Overcoming The Dawn Phenomenon - Page 5

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Overcoming The Dawn Phenomenon - Page 5


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Old 09-06-2016, 00:48   #41
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Obviously I'm neither a T1 or a doctor but I'm curious why you were hesitant to correct the 178? Or is the issue that when you wake up with great BG, it's not clear how much insulin to take to prevent the spike?
I was hesitant to take insulin for the 111 reading, though I knew it would go up by the time I tested again before breakfast. 6am it was 111, at 8am it was 178. I'm starting to get an idea of how much it is raising in the morning, and I'll start giving a lower dose and see how that does. Then go from there, I think.

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Old 09-06-2016, 05:27   #42
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I was hesitant to take insulin for the 111 reading, though I knew it would go up by the time I tested again before breakfast. 6am it was 111, at 8am it was 178. I'm starting to get an idea of how much it is raising in the morning, and I'll start giving a lower dose and see how that does. Then go from there, I think.
.
Those are similar numbers that I saw for years. But do consider that I am type 2, so different than you, nor do I take Basel. but here's my experience.

I have struggled with DP in the morning for many, many years. I recently was able to get control using Humalog in the morning only. I'll wake up between 105-120, but will rise to 180+ within a few hours - without fail. I do have some variation in my FBG number though. I only recently was able to get lower FBGs through diet changes. But one thing that's constant is that During the week I get up at 5 and my FBG is lower than on the weekend, when I get up at 7 or so.

To manage the DP, I have found the following works for me:

1) I must eat (and inject) within 30 minutes of waking up. The sooner you can catch it and keep it down the better, and the less insulin resistance you need to deal with.

2) I need the same amount of Humalog in the morning regardless of what my FBG number is/was. If I wake up with a FBG of 90, 105 or 140, I still take the same 24 units to overcome the DP no matter what.If I take less, I will still go up and will not come down low enough. With 9 grams of carbs and 24 units I will end up in the high 70s to low 80s within 3-4 hours of injecting. Having tested every hour after injecting, I will go up 10-20 points of my FBG, but the Humalog is definetly combating the DP.

3) I really only take Humalog in the morning, because rest of the day I do not need it. In the beginning, I did try to use the Humalog to off set large carb loads and found that I need 2-3x the amount of insulin in the morning than I needed the rest of the day. This is because the DP increase insulin resistance.


.

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Old 09-06-2016, 15:30   #43
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I've been noticing the same thing, the earlier I get up the lower my sugars are. I normally get up around 5 or 6, but sometimes not til 7. Though that isn't too common.
I don't want to change too many things at once, I just had my insulin switched and am changing my diet too. Thank you again, that helps and gives me some ideas. Hopefully I'll get everything straightened out sooner than later.

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Old 09-07-2016, 05:40   #44
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I've been noticing the same thing, the earlier I get up the lower my sugars are. I normally get up around 5 or 6, but sometimes not til 7. Though that isn't too common.
I don't want to change too many things at once, I just had my insulin switched and am changing my diet too. Thank you again, that helps and gives me some ideas. Hopefully I'll get everything straightened out sooner than later.

No doubt you will. The key is to take it slowly. Try to figure out how much insulin you need to overcome the DP. Start by eating & injecting closer to when you wake up. I think that may help a lot and you can do that now. Be sure to start with smaller boluses and see how much you come down. Test all the time to be sure you don't go too low and be ready with some fast carbs.

It took me several months to come to the conclusion that I should take the same amount of insulin regardless of my FBG, and to figure out how much insulin I needed. When my FBG was lower, I was worried that I might take too much insulin, so I injected less, but at 4 hours I did not come down enough. So it's experimentation with lots of testing. But now the results are predictable.

.

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Old 09-07-2016, 13:03   #45
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This morning I woke up at 6, my sugar was 173. From the past experience I know that 10u will only bring me down about 10 points so I took 12, raising it slowly. I also ate a spoonful of coconut oil. I tested again at 7:30 and it was 131! But now, was it the insulin dose, the coconut oil or both? I see more trial and error to come.

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Old 09-08-2016, 02:15   #46
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This morning I woke up at 6, my sugar was 173. From the past experience I know that 10u will only bring me down about 10 points so I took 12, raising it slowly. I also ate a spoonful of coconut oil. I tested again at 7:30 and it was 131! But now, was it the insulin dose, the coconut oil or both? I see more trial and error to come.
Excellent! I doubt the fat did it, although it may have stopped the DP increase. I needed carbs to stimulate insulin, but since you are T1, you don't have any to stimulate.

This is exactly the way to do it. It will take a while. Try that again tomorrow. If the same results, try increasing the insulin 1-2 units. The key is to eat the same thing every time so you can focus on countering the DP rise (glucose dump). If you change the food it will be hard to match the glucose dump.

BTW, which meter are you using?

