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Re: [IP] Dawn Phenomenon


First, test your BGL a couple times during the night.  So, test before bed, 
 twice at night, and then test the MOMENT you wake up, and then 15 minutes after
you get up.

This will help you determine where the "dawn phenomenon" is occuring.  Some 
people experience it prior to waking up, and other experience it the moment 
they wake up, etc.  For myself, I find that my BGL shoots up as soon as I wake 
up.  If I test when I open my eyes and then 15 minutes later, my BGL can have 
gone up 50 mg/dL by then!

Anyhow, at the point that it is going high, increase your basal rate by .1 
unit/hr TWO HOURS before it goes up (typically, before you wake up).  Try this 
for a couple days.  If it doesn't help, increase your rate again by .1 

WAIT...you aren't on the pump yet, are you?  Hmm.  That complicates things.  
This is harder to control.  It depends on what long-acting insulin you are 
 using. When your long-acting is peaking, you want that peak to hit just before
you wake up (or whenever you find you start to go high).  On insulins such as 
Lantus or UL, which have a little to no peak, there is little to be done.  On 
NPH, however, you can control this by giving yourself 3+ shots of NPH a day to 
get a better basal rate.  (This is what I did for a few years before switching 
to Lantus, which I was never again able to get nearly as good of control on 
compared to 4 shots of NPH.)

If I recall, you were taking UL.  UL does have a slight peak.  So, when this 
starts to peak in your body, make sure you give the UL so that the peak takes 
place when you would normally start going high.

Also, make sure you are bolusing for that bedtime carbs at least partially.  


>Hi all.
>How do you personally deal with the Dawn Phenomenon? Can you share how you
>tackle this with me? I'm getting high sugars in the morning and prior to bed
>my bgs are in normal range and I only eat 15 grams of carbs prior to bed and
>mornings am 200 to 240.
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