I have an erratic and time-variable dawn phenomenon (and sometimes an afternoon or evening phenomenon, too), and I don’t treat it with a corrective bolus. I treat it with a Temporary Basal.
When my high alarm goes off (anywhere from 4am to 8am, and occasionally later, or not at all … perimenopause sucks!), I look at how fast my BG is rising and start a Temp Basal of 1.0 to 1.5 units/hr. (My basal rate at that hour would usually be between 0.5 and 0.7 units/hr, depending on which basal pattern that I am currently using … again, perimenopause sucks!)
If my high alarm goes off again (set, for this reason, at a one-hour interval), I adjust the Temp Basal. The time-frame that the Temp Basal is set for depends on just how high the Temp Basal has to get before it does any good. Sometimes 1.5 works, and sometimes it has to be 2.0, or even 2.5. This goes on for anything from 2 to 6 hours.
I have a fall-rate alert set for 2 mg/min because, once my BG starts to fall at this rate, it indicates that my chemistry has shifted and the Temp Basal is no longer necessary. HOWEVER, I try to notice when it is dropping at +1 mg/minute, and has gotten below 180, because that is usually the best point to stop it at, as it wil continue to drop for 1 to 1.5 hours before leveling out.
I am still refining this, as not catching the drop fast enough leads to 10-30g of candy, which doesn’t help my weight.
The reason that I don’t use a bolus is two-fold. First, is that there is no way to know how much insulin will be needed. And second, there is no way to know how long this BG rise will last. I figure that the hormones, or whatever, are not usually being released in one short burst, so the treatment shouldn’t be, either.
I’m getting pretty good at using Temp-Basals in this way, and rarely use corrective boluses. Even so, I rarely get away without a BG over 200-250 during these episodes, and occasionally get as high as +300. I am getting better at judging what is likely to be needed, and for how long. But, I have only been pumping for just under 1.5 years, and have been experimenting with these Temp Basals (very cautiously) for about 8 or 9 months.