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Old 09-08-2016, 03:28   #47
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My meter is the Contour Next EZ. I was using Freestyle something or other. But those test strips cost way too much and I was waiting for my insurance to say I could have them and cover them. It was really stupid, they needed my Dr to fill out a form telling them why I needed the test strips and then see if they would approve it. They finally did, but will only give me 100 per month and I'm using a lot more than that. These strips are much cheaper.
For tomorrow I plan on doing the same thing as today. But I am really stressed right now and I know that affects my sugars. So we'll see what happens. I had to take my basset hound to the emergency vets tonight, he has a bad GI upset. Waiting on blood work and Xrays, till I know what is going on with him I think my sugars may be a bit out of wack.
I'd like to be able to take as little insulin as possible when I wake up, I just can't stomach food that early.

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Old 09-08-2016, 04:16   #48
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My meter is the Contour Next EZ. I was using Freestyle something or other. But those test strips cost way too much and I was waiting for my insurance to say I could have them and cover them. It was really stupid, they needed my Dr to fill out a form telling them why I needed the test strips and then see if they would approve it. They finally did, but will only give me 100 per month and I'm using a lot more than that. These strips are much cheaper.
For tomorrow I plan on doing the same thing as today. But I am really stressed right now and I know that affects my sugars. So we'll see what happens. I had to take my basset hound to the emergency vets tonight, he has a bad GI upset. Waiting on blood work and Xrays, till I know what is going on with him I think my sugars may be a bit out of wack.
I'd like to be able to take as little insulin as possible when I wake up, I just can't stomach food that early.
I'm so sorry to hear about your dog. Positive thoughts that everything turns out to be okay.

So tomorrow may not be a good day BG number wise. If they are offs Just see how they are the next day.

In my testing, I find the contour next to run a little high, so do give yourself a buffer so you don't go too low.

If you are limited on how many strips you can get, and are able to buy some yourself, I have found the Walmart Relion Prime to be pretty darn accurate. When I bought it to do competitive tests, it was something like $50 for the meter and 200-300 strips.

Look forward to your next updat and best wishes for your Bassett Hound.

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Old 09-08-2016, 21:14   #49
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I'm so sorry to hear about your dog. Positive thoughts that everything turns out to be okay.

So tomorrow may not be a good day BG number wise. If they are offs Just see how they are the next day.

In my testing, I find the contour next to run a little high, so do give yourself a buffer so you don't go too low.

If you are limited on how many strips you can get, and are able to buy some yourself, I have found the Walmart Relion Prime to be pretty darn accurate. When I bought it to do competitive tests, it was something like $50 for the meter and 200-300 strips.

Look forward to your next updat and best wishes for your Bassett Hound.
Thank you, for your help and wishes. Right now I'm not sure how Shorty, the basset is going to be. He's 12 and it could be cancer. Waiting on some test, why do they always have to get sick over the weekend or on holidays?

Anyway, I'll look into your suggestion on the meter. I feel confident so far with this one, and I have something like 200 strips now. But I will keep it in mind. I know this one and the Freestyle were reading around 20 points difference.

My numbers today were surprisingly similar to the yesterdays. Woke up and tested around 5:30, 167. I took 10u(2 less than the day before) and took some coconut oil. At 7:45 it was 113. So something looks like it is working, now I just have to work on getting that morning number down.

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Old 09-09-2016, 05:57   #50
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Thank you, for your help and wishes. Right now I'm not sure how Shorty, the basset is going to be. He's 12 and it could be cancer. Waiting on some test, why do they always have to get sick over the weekend or on holidays?

Anyway, I'll look into your suggestion on the meter. I feel confident so far with this one, and I have something like 200 strips now. But I will keep it in mind. I know this one and the Freestyle were reading around 20 points difference.

My numbers today were surprisingly similar to the yesterdays. Woke up and tested around 5:30, 167. I took 10u(2 less than the day before) and took some coconut oil. At 7:45 it was 113. So something looks like it is working, now I just have to work on getting that morning number down.
Well I hope that everything is okay for Shorty.

Sounds like you are making some progress. Two thoughts on your morning number. Please do keep in mind I am a T2, so I am not sure how things work for a T1. This is just based upon my personal experiences.

I am thinking that there could be two potential contributors to your morning number.

First, you could be going low at night and what you are seeing is a rebound from a glucose dump. It's called the Somogyi Effect.

Somogyi effect VS. Dawn Phenomenon

Look at the link and do some more searches on Somogyi. Some solutions include having a snack before bed, or adjusting your Basel.

The other issue could be what you are eating at night. Perhaps you are taking in too much protein. This was my problem. I learned that up to 50% of protein can convert to glucose, especially if you are taking in more than your body needs. In addition, protein uses insulin to be process, so with too much protein, your insulin could be in short supply to handle glucose and protein processing.

When I cut my dinner protein and increased fat, my morning FBG numbers came way down. BUT, it did not stop my DP rise. I still need the insulin to offset the DP. This morning my FBG was 105, but I still took 24 units of Humalog. BTW, my breakfast is only 9 grams of carbs. My BG was 79 before lunch. So I know this is working for me. Also, before I would typically see a morning FBG between 160 and 180 daily for years. Then I was able to get it down to the 130s with Berberine (not sure if that is useful for a T1) and then got it to the 10x range by reducing protein.

As for the meter, all I am suggesting is to assume it might be 10-20 points high to leave a buffer to be sure you don't go too low. Everybody is different, but based upon my testing it runs high. Since you are on insulin, just want you to be careful.

Keep at it!!


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