I don't have DP, Trudy. And isn't DP where you wake up normal but then begin climbing if you don't eat? This is an entirely new problem this week where I'm waking up very high, and I've never had DP. My routine is to get up and drink my capp while I'm online then eat about an hour later. My blood sugar has always stayed stable during that time.
Well, if I wait to eat without that initial shot, I have to eat while high taking a large bolus. I don't know, I think that what I have is DP! As I recall, Dr. Bernstein also takes a unit of insulin first thing in the morning, but I can't recall if he calls it DP.
Yes, that is exactly what I understand DP to be and I don't have that. If I wake up at 100 I will stay mas o menos 100 no matter how long I wait to eat and can just bolus for my carbs. This is where I just wake up super high.
I suffer from Sleep Apnea which can greatly exaggerate my DP. My DP causes me to wake high, testing the minute I wake, I am high. Then if I don't treat I will continue to rise. And simply waking up in the middle of the night and having trouble going back to sleep gives me DP grief.
The dawn phenomenon, also called the dawn effect is a normal early-morning rise in glucose (blood sugar) that occurs before or shortly after waking. Everybody experiences this physiological phenomenon, but it is a big ole hassle for people with diabetes.
Between 4 a.m. and 8 a.m., the body increases the production of certain hormones. These natural body chemicals suppress the activity of insulin.
Adjusting the basal will handle the DP, but you need to figure out your own timing and level of rise and stuff.
In my experience DP comes and goes. The winter in Germany was the darkest winter since we begun to log the sunshine duration here. For me the seasonal change lead to a very pronounced DP for the last 6 weeks. This usually begins at 5am. I have to wake myself up, measure my BG and correct if necessary. Slowly this is starting to normalize again. I have seen the first few days with normal morning numbers so hopefuly things are starting to settle. Every 10 years things get a little rough in my experience. Diabetes has its own patterns and seasons so it seems.
Hi Zoe. I'll mention what my endo has done when we have had these events, and that is to go in for a CGM implant for 5 days which is downloaded and reviewed by the endo, CDE and staff to rework dosing and eating habits. You have to keep excellent written records of your carb intake, bolus, etc. The CGM is timed to take your BG every 5 minutes 24/7 and gives amazing charting of your results. While I had to go off the Ping and back on MDI, I've done the CGM several times and it makes the course of correction much clearer.
Hope this helps and best of luck in getting this resolved ASAP.
Seems like this has been pretty well covered, but fwiw, I ran into something like this a few years ago when I'd visited an orthopedist for arthritis in my shoulder and was given a cortisone shot. I had told him I was T1 but specialists don't always seem that well informed about metabolic issues outside their area. Apparently it's well known that a hefty wallop of cortisone will knock your sugars through the roof for a while--weeks in fact--but I hadn't known and nobody told me until I contacted my endo. So.... had a cortisone shot recently?
Do you think it's likely, Holger that someone who has never had a trace of DP would all of a sudden get it?
Nope, although I did several months ago and it drove up all my blood sugar numbers, not just the fasting one!
I know what it is, Karen. Not all diabetics have it. I've never had it before....AT All! Unless it's possible to suddenly develop it after 6 years, I don't have DP. As I've said..lol
Thanks, Judith!
Another “for what it’s worth” response, but I had nary a hint of DP for 17 years, then randomly developed it about 6 months ago, so it’s possible. Good luck figuring it out!
Thanks, bojibridge, that's useful to know; nobody seemed to be answering the question if that could happen.
Seems like everyone is saying that DP is likely the culprit. My own basal increases at 5 am to cover my version of DP. As mentioned and as DP is defined we all have it. Also without the testing to see what is happening it's very possible that the Somogyi effect could be at play. No way to know without testing. In the end only YOU can really answer the question asked.
Per John Walsh, Karen only some 50-70% of people with Type 1 have DP.("Using Insulin" page 8) So no, we don't all have it. And I know for sure that I have not had it for the last 6 years. I didn't think you could develop it when you had never it before but it seems like maybe that is a possibility I'm going to have to check into.
I don't think that it's unreasonable to surmise that DP is here. Elevated BG in the AM, for no apparent reason would be what I would call it. Barring an infection or some other cause, I would think that turning up your basal in the evening would be the way to go.
Early Morning Hyperglycemia in Diabetic Individuals Treated with Co... finds that a typical pre-dawn increase in basal of 37% works in many patients.
It's interesting that so many interpret the "dawn phenomenon" as "something that's wrong with me". Really it's the same way the normal healthy liver works, releasing glucose in the pre-dawn hours, in non-diabetics. Often goes mostly unnoticed in those with substantial endogenous insulin production.
Many (most?) books give dawn phenomenon a pretty short shrift. The concept that not eating raises your bg more than eating, just goes against the grain of what most bookwriters are trying to sell. I think a typical diagnosed-as-an-adult person doesn't experience it the same way, those of us who were diagnosed earlier did when we had raging hormones as a teenager.
Since I haven't had to deal with it before, Tim, it does seem like something wrong with me now. But it's definitely something I will deal with. Thanks for the input.
Well, sometimes it gets really messy and you have to restart to some degree. Since three weeks I am now running on 16 units of Lantus although 12 units have been fine all winter long. T1 is quite a ride and we need to adjust to stay on top. You have seen a pattern of elevated numbers. Then you got a new pump but the levels are the same. From what I have read California has its own subtle seasons. If this is enough to provoke your current problem is hard to say. Are there other things you have changed (the baker, certain food, habits etc)? Perhaps the latest attack wave against your residual beta cells was very successful making you more T1 than T1.5 (pure speculation on my behalf)?