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[IP] Re: Dawn Phenomenon

I experience the dawn phenomenon.  What I've found, however, is not 
that my BG levels are significantly higher when I FIRST wake up...but 
shortly thereafter.  I'm talking 20-30 minutes later.  

I did a test where as soon as I woke up, before I got out of bed, I 
tested my BG.  It was slightly elevated, but not a lot.  I then tested 
about 30 minutes later as I was about to eat breakfast.  My BG had 
risen SIGNIFICANTLY, and continued to rise (unless treated with higher 
basals) for the next couple of hours.  

I did a bit of reading, and found out that the act of waking up 
triggers certain functions in the body that release stored sugar into 
your body.  I guess this is actually normal, because it is supposed to 
help a person jump start their day, in a sense.  The non-diabetic, 
however, compensates by automatically releasing insulin as well.  We, 
obviously, don't have the luxury.

The reason you have to increase your basal rates a few hours before 
waking up, though, is primarily due to the delay it takes for the 
insulin to start working.  For example, let's say you have a rate of .5 
u/h through the night.  Then, you increase that rate to .8 u/h at 6:00 
am.  Well, that means in that particular hour, you only get .3 
u/h...and of that, MOST of that additional amount won't even start 
being active in your body until 7:00 or later, not including the 
delayed time it takes for the insulin to start working.  That means 
that if you wake up at 7:30 or so, then increasing basal rate to fix 
that DP would need to start at 5:30 or 6:00.  

Now, you WILL get a slight increase before you wake up because your 
body is already starting to be more active even before you wake up.  
Your body "knows" that you are almost done sleeping, in a sense.  But, 
this is typically very close to your wake up time...and is generally 
minimal compared to what happens basically the moment you open your 
eyes and get out of bed.

One additional thing I have noticed, however, is that if I eat food 
before bed and bolus for it, I will tend to wake up high even if that 
bolus amount works fine any other time of the day.  I'm not sure why 
that is...but I'm sure the sleeping body must play into it.
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