[Cyborg]

Take a look at this link that was pointed out earlier in this thread: http://www.diabetic-talk.org/dp.htm. It tells the difference between the Dawn Phenomena and something called the Somogyi Effect. I've been having this DP long before I moved to the pump. I would always just bolus for it as soon as I got to work. Apparently I'm not the only person here on the forum that it affects only after they awake. In fact I have slept in till 9 or 10 and the effect does indeed start when I wake. It also happens when I get up before the sun to go fishing. It's wierd. I figure that if setting the basal rate higher at an earlier time in the morning helps, then I'll set an alarm on the pump to wake me and I'll wake up at the same time every day or earlier. Once I get up and kick start the DP, if I want I can lay back down and rest. If I'm lucky I can go back to sleep and the DP will continue, but that will be another test. First things first...

[duck]

I read the link when Cinnabon posted it, and I personally disagreed with some of its assertions. I take that back, I disagree with the author stating what they state without acknowledging everyone is different, indeed they take the opposite tack and say "everyone" in the second paragraph and then in the "dealing with" section alludes that you can cure DP with one of two methods. Does anyone here agree with that?

I'm weird, though, from what I read other members post about different things: I don't seem to suffer from bad liver dumps, I don't get DP (though in the last year of my life I have had to increase my early morning basal because I was getting up earlier...that may be changing back soon, though), and I don't seem to suffer from Somogyi either (though I haven't really sat around and tried to figure out how I would test for that). I sometimes wonder if I am this way because I have hypo-thyroid?

If you can get on a CGMS the results would be interesting! What my diabetes team told me was that for whatever reason, the sensor doesn't stay inserted very well, and some complain it is uncomfortable (it's just like a pump/insertion set). One of these days I'm going to do it as well, if for no other reason than to dial-in my basal rate better.

[jen_slc]

Cyborg, I'm the same way, though I have a much more pronounced rise: I wake up with a normal bg and as soon as I get up and moving around, my bg spikes well over 200-250. And it happens whenever I wake up, whether it's 6am, 10am or 1pm. But my endo explains it as a liver dump. Not dawn phenomenon, because I don't wake up with an elevated bg and that's what you'd expect with DP. And not Somogyi Effect, again because I don't wake up with a high bg. Just a plain old liver dump, my body realizing that I'm up and awake and needing energy for the day. The only way I can prevent it is by eating breakfast, regardless of the time of day, and bolusing a HUGE amount for it - I take more insulin for a teeny breakfast than I do for a huge dinner.

[Cyborg]

That's interesting. Was there anything your endo did to confirm the liver dump? I'm definately going to talk to him about it next week to see if that is what may be happening with me also.

Thanks for the tip.

[Cyborg]

Does anyone actually take Metformin for the Dawn Phenomena or to prohibit or reduce a liver dump?

[Cinnabon]

I have heard a few on here that do, hopefully they will chime in soon.

[duck]

Does anyone actually take Metformin for the Dawn Phenomena or to prohibit or reduce a liver dump?

Munday does, with some success. He's been very creative in attacking his issues.

[jen_slc]

That's interesting. Was there anything your endo did to confirm the liver dump? I'm definately going to talk to him about it next week to see if that is what may be happening with me also.nah, he didn't confirm the liver dump was happening (but how can you, besides a CGMS and testing?), we just went over my bg records with a fine tooth comb and he showed me how it couldn't be DP or the Somogyi Effect. So what else could it be but a liver dump? My levels were stable through the whole night, no highs, no lows, and absolutely no rise in bg as it got closer to getting-up-time, it actually dipped very slightly - until after I got up, and then it clearly went nuts.

[Simon]

Well I managed to measure my bs in bed before I got up and then several times after getting up this morning. Here's the result showing a clear liver dump after getting up.

[Cyborg]

Well I managed to measure my bs in bed before I got up and then several times after getting up this morning. Here's the result showing a clear liver dump after getting up.

What caused your sugars to go back down within the hour? Did you take a bolus or medicine?

[seacomp]

There is certainly a phenomena of raising bg either before ao at rising. How it presents itself apparently varies from person to person.
The response people have gotten from their doctors/endos appears to vary as much or more. I would suspect that there is really no fixed medical definition for the Dawn effect, just a pragmatic recognition on the part of doctors that something strange is happening.
Before people did extensive home monitoring of bg, I'm sure that the effect was not even known.

[Simon]

The drop in bs was either spontaneaous or caused by very light exercise as I prepared the fire for lighting tonight. I supose the glucagon release was a one off that stopped as soon as bs levels got above a threshold. The DP is known to be more pronounced in recent diabetics so I guess that the threshold lowers as your body gets used to normal bs again.

[jen_slc]

To me, a bg that goes from 100 to 117 to 111 doesn't show much variation, but I guess it depends on your definition of tight control. If those were my levels, I'd say I was perfectly stable and a "spike" to 117 wouldn't be anything to be concerned about! I'm constantly amazed at how differently it affects us all.

So does anyone think the extent of a bg rise due to liver dump varies within one person or do you think our liver dumps tend to be the same within each one of us? i.e. do people experience both mini liver dumps (small or barely noticeable bg rise) and huge liver dumps (very clear bg spike) or do they generally see the same response in themselves time after time (like me, I just get liver dumps that produce HUGE spikes)?

[Simon]

Looked at in isolation the rise in bg is not a problem. It is more that it seems to be indicative of a drop in insulin sensitivity. Looking back at my past test results it appears as though if I eat before the spike I need around half the insulin that I need if I eat during the spike. More experimenting is needed. With luck I can eat before the spike every time and tighten my control. Until now I didn't know it was there so was not only going hyper and hypo as I tried to work out a bolus for breakfast but was also taking too much basal as I worked from pre-breakfast readings.

[Cyborg]

To me, a bg that goes from 100 to 117 to 111 doesn't show much variation, but I guess it depends on your definition of tight control. If those were my levels, I'd say I was perfectly stable and a "spike" to 117 wouldn't be anything to be concerned about! I'm constantly amazed at how differently it affects us all.

So does anyone think the extent of a bg rise due to liver dump varies within one person or do you think our liver dumps tend to be the same within each one of us? i.e. do people experience both mini liver dumps (small or barely noticeable bg rise) and huge liver dumps (very clear bg spike) or do they generally see the same response in themselves time after time (like me, I just get liver dumps that produce HUGE spikes)?

I'm not used to looking at English units so I didn't realize that the spike wasn't as extreme as it appeared to me at first glance.

I am like you, I see a huge spike when I wake and I will go from around 90 to over 150 within 2 hours, even with an increased basal rate. This will be the first topic I take up with my endo on Monday...

[greendavid]

The hormone-mediated insulin resistance of DP is the most important effect for me, as far as I can tell.

For a long time, I have been mystified why my BG would shoot to 235 at 11 a.m. after a small breakfast. (I'm type 2 on metformin and glyburide.) Then, in the late afternoon, I have to gorge on carbs (relatively speaking) to keep from going low.

It is reassuring to read in two different sources (here (http://www.faqs.org/faqs/diabetes/faq/part2/section-13.html) and here, cited in previous posts (http://www.diabetic-talk.org/dp.htm)) that there is a medical reason for this behavior by my body. Specifically:

Overnight, usually between 4am and 11am, your body releases some hormones. These are Growth Hormone (GH) from the anterior pituitary gland, cortisol from the adrenal cortex, glucagon from your pancreatic alpha-cells, and epinephrine (adrenalin). These hormones cause an increase in insulin resistance, raising your BG. ... Dawn Phenomenon, and its associated increase in insulin resistance, is the reason most diabetics are far more sensitive to carbs in the morning.
-- http://www.diabetic-talk.org/dp.htm

[Cyborg]

I never found out from my endo what the cause of the problem was but we did seem to be onto a possible solution for now. I asked him the cause but he did not know. He suggested a modification to the basal rates and it seems to be the key. With a little more fine tuning, we may be able to get it to the point where a morning basal test can be accomplished successfully. Here is close to the insulin requirements my body apparently is needing.

basal settings
12 am - 0.9
6 am - 1.8
8:30 am - 1.5
11:00 am - 1.1
10:00 pm - 0.9

Apparently I require a high increase in insulin right before awaking at 6:30 am. This insulin needs to be enough to offset whatever process my body is peforming to increase my bg after waking. I still have some fine tuning here but this is very close and has seemed to reduce a spike in my bg that I was seeing every morning from below 100 and seeing it rise by itself to nearly 170 a few hours later.

[Cinnabon]

Greendavid explained exactly what we have been explaining. It is a true Diabetic mystery. I suffered from this for a REAL long time until I gat a pump.

Cyborg- with a bit of time you will find the correct settings to the DP. This is a true way to stop this liver madness.