I’ve noticed a trend lately that when I rise in the morning, even if I don’t eat, my blood glucose starts to rise. I suspect it is tied into the dawn phenomena I experience. I need to take some insulin to avoid a blood sugar boost from say, 80 to 120 mg/dL.
I’ve read references to this before and now I wonder what others might do to counteract this trend.
I notice this trend from time to time… usually comes on for just a few days at a time and when it does I’ll start preemptIvey bolusing for it… after a few days the trend of needing to do so usually fades away for me… often these trends are in periods of transition between work life and home life, etc for me
Dawn Phenomenon has been a constant for me and a “feet on the ground” bolus is a daily need, even before considering any morning food.
In my experience, morning caffeine increases the bolus need, but is just a contributor, not the reason for it.
I raise my basal 1.5 hours prior to getting up. That seem to help ward off the increase. My basal needs in the morning remains higher until 10:00 then they decrease.
I do that almost every morning. I don’t have a programmed increase, just in case I am too low, or because I don’t always get up at the same time. So I take it with a manual bolus after a BG check. Just part of the morning wake-up routine like brushing your teeth. I agree on the coffee thing too.
Yes. Absolutely.
Most of my morning BG rise does not start until I get out of bed. I almost always take a bolus right after getting up, because if I do not catch the rise early, it takes me most of the morning to control it.
If you use the mySugr app at all, you’ll see an icon for “Foot on the Floor.” It sounds way cooler in German as described by the Austrian creators of mySugr.
I have my hardest mornings when I wake up on the low side and feel like it is unsafe to take a bolus.
Even Dr. Bernstein writes about a bolus upon arising.
IMO this phenomenon is different than dawn phenomenon because it is variable based on when you get out of bed. I also think that it is more of a T1 thing than T2. But I won’t bet the farm on that remark…
My BG dawn phenomenon starts between 3 and 4 AM and BG typically rises around 40-50 points by 10 or 10:30 if I don’t bolus and/or eat. It doesn’t matter whether I get up or not. The rise happens even if I sleep in late.
Since I am on MDI, I don’t have the option to program in different bolus amounts. But neither do I want to jab myself any more times than necessary. So if I happen to wake up at 3 or 4 AM (and I often do to use the facilities), I do a combination correction (if necessary) and meal bolus, eat breakfast, then go back to bed. Since I’m retired, I can sleep in as late as I choose. I end up having a split shift of sleeping like that about half the time.
I need twice as much insulin per gram of carb for breakfast as I do later in the day.
I don’t get up at the same time each day and I noticed this BG rise waits till I get out of bed. Maybe it has something about standing up after being horizontal all night that triggers this effect.
Thank you to all for your feedback. I’ve been seeing this effect for a while now and it’s good to know it’s relatively common.
Sadly I have to take some insulin right after arising, even if I don’t eat. I take 3-5 units of insulin even if I awake at 83 mg/dl. If I am higher I take more insulin. And this is on top of any insulin I take for breakfast. I find I need this simply to offset the Darn Phenomenon. Tresiba really helped me wake to a normal blood sugar but it cannot beat the dreaded dragon that emerges when my eyes open.
Is this clock dependent or does it follow your rising even on the weekends?
This happens whatever the clock does. It seems tied to my awakening, whatever time.
I’d really like to explore that question more. Ive floated the question quite a few times on here… and given what I do for a living and the hours I keep I would have thought I’d be the worlds leading expert on the subject by now… but this one seems to be a really unexplored and Unmastered topic.
I don’t have profound dawn phenomenon, and other than some difficulty pinning down awakening trends sometimes my general theory is that my body seems to know what time it really is and more often than not my different bolus rates throughout the day stay true to the clock even if I’ve slept all day and been up all night.
Really hard to pin down, made more so bc as I was really getting all of this figured out (or trying to) I was transitioning from a by and large shift-work type of employment to pretty much 24 HR/ day on-call sort of stuff… so consistency in my observations is elusive at best
Before I was using Tresiba, this was a normal thing for me (1 - 2 units of bolus as soon as I woke up). I don’t do that any more, however, if I am higher than I expected upon waking up I will do a correction still (not very frequent).
Add me to the foot on the floor train. It’s this phenomenon that made realize my cardio exercise is easiest to do in the morning. No need to eat carbs to get my BG up. My body handles that for me.
Me, too, but not on a regular basis, so far. I just love how unpredictable D can be–not!
For me it happens whenever I wake up. Even if it is an afternoon nap. It took me a long time to figure out that just waking up - no matter what time - took a little extra insulin.
I used to have to do this but it hasn’t been needed recently. Not sure why.
80 to 120 is NOTHING. Ever since I was a teenager, if I skip breakfast and don’t take any fast acting insulin (just basal), I go from 80 to 300 within a few hours.
I actually end up using more units of insulin chasing that 300 than I would have if I had taken insulin immediately after waking up and eating my usual high-carb breakfast.
I agree. If I don’t have an increased basal rate I go from 5.5 to 17+ without breakfast. A big reason (the main reason) I switched to a pump, since the rise starts while I’m sleeping.
I do sometimes rise when I wake up, but sometimes I fall, and sometimes I stay steady. No consistency that I can find. Sometimes my basal keeps me flat overnight, sometimes I go low, sometimes I go high. Yesterday blood sugars were great and stayed largely in range all day, today I’ve been correcting non-stop and running double basal rates just to skirt the top of my target range, despite identical schedule and identical low-carb food. So I can’t say I notice any consistency in rising or not rising upon waking.
I definitely see this – do not have “dawn” phenomenon, but definitely “feet on the floor” (love it!). Will see my blood sugar rise by 200 points within an hour or two of getting up (without eating breakfast) if I don’t bolus. I see more of a rise after ovulation in my menstrual cycle (and sometimes NO rise prior to ovulation). I’ve had endos attribute it to caffeine in my daily coffee habit, but because the rise (or not) is so different each day (and I NEED my coffee daily!), I don’t think it has do to with the coffee, but likely because of hormones + signaling liver glucose dump. Such a frustrating part of IDDM. Jessica