Dawn Phenomenon Help

Hello all,


Recently my blood sugars have been ridiculously high -- for a while I couldn't get them under 400 and I took a couple trips to the ER.  I've been able to get my blood sugar in normal range by bed time, but my sensor is showing that there's a rise in my blood sugar around 4am every day. I've been diabetic for almost 10 years, so it seems weird that the dawn phenomenon would be starting now, but as we know the 'betes has a mind of its own.


Any thoughts, advice, encouragement, etc...?  I'd really like any/all of the above.  It's just one of those times in my diabetes life -- figured some vets could help.


Thanks.  I really do love and appreciate you all.

The last month I've been having some problems with the DP too (but mine doesn't kick in until around 6am). Starting at 4am, I have a fairly significant rise in my basal rate (about .55 units), then at 8am I have another rise to combat the "waking up" rise in my BGs (that's almost an entire unit rise in basal rate). My morning BGs are getting better (they're below 150 now, as opposed to the over 200s I was having before). About every 5 days, I'll tweak the rate again and watch how it changes. 

Praise the Lord for CGMs and insulin pumps! :D

Think Like a Pancreas says DP commonly emerges when people are in their early 20's.  But some folks on this forum say they had it even as kids, so it can happen anytime. 

To treat increase basal rates just before the glucose rise begins and then taper it off  mid-morning.  I also adjust my carb ratio a bit for breakfast, so instead of taking a unit of insulin for ever 15g of carb  I take a unit for every 10g.  Experiment a little and see what works for you.


I've had trouble with this before too.  Like jennagrant, my insulin-carb ratio in the morning is higher, 1:12 rather than 1:15.  What does your endo say about it?

I hope things even out for you soon!  There's nothing worse than feeling like you're doing everything you're supposed to and your sugars go on the fritz!  Keep us posted!

Riley has been doing this. Hers starts in between 3 and 5. I am up at 3 to test so I correct her then actually around 4 is when I retest and correct. She gets up at 7 so she has no more fast acting on board. If I need to I can give her another correction with breakfast if needed. She is normally pretty close to being in range tho. Then does ok for the rest of the day. If I dont do that and wait for breakfast to correct the first time by noon and lunch time she is barely under 200 if that. She doesnt come down until 3 p.m. ish. Lately too tho she is down to a good number 80ish at 3 a.m. and still within range but climbing by 7 like 12-130ish which if I just give her insulin for her breakfast she is ok for the rest of the day.

Thanks all.  I just had a "wake up in the middle of the night and have a ridiculously accurate epiphany" moment.


I have every symptom of hypothyroidism.  Time to go in for blood tests.



my mistake.

I'm sorry, Sonja!  But hopefully checking this out will help your swings.  Keep us posted!

Could be that the problem is not too little insulin, but too much insulin.  If your BS goes down low at night, your body (unless you've been drinking alcohol) will release glucose of something to bring your BS back up.  But, it releases way too much and your BS skyrockets.  Has been happening to me lately and I'm 52.

DP didn't start for me until my late 20's. For awhile, like DDrumminman, I wondered if I wasn't going low and rebounding. But, thanks to CGM's, I now know exactly what's happening.

Anyways, the other thing I do (that I don't think anyone mentioned unless I missed it) is bolus for breakfast waaaay before I'll eat to avoid a huge post breakfast spike. I experimented and found that 45 min before eating works best to make sure the insulin is working, but before I go low. A T1 friend of mine has to wait an hour. I just take the insulin when I get up, get ready, and eat breakfast last. And, obviously, I go pretty low-carb at breakfast.

Sarah - awesome idea bolusing early.  I have huge problems with post meal spikes (almost 400 after ever meal) so I'll try that out as well.  I have been doing about 15 minutes early, but it could be i need to bolus even earlier.


And I definitely don't get low in the middle of the night.  Recently I've been sitting at about 180-250 until about 4am when i shoot up about 200 points.


I have an appointment to check my thyroid this week.  meh.

Hope the thyroid is okay! :P

It sounds like you could use more basal / long-lasting insulin (not sure if you're on MDI or a pump) if you're running that high over night. Glad you'll get in with the dr soon to work on it! At least for me, I feel AWFUL when I wake up high.

I'm on a pump.  I'm already taking triple the amount of insulin i was taking 2 weeks ago... I'm kind of scared to take any more, and my endo agrees. 


I got blood drawn today and I'm supposed to find out about my poor thyroid by friday.  I don't care what's wrong, I just want an answer.

Sonja, I hope you won't have to wait long for the results...  and answers...  I'm thinking about you! 

I hope you get answers soon, Sonja.  I'm concerned for you, too!


I'll be thinking of you!  I hope they figure out what's going on so you can start feeling better soon.  We're here if you need anything!