# Re: [IP] Dawn phenomenon

```> First I would like to thank all the members who replyed to my last
> question, but I think I need to clarify it a little better. I have a
> question about dawn phenomenon.What exactly is it, and how do you
> overcome it? I believe my daughter may have it. In the morning if
> she doesn't eat, her basal rate is just fine, but if she eats, she
> goes way up to 300 an hour and a half later.

That's not dawn phenomenom. There is a name for it, but I can't
remember what it is, for now let's call it XX. It also sounds like
there is some mismatch between the glycemic index of the food and the
insulin dose. Try adding a little FAT to the breakfast, butter on the
toast, cook eggs with butter, etc... or have her eat "sweetened"
cereal, which uses complex sugars that take a while to break down.

Back to the bg rise which is unrelated to carb content.
The XX is related to the state your body is in when you wake up and
transition to "operating" mode. Some folks find that if you sleep in,
it does not happen. It seems directly related to eating in the sense
that eating is the trigger (in addition to waking) but it is not
proportional to what you eat. XX bg rise can be separated from the
food bg rise by careful testing of bgs and knowing the carb content
of the "test" meal. From that info, a standard bolus can be
calculated for the XX rise which is taken prior to the meal.

Example. Day 1. Rise at usual time. Eat breakfast of cereal, toast
and milk -- carbs about 30 - 45. Bolus for breakfast with your
standard ratio. Measure bgs every hour for 4 hours.

Day 2. Rise at usual time. Eat breakfas of scrambled egg and crystal
lite -- carbs 0  Measure bgs every hour for 4 hours. (All right!! if
you must, have a piece of toast = 15 g). Bolus if necessary and
measure bgs every hour for 4 hours. The difference should be the bg
rise attributable to XX.
Calculate the high bg bolus for that bg rise

Try a bolus of 50-75% of the XX amount on Day 3 with the same cereal,
toast milk breakfast as Day 1 + meal bolus. Raise or lower the XX
bolus until you get a match. Remember that post-prandial bg's of 150
to 180 are OK.

The preceeding assumes that everything will go perfectly on the test
days. Of course, they won't. It will take some time, be patient.

Michael

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