Anyone find unique ways to Lessen the Dawn Phenomena? This is for a low carber not on a pump.
You might look into taking Metformin. I’ve had T1 for 32 years, and about ten years ago, when I was still on MDI, my endo started me on Metformin to deal with an increasingly stubborn dawn phenomenon. I had started taking extra insulin at night, which is kinda dangerous, and Metformin does seem to help. I still take it even though I’m using a pump now because I’m trying to minimize insulin in order to lose weight and just upping my overnight basal rate to deal with it is counter productive.
After posting, I saw that you’re a parent of a person with T1. Not sure what the recommendations are for Metformin with younger patients, but it may still apply. If your T1 is on basal-bolus you might also look into splitting the basal dose if you’re not already doing that, as those insulins seem to tail off sooner than advertised in some cases. Seems to help with this problem for some people.
Thank you. This is for my 18 year old. Diagnosed three years ago. And yes, you are correct, to lessen and not to hasten. I edited the post. Metformin. This is a thought. It may be too much for him now. And yes, if he increased the night time basal amount he would surely go low. He does do a split dose of basal.
And I’ve edited mine accordingly so as not to confuse anyone else coming to this thread.
Eighteen is pretty mature, physically, so I would definitely ask my endo about Metformin. Used to be thought of as a T2 drug exclusively but it’s increasingly prescribed to T1s as well. Some people have tummy troubles with it, which range from just needing to take it with food to not being able to tolerate it at all. I’ve been fairly sensitive to that kind of trouble my entire life, but oddly Metformin doesn’t bother me at all.
“Dawn Phenomenon” covers a lot of territory; it follows different patterns in different people. (Gee, where have we heard that before??? 
)
One aspect that varies from individual to individual is timing. Some people’s DP starts in the wee hours, for some it’s just before arising, and for others (like me) it starts as I get up and start moving around. The solution that worked for me was 1 unit of fast acting insulin as soon as I got out of bed. Your situation may be different.
$0.02
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I will inquire. Thank you.
At this point in time it seems that my son’s BG’s start to creep earlier in the morning. A CGM will point this out. I have asked him just that same question this morning. I even suggested setting an alarm to give him the tiniest amount at 5:00 in the morning. The teen was not happy with that. So it seems that giving him the smallest amount as soon as he arises may assist. He would have to pair that with the time that he is eating and giving himself the extra bolus for food. If too close together it may not work as well.
I did hear a quote recently that said something to the effect that the liver will slow once food is given. So upon arising a few low carb morsels of something may even help.
I won’t suggest the fun solution, several glasses of red wine before bed.
Metformin can help suppress Darn Phenomenon (DP). You can increase basal rates overnight, program your pump or use a split basal injection with a larger injection at night. Some people report Tresiba is more consistent overnight and suppresses DP. Some people argue you should just wake up and bolus at a particular time. My solution has been to use a split basal, accept DP as the bane of my existence and take a bolus correction dose upon awakening. I also find that eating first thing in the morning can avert further rises later in the morning.
Oh, and I discovered the cause of my DP, it is space aliens:
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That is my solution, too. Although I do find that the split basal (larger at night) seems to reduce the DP. Some days I need the morning correction, some I don’t. It’s a day to day thing. Today I needed one.
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It doesn’t seem to matter what I do, I never know when it’s going to hit, or even happen at all. then there’s a morning like today, off the charts. I woke up at 4am, was 104, went back to bed and fretted about things for couple hours, went back to sleep, got up at 7, was 139, so I took a little correction, at 740 was 160, took a larger correction, at 840 I was 173, took an even larger correction. started going down at 930, ate some scrambled eggs and settled into the 130s and ate a green salad with grilled chicken at 1pm. I’m going to change out in a few minutes when my lidocaine kicks in. someone has requested homemade macaroni and cheese for dinner, and I’m going to have a little.
I actually have over time developed a correction that works for me. I basically give myself like 5 units or so even if I awake with a normal blood sugar. If I don’t then my blood sugar will start rising and I will go high and fight possibly all morning to get my blood sugar down. If I awake high I add even more to correct the high. I basically have found that I need insulin just to reverse the crazy stuff the aliens did to me.
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I’ve tried fiddling with my overnight basal, which works to an extent but so much depends on whether I’ve been able to get out bike riding consistently, ups and downs in weight, moth beating its wings on the other side of the planet, whatever. Recently I’ve been setting a dual wave bolus that gives me a unit or three, depending on bedtime BG, at about 3:30am and that seems to work pretty well. At the moment.
Weirdest thing is that with the weather improving I’m back to bike-commuting, and I do a pretty hard 25-minute ride in the a.m, but instead of knocking my bg down, which it definitely does on the homeward leg (too much, frequently), my morning ride has no effect–bg keeps ticking up. Not severe, but kinda baffling and annoying.
It is interesting your major factor is exercise. In my case, I have disturbed sleep and the major factor is how I slept during the night. If I have trouble sleeping or awake repeatedly during the night I might as well have been carried away by the aliens and subjected to experimentation.
Have you consulted Scully and Mulder about this???
This kind of sound, temperate advice is what keeps me coming back to TUD.
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I am taking Lantus at bedtime. In order to prevent the dawn Phenomena I wait to take my shot at my usual 12:45 restroom wake up call. When I take the shot at a later time. my numbers are more respectable at 6:30 am upon waking. I did this by trial and error and so far it is working for me.
How do you set this up? I’ve often wished I could set up a bolus to deliver in a delayed fashion (like when I swim for an hour, I need to bolus shortly before stopping if I’ve lowered my basal rate to avoid a high). But I’ve never figured out how to set up a combo bolus so that it delivers properly…
Different pumps do things differently, but with Medtronic you select “Dual Wave” when setting up your bolus and it lets you specify the split and the timing of the second dose. If everything’s in range at bed time I might select “0” for the first amount and 1.2 or whatever for the second, and if it’s say 10:30 pm I put the timer at 5 hours for 3:30am.
Hmm. On my Animas Ping (and also on my old Deltec Cozmo), all that would do is deliver no bolus up front and spread the remaining bolus out over five hours. I was thinking that it would deliver nothing for five hours and then deliver the full bolus amount at that mark…