Tackling Mornings...AGAIN. Symlin options?

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1

I cannot get a grip on my morning blood sugars. I’ve tried so many tips from books and this community, but I still have problems.

I have Dawn Phenomenon on days that I wake up early only (not on weekends). I also have MAJOR insulin resistance in the morning–at least, that has to be what this is. I can’t make sense of it.

I have a higher basal rate set two hours before I wake up on weekdays. WAY higher. Like, more than 2 times as high. Is this normal for others with DP? I leave it higher like this for 3 hours. I’ve found if I don’t eat, this will keep me from rising/falling much.

But, if I do eat carbs, everything goes to crap. I have a different insulin/carb ratio in the morning hours. Normally, I am 1:9 throughout the day. In the morning, I have this set on 1:6, and honestly, more often than not, I give myself 1-2 extra bolus units with breakfast. (And end up correcting with another couple after that!)

Like this morning for example. I woke up at 132mg/dl (steady line, no spike), which is a little higher than I prefer for sure, but I had a low before going to bed last night that I had to treat, so it doesn’t surprise me I was higher when I woke up.

I took a correction bolus for this and went ahead and bolused for my breakfast, a 36g carb (supposedly, but now I’m skeptical) muffin along with it. I took 8 units for this, which is a little absurd (seriously, at night I would take 4u for 36g!), but oh well.

Waited about 30 minutes before eating the muffin.

About an hour and a half after eating my muffin, I notice my CGM is in the middle of a major spike. Test with my meter, and sure enough: 228mg/dl!

What a bunch of crap. What could I have done differently here besides not eat the damn muffin?

I don’t always have a nice treat of a muffin in the morning, but you know, sometimes you just want that muffin! It annoys the absolute hell out of me that breakfast contains all the most deliciously wonderful carby foods on the planet. I really love breakfast food. And I love eating it in the morning. It makes me mad that I feel I can’t indulge every once in a while and maintain decent blood sugar control.

Anyway, after the 228, I took 5 correction units. Pump wizard told me 2.6, but screw that. I was still on the rise. It’s been one hour since the 5 units, and I’ve leveled off to a straight line–not even falling yet. So I guess the extra amount was the right decision.

And I’ve now bolused my way through have my normal daily bolus TOTAL for the day before 11am. Fan-bloody-tastic.

I’m wondering if I should consider taking Symlin in the mornings. I tried Symlin once a few years ago while I was on MDI, and I abso-damn-lutely HATED it. It made me so sick and miserable for hours. I never threw up. I just felt rundown and terrible. I started off on such a low dose of it too, I never saw any benefits (I never took less insulin). But now I’m almost considering giving it another shot (har-har) because I’m so ticked at my morning situation.

(When I was on MDI, these morning issues are things I didn’t notice at all, but that might have been due to my own not caring about my diabetes as much back then. I also didn’t eat breakfast on workdays, and that might have been part of it too!)

2

i have found cereal and carbs are just out of the question for me in mornings so i too will spike. Lately i’ve switched to 2 boiled eggs and a slice of w/w toast for breakfast and its actually done wonders to my sugars compared to the cereal days (as much as i’d die for my strawberry special k) . You should try high protein in the morning low carb and see if that makes a diff! :slight_smile:

3

Yeah, that’s what I usually do—and it makes a huge difference. But sometimes I just WANT that muffin, you know? Haha. Maybe I’m just being unreasonable. But this is the one area where I feel I can’t adjust my diabetes treatment to make me operate like a semi-normal human.

4

If it makes you feel any better my 12 year old daughter has the same “dawn phenonemon” Her morning wake up #'s this past weeks were 246, 221, 157 one day 71. she starts with a correction eats a well balanced b-fast of eggs 2 bacon and maybe 1 slice of toast has to do a 1:5 ratio in the AM then in two hours usually a corretion of 3-5 units. Its crazy! she doesnt want to give more initially as she is in class and it would be terrible for her to go low at school, so she opts for an extra shot at passing time.( she is still resistant to using a pump) But her outlook is good, she figures as long as she’s catching these spikes - she’s bringing her bs’s down in a pretty timely manner so it is what it is.

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Have you done over night basal testing to see where you are dropping to low? If you can pinpoint the time you are dropping to low and give yourself less insulin then and then increase it right before you wake up and see if that makes a difference. This was happening to me for a while and once I figured out I was going low around 3 am and adjusted my basals I was good to go in the mornings.

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Veronica - yeah, it is crazy. The pump and CGM has helped me from waking up that high, but it seems even so there’s still only so much we can do. Comforting to know I’m not the only one with a crazy insulin carb ratio in the morning–that doesn’t even help all the way. And yep, at least we’re catching those spikes and bringing them down early! Guess we have to take what we can get sometimes. Good luck to her!!

Cody - I have a CGM and am definitely not dropping to low during the night. Only last night I went low before going to sleep (had to do more with food last night than basal), then didn’t stay awake to see how much I bounced back after the correction, which is why I woke up at 132, instead of the usual 80-100 or so. I already have the higher basal before I wake up. So many factors. Haha. Frustrating!