I’ve been slowly having to increase my 11 year olds Lantus for the past few months. We’ve gone from 11u to 17u. For the past 3 mornings he’s been waking up low to high 300’s. Last night I even checked him at 12:30 am and he was at 119. This a.m. at 6:30 up to 348. He’s not sneaking food…he’s a very well behaved diabetic child.
I’m going to up his Lantus to 18 tonight. So do you other parents check and give insulin at say 4 a.m.? When he wakes this high, he’s going to be that high until the afternoon. Is there a way to handle this better? He’s not on a dexcom and no pump…just pens. Thanks!
Testing in the morning not fun. To get blood in the morning for me takes repeated jabs. It is high anyway. The blood flows easily later and is usually good.
Is it possible that your son may be experiencing a growth spurt? I’ve read reports from other parents of young T1Ds of having to increase insulin doses temporarily to cover for growth hormones.
I had a similar experience (only I could wait till around 6 am). Increasing the Lantus only resulted in loads of hypos at other times of the day. IMHO, you can’t deal with significant DP with long acting insulin. That’s one reason I went onto a pump.
If you increase the Lantus too much your son may be experiencing hypos in the night which result in counterregulation and resulting highs. Are you comfortable that he isn’t experiencing lows overnight? Have you checked his blood sugars?
What time do you administer Lantus? I’ve noticed that the “24 hr” number can actually be 22-25ish. This could cause a lapse in basal that could be contributing to a high in the morning. Possibly changing the time of Lantus shot or dividing them in 2 at two times of the day could be a possible work-around.
Is the Lantus all at once? I would try splitting the dose. What rapid insulin is used?
11 years old for sure is a growing ever changing youngster, this causes havoc. Does his dinner have a lot of protein? I ask because this particular nutrient is the one thing I know will deliver a high bg for me in the morning.
To answer your title question - Dawn Phenomenon…How do you handle it? - My answer is to adjust my basal if/when it needs to be adjusted. But I’m a grown up, and basal testing is easier.
I agree with Brian, I was fighting dawn for a while … my Endo had me test during the night (what a PITA) but it did show that I was going quite low around 3:00 am…which was then causing my body to release sugar and raising me substantially… our bodies release as much as a can of coke… I would check him during the night for a few days…assuming you don’t have the CGM
Thanks guys! I normally put him down around 9-10 and then check him around midnight. We give him his Lantus at 8:30 in the evening. Evening works best for us, as on the weekends he sleeps in. He is going through a growth spurt. Up 1 whole shoe size since Christmas! Probably grew a few inches in height lately. I’m sure this is my culprit…hormones. We typically have dinner at 6ish but he will often eat 2 to 3 snacks before bed. His endo told me not to deny him food since he’s growing. I took him to the GP today, bc my 13 year old T1 is sick and he was complaining of a sore throat too. Now both are on antibiotics. I really wish he would wear the dexcom so I could see if he is going low, then shooting up because of that. It really worries me to the point I hardly sleep well. But I don’t want to disturb his sleep constantly checking him all throughout the night. I make him check his BG before he lays down too. I might just have to force him to wear it a few days just so I can see what’s going on.
Try this sentence:
“Wear your Dexcom, or Mommy will roll down the windows and blare her 1980’s one-hit-wonders CD every morning when she drops you off at school…”
Such a hard place to be as a parent when you know what they should be doing but they aren’t on board. And at this age, they think everything their parent do and say is stupid. I do think you might ask his endo if they do the loaner deal with CGM’s. That way you can tell him, it’s just for a week and maybe at the end of that week, he might be ok with it. Because it really isn’t very noticeable. Good luck. Parents are the angels from God.
I’m an adult (age 75 at that), so this may not apply, but I find that my dawn phenomenon isn’t as bad when I have a bedtime snack as when I go without. A snack like cheese seems to cut the size of the DP in about half. Of course, at your son’s age, he is probably having a bedtime snack all the time already.
he does! This kids eating me out of house and home! Actually I’ve found if he doesn’t eat a snack close to bedtime, then it seems to help his morning BG. I always tell him he’s got diabetes voodoo lol
Yes! Plus my son is autistic so anything out of the norm touching him poses a problem. Even normal things sometimes pose a problem. I’m torn between which problem to cater too, if that makes sense. Do I make him uncomfortable with his autism or fight for his diabetes. Obviously I know the diabetes is more important in the grand scheme of things bc not properly treated that can cause major health issues. But I kinda feel like the CGM is “optional” in care at times.
good luck and well wishes
he does! This kids eating me out of house and home! Actually I’ve found if he doesn’t eat a snack close to bedtime, then it seems to help his morning BG. I always tell him he’s got diabetes voodoo lol