am highs for the last week
for the last week I have been going very high in the early morning (highest between 5:00 am and 6:30 am) I have heard of the dawn effect but this is the first time it has happened to me and I can’t point to anything I am doing differently now that would account for it.
It could very well be the Dawn Phenomenon. Here is some information from the Mayo Clinic about things you can do to combat it.
If it were Liam and we noticed A PATTERN (of 1 to 2 weeks), I would adjust ISF (Lower the number so that he gets more insulin), adjust the basal rate during that timeframe, or both.
It also could be a higher intake of slow acting carbs the night before, but you said you have not done anything different, so the more likely case would be DP. I know for me if I have “extra” carbs the night before, they will show up in my overnight/early morning BGs!
thanks
Thinking i will try a new basil program to increase insulin late night/early am, and see how that goes
Thanks
I will try limiting "extra’ and see what happens … could be that I getting lax in my counting
Have you stumbled on the next cinnamon cure? I haven’t heard about Basil helping with diabetes, but it grows like wild around here, so couldn’t hurt. By the way, I am totally poking fun and guessing that you are going to try a new basal program, but being a little silly this morning seems reasonable.
lol well in addition to diabetes I have dyslexia which makes spelling a crap shoot when spell check doesn’t mark a word as misspelled because it is still a word 
True story…when our son was first diagnosed, I was very confused. I was scratching my head, wondering how the heck Basil would help with diabetes. Most of us started over on TUD and branched out into our own community but over there, you will probably find a thread of me asking wth basil has to do with diabetes or something to that affect.
They quickly educated me on the difference in BasIl and BasAl.
I didn’t know! Before our son was diagnosed the only thing I knew about T1D is you had to eat too much sugar to get it (thanks TV).
I can see how that would happen
There were a couple of early morning spikes for me last week, which is unusual for me, but not as high as that! Similarly, I couldn’t identify a reason such as a high fat meal or late night snack. Anyway, I find it can take more insulin than typical to correct such highs.
same for me, takes almost twice the insulin to make it come down…and it keeps going up for like 30 min to an hour after insulin
The key for us is making no changes unless we see a pattern. If your body is going through something at one point but it’s not every day or every x days at x time, etc., then it’s not something we change. The body is ever changing…illnesses, etc.,…who knows. But if there’s no pattern we don’t change a thing. We’ve learned that doing so only causes more issues. We observe for a while until we are certain it’s reproducable and only then we adjust.
agree, need to see a pattern, i guess the question is how many days does it take to be a pattern requiring a change
To me the graph looks like dawn phenomenon rather than excess carbs before going to bed, because in the latter case I’d expect to see a rise all night long.
Since the rise was starting at 4am, I’d try a slight basal increase at 2:30 (maybe until 8am?) and see what happens.
In my case I’ll start making very small changes after 3 consecutive days; sometimes after only 2 days. After all, the worst that could happen is I’d have to go back to the previous setting if it turns out that the extra basal starts to send me low. I expect to need basal changes, up or down, 2 to 4 times per year, and each change can take a few tiny increases or decreases to get it dialed in.
I agree, seems like a rise so late in the night rather than all night is dawn phenomenon, just wasn’t sure since its a new thing for me, I do think 2:30 am increase in basal sounds like a good place for me to start
thanks
Wow! I had always assumed “Dawn Phenomenon” meant something that happened in reaction to the dawn of day. What an incredibly stupid name! I do boost my insulin at dawn sometimes; I figure my body is gearing up in response to the light and starting to process stuff requiring extra insulin. But that’s off topic because it happens at dawn, not in the middle of the night.
I do also have middle-of-the-night phenomenon, but for me it is completely correlated with fat and, to a much less extent protein, intake late in the preceding evening. This is to be expected.
As for the Mayo clinic hypothesis (from @Chris’s link):
Some researchers believe the natural overnight release of the so-called counter-regulatory hormones — including growth hormone, cortisol, glucagon and epinephrine — increases insulin resistance, causing blood sugar to rise.
Apart from the wording (eh, high blood sugar due to glucagon is not insulin resistance) that seems to correlate with what I see; I tend to drift up as I sleep, not always, but it’s consistent. This may just be the fat but I suspect it is simply a lack of activity failing to pump the insulin through my skin. Long acting insulins seem to behave better than pumps, this makes sense to me; NPH etc delay adsorption at a more basic chemical level, pump boluses always have to be pumped (in turn) through our skin.
I do tend to wake up and correct as necessary two to four times a night these days; I can sleep through moderate highs (up to 250mg/dl) but I think I’ve trained myself to not do so by responding to rising BG by waking up.
I had DP for quite a long time years ago and when I started taking stuff for my thyroid it went away. Slack off on the thyroid supplements and it comes back. But even when I do take my supplements it will pop up for a few days here or there or even for a couple of weeks at a time. I didn’t realize I even had it until I first got a CGM and could pretty as you please stay flat up until 5-6 am and a pretty drastic increase of my BG level started.
I actually have a DP program already set up in my PDM to switch too. At first after 3 days or so I will tweak my regular setting a little for a couple more days. The thing is mine goes away easy nowadays so I’d rather wake up to a high than by a low and then having to eat or drink something. And then if it keeps up I switch to my DP program.
The thing that I find useful in determining setting changes is making sure I log all my temp basal increase, all my extra bolus and how much and what time. While DP usually starts hitting me about 5:30 it can vary some…an hour later and my high setting has me eating something right when DP will start to hit in a few minutes. So if 4 out of 5 nights it starts at 5:30 but the 5th night it starts at 6:00, I’d rather plan on 6:00. That’s just me though. Also take into account the time it takes for insulin to start working, especially with DP involved.
I vote Dawn Phenomenon. I agree with everything said above.
I had a crazy sharp spike the other night, but I think it must have been from a pretty intense (and totally random) nightmare I was having. I woke up totally soaked with sweat from the nightmare…definitely not from a low!
I just like to tell stories. This really has nothing to do with your question.
So yeah, probably Dawn Phenomenon.
I wake up when my cgm beeps at a high or a low, which until recently has been very rare and has only been from lows, But I have been on cgm only since early since spring so before that I guess it is entirely possible this was happening before and I just slept through it. without the beeping cgm don’t think I would wake up.
Thanks
I am going to have to start timing how long it is taking for insulin to start working, it seems like at least an hour, and sometimes more, can get it to move up pretty fast but not go down very fast at all
