Dawn phenomenon?

Will you please post a link to that UWMC page you discussed? Thanks!

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The UWMC info Uff_Da referred to in her (his?) post does not imply that PWD “can’t bolus properly for meals because the bolus would burn out before food turned into glucose and hit”. If this is your conclusion based on this information, then you are misunderstanding something…

you’re funny…!

If you were told “fat was the only thing that really doesn’t raise BGs”, then you were told wrong. For a simple explanation:

http://blog.joslin.org/2011/09/why-does-fat-increase-blood-glucose/

The chart I referred to is in section 1, page 1.

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Some of us were taught to count only carbs in calculating the amount of insulin to bolus. Others were taught to count carbs at 100% and protein at 50%. I took an online diabetes course where I believe the lecturer said to only count those grams of protein over 5 grams and to count those at 50%. (Sorry, I didn’t save that video, so I can’t go back and check, but I think that’s what she said.)

The U of W reference indicates that only 10% of fat gets converted to glucose. That’s a pretty small amount, so in most normal mixed meals, it won’t throw one’s calculations off too much if one ignores it, IMO. Besides, if much of the effect comes after our fast-acting insulin is through working, one wouldn’t want to take insulin too soon for food that won’t be absorbed until later. Better to just do a correction for it later. The way I look at it is to just be aware that it exists and may often be the difference in BG result that we tend to attribute to “aliens” or “the phase of the moon.” But if a meal or bedtime snack has an unusually high amount of fat and protein, and especially if we eat that way often, we might need to consider how to best handle it.

Currently I’m in the process of evaluating how much my frequent bedtime snack of peanuts and/or cheese may affect what I tend to think of as my “dawn phenomenon.” My best guess at this point is that only part of it is a true dawn phenomenon and the rest the result of delayed digestion when I have a larger snack. That might explain why the increase is greater some days than others, even after allowing for the carbs and protein in the snack.

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I have a similar basal change on my pump to account for the DP. From 1.5 units at midnight to 3.0 units at 4:00 AM and then back down to 1.8 units at 10:00 AM. The only way to control it on Lantus was to get up at 3 AM or 4 AM every morning and take several units of Humalog. If my basal rate gets too low for some reason, I can easily rise by 150-200 mg/dl during the early morning hours.

My diabetes is like this as well. In fact, I think a lot of women with Type 1 have these sorts of problems. But, going on a pump helps so much in actually keeping up with all these rapid changes. On MDI changes take days to kick in. On a pump, changes take hours. I had no real hope of keeping on top of monthly hormones before I started using a pump.

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I have to bolus before my feet hit the floor. :stuck_out_tongue_winking_eye:

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Part 1 was very informative. Looking forward to more videos.