What should i do in order to beat "Dawn Phenomenon"

i got this formula years ago for the morning highs. i tried not to wake up and see what would happen, but then my morning blood sugar has increased to even 300-350 range.

it is really hard to wake up at midnight especially if you are tired but i have no solution, otherwise.

by the way i use insulatard, but passing through levemir would not mind in my opinion since they have simular efficiency time.

generally if my blood sugar is okay at midnight, i inject 10 units of insulatard and in the morning i do not do long acting insulin.

so what should i do not to wake up?

For those that don't know, Insultard is the name for NPH human insulin in many parts of the world.

My experience is that Darn Phenomenon (DP) can be dealt with by getting a proper insulin level overnight. It is likely that one key way of dealing with your DP is getting your insulin levels up in the early morning hours 3-5 am.

If you can increase your Insultard dose at night without experiencing hypos, that may work.

But Levemir may be better. Insultard and Levemir have a similar onset of action, but Levemir lasts longer, peaking for 8-10 hours, while Insultard peaks for 4-9 hours. If your Insultard peaks at 4 hrs, you may have too little insulin acting during those critical hours of 3-5am. In that case, Levemir might make a big difference.

The best answer is to consult your doctor with the change. Roughly you would expect each unit of NPH and Levemir will act the same, but they will act over a different time frame. If you take one shot a day of basal (Levemir), take it in the evening, that will result in a peak overnight when you need it most.

That is exactly what I am talking about. Rather than taking it at 7pm, you can take the NPH/Levemir before bed. It is best to take it at the same time every day.


is a chart I've found useful to consider how the insulin works. I took NPH 1984-2008 and generally split doses, having about 2/3 in the AM and 1/3 in the PM to provide all day coverage. I had ok BG results (6ish A1C much of the time, although I had several lengthy periods where I blew off going to doctors...oh well...) but gained a lot of weight, overshooting and "chasing the dragon" with potato chips and beer? When I got my pump, the doc mentioned that NPH only has a 53% chance of "peaking" when it's supposed to. I haven't seen this reported elsewhere but it explained a lot of the odd data that I had observed, numbers flying all over the place, etc.

Your NPH (insultard) dose at midnight might actually be causing you to go low around 5-6am... thus you are maybe getting a rebound high in the morning?
What about trying an earlier does of NPH (if you want to stick with it) 6-7pm .. see what it does to you BG in 4-5 hours (still means a couple of sleep interrupted nights)
Like acidrock I too found that splitting up my long acting insulin dose helped.
Different things work for everyone!
I now take most of my Levimir in the morning but also a smaller dose when I go to bed (this prevents my morning highs, usually)

i suggest going on the pump. it is the only solution i found to those pesky morning highs. i increase my midnight basal and wake up in the 100s, eat bkfst around 5 -6 am(eggs, always, with a piece of buttered toast) and then i go bk to sleep. why this formula works, i have no idea. it just does. maybe for you, there is a way to adjust your midnight insulin so that it peaks early in the AM. I used to be on NPH and Lantis, & Humolog. i was forlorn and frustrated. the pump changed my entire life.

just a thought.