Sarah Howard (nee Tackett) has dedicated her career to supporting the T1D community ever since she was diagnosed with T1D while in college in May 2013. Since then, she has worked for various diabetes organizations, focusing on research, advocacy, and community-building efforts for people with T1D and their loved ones. Sarah is currently the Senior Manager of Marketing at T1D Exchange.
My “dawn phenomenon” is like yours. My blood sugar seems to rise from a fairly normal place as soon as I get up so I have to bolus something, maybe 1-2 units.
Yes. Endocrinologist thought it was rebound til I figured out was my NPH running out. Put me on ultralente helped. Now 16 years on Omnipod just program higher basal starting 3:00 am
Always, starts about 4a. THEN a rise again soon after I get up – 5a, or 6, or 7. Within 45 min I’ve gone up 50-60 points. Loop covers it well, but the other 2 pumps require 15g “fake”carb bolus.
I actually experience the complete opposite–a huge drop starting around 4-5 AM. My basal is the lowest of the day during those hours, by far. I don’t understand it!
Lots of mornings, I take humalog and just wait for the numbers to come down before eating anything but do drink some coffee while I wait. This is realtively new but since I watch on a cgm, I can see the numbers whenever, wherever. If I take more Lantus, it may increase the chances of lows during the night, but might increase by a unit to see if that doesn’t help the pre dawn syndrome.
No – strangely enough. I usually bottom out around 1 – 2am and very very slowly rise. I do have feet on the floor bump of 20 points the second I get out of bed.
I would agree. Circadian hormonal variation that affects blood glucose levels in normal. For clarification, if you mitigate the dawn rise by increasing basal insulin delivery, you still have the dawn phenomenon.
I used to, while on MDI. First thing we tried was splitting my Lantus dose. That helped somewhat, but once I got my pirst pump (pre-CGN days) and saw that I could vary the basal setting by time of day, it basically doesn’t happen all that often. My CGM data shows me when I should start the very early morning increase in basal since insulin can take some time to do its job. I do rise due to my first cup of coffee (black – no additives) so I bolus for 6 grams and that handles it.
I have adjusted my basal to reflect and adjust for dawn phenomena and I have to be careful about my morning foods as my insulin needs are higher in the morning for food eaten.
Since being on a pump/CGM, I don’t experience dawn phenomenon any more, but I need to be careful with morning exercise because of the increased insulin I get from 3-5 AM. I drop pretty quickly if I don’t eat a snack.
My BG almost always rises. So I have the basal rate on my pump to increase beginning at 5:30 AM. The effect is that my morning BG usually stays stable until whatever time I choose to eat breakfast and take the mealtime bolus.
The control IQ keeps me flatline from about 2200 hours to 0530 hours. Then the fun begins. I have been advised NOT to cover it with basal but to use corrective doses. Between the growth hormone factors and the gastroparesis random number generator factors, I am having an exciting every-day-is-new-on-the-roller-coaster experience. Ain’t life fun? 🙈 ⚠
I have my basal set higher to cover it so since being on Tandem it is not an issue. If I don’t do much or eat breakfast I can straight line up to 12:00 noon before it starts to come down.
This is a very poorly written question as can be seen by the comments. DP happens only while sleeping and that should have been in the question to eliminate the “feet on the floor” syndrome which only happens after you wake.
Yes, dawn phenomenon is pretty constant and I have it programmed into basal. As others are mentioning foot on the floor can be a real pain to deal with.
Since starting on a CGM in 2012, I’ve had a very quick, severe morning rise 5am-6am timeframe (I’m a morning person, so no surprise). I also have a natural rise at 11am and 10pm for some reason. I’m currently 90-93% in range so my endo is happy with the short-term(30-60 min) rise in the morning. I plummet soon after… prebolusing, basal corrections, carb ratio adjustments make no difference. The only thing that eliminates it is a hot shower immediately after eating or getting up and moving around, as opposed to sitting and reading the paper 🙁
I always take 10 grams of “ghost carbs” when I wake up to help even out the feet on the floor syndrome as I call it.
So agree, most women call it “feet on the floor” I’ve heard med call it “after shower” rise!
My “dawn phenomenon” is like yours. My blood sugar seems to rise from a fairly normal place as soon as I get up so I have to bolus something, maybe 1-2 units.
This is feet on the floor not DP, which only happens in your sleep cycle.
Prior to Control-IQ it was a daily ritual. Now I’m wake up about 90-110.
I raise my basal a couple of o
Points starting at 3 am each day to counteract it.
Yes. Endocrinologist thought it was rebound til I figured out was my NPH running out. Put me on ultralente helped. Now 16 years on Omnipod just program higher basal starting 3:00 am
Always, starts about 4a. THEN a rise again soon after I get up – 5a, or 6, or 7. Within 45 min I’ve gone up 50-60 points. Loop covers it well, but the other 2 pumps require 15g “fake”carb bolus.
I do but my pump increases basal to compensate.
I actually experience the complete opposite–a huge drop starting around 4-5 AM. My basal is the lowest of the day during those hours, by far. I don’t understand it!
Lots of mornings, I take humalog and just wait for the numbers to come down before eating anything but do drink some coffee while I wait. This is realtively new but since I watch on a cgm, I can see the numbers whenever, wherever. If I take more Lantus, it may increase the chances of lows during the night, but might increase by a unit to see if that doesn’t help the pre dawn syndrome.
Yes but TSlim sleep mode adjusts for it
No – strangely enough. I usually bottom out around 1 – 2am and very very slowly rise. I do have feet on the floor bump of 20 points the second I get out of bed.
Yes always but because of that I have my basal set higher for that time of day.
I thought I did when I was on Medtronic’s automated system. Now I am living unlinked and can control my basal myself and I’m steady all morning.
Yes, I find it occurring almost every day. So much so that I am surprised that this question says it’s “abnormal!”
I would agree. Circadian hormonal variation that affects blood glucose levels in normal. For clarification, if you mitigate the dawn rise by increasing basal insulin delivery, you still have the dawn phenomenon.
I used to, while on MDI. First thing we tried was splitting my Lantus dose. That helped somewhat, but once I got my pirst pump (pre-CGN days) and saw that I could vary the basal setting by time of day, it basically doesn’t happen all that often. My CGM data shows me when I should start the very early morning increase in basal since insulin can take some time to do its job. I do rise due to my first cup of coffee (black – no additives) so I bolus for 6 grams and that handles it.
No, unless you want to count being carb-bad the night before.
I have adjusted my basal to reflect and adjust for dawn phenomena and I have to be careful about my morning foods as my insulin needