Dawn Phenomenon

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tommo DAFNE Graduate
Norfolk and Norwich University Hospital
7 posts

All this week my blood readings before breakfast, which is shortly after I wake up, have been ranging from 14.8 to 16.5 Is this the so-called Dawn Phenomenon or is it down to the very hot weather. Normally I wake to readings of 4.5 to 8.9. It is worrying but more to my wife than to me at present. My night time insulin is 4 units of Insulatard. I should be grateful for any advise anyone can offer please.

Warwick DAFNE Graduate
Diabetes Australia-Vic, Melbourne, Victoria
389 posts

Hi Tommo,

Very likely DP. Hot weather usually (but not always) leads to faster processing of insulin, leading to hypos so it probably isn't that, although there are always exceptions.

You could try increasing you basal insulin to compensate, but you do need to be careful of overnight hypos earlier in the night if you do that. Follow the DAFNE golden rules and only increase by 10%, or one to two units and monitor for a few days before increasing further.

dmc_katana DAFNE Graduate
Glasgow
2 posts

What is your blood sugar at 3am. If that is fine it probably is dawn phenomenon

tommo DAFNE Graduate
Norfolk and Norwich University Hospital
7 posts

Hi Warwick. I adjusted my insulin by 10% last night, when my reading was 10.9. I also took a 3.00 am reading - 16.3. It was the same when I woke up at 6.00 but by 6.45 it had risen to 19.0! I daren't increase by too much as I only take 4 units of insulatard so it was 4 1/2 last night. I used to be on 5 units but my DAFNE Educator suggested reducuing to 4 because I was getting massive hypos of 1.7 and 1.8 (ironically whilst I was on my DAFNE course!) I am now getting worried so hope to see someone at our drop-in clinic tomorrow. Thanks for you help and advice.
Tommo

tommo DAFNE Graduate
Norfolk and Norwich University Hospital
7 posts

dmc_katana said:
What is your blood sugar at 3am. If that is fine it probably is dawn phenomenon

Thanks for your reply and help. My last 3.00 am test was 16.3 and this was after I had increased my insulatard by 10% from 4 to 4 1/2. It was 16.3 when I woke up at 6.00 but by 6.45 had increased to 19.0. I'm now getting very worried by this and hope to see my DAFNE Educator at the 'drop-in' clinic tomorrow.
Thanks again
Tommo

tommo DAFNE Graduate
Norfolk and Norwich University Hospital
7 posts

dmc_katana said:
What is your blood sugar at 3am. If that is fine it probably is dawn phenomenon

Thanks for your reply and help. My last 3.00 am test was 16.3 and this was after I had increased my insulatard by 10% from 4 to 4 1/2. It was 16.3 when I woke up at 6.00 but by 6.45 had increased to 19.0. I'm now getting very worried by this and hope to see my DAFNE Educator at the 'drop-in' clinic tomorrow.
Thanks again
Tommo

Warwick DAFNE Graduate
Diabetes Australia-Vic, Melbourne, Victoria
389 posts

Hi Tommo,

If it is dawn phenomenon, then you would expect to see a reasonably normal BG reading at 3 am followed by a spike later in the morning. The fact that it is already so high at 3 am indicates that you could increase your basal insulin to drop the BGs over the whole night and that it may not be DP, but just basal insulin that needs increasing.

It would be worth doing a couple more 3 am checks as it could just be that it was a one-off high.

Keep us posted.
Warwick.

Peter DUAG Committee Member
University College London Hospitals (UCLH)
109 posts

Probably also worth thinking about the timing of your basal insulin, its type and whether your taking it once or twice a day. For many, including me, having Levemir twice a day works best. Definitely worth talking through with your healthcare team if you're still having problems.

Rafa DAFNE Graduate
St Vincent's Dublin
99 posts

I have a struggle with morning readings myself. I decided to just try and cut out my carbs at night and so far it seems to have worked. I would now eat 2 or 3 max cps and leave it at that. So far it has worked out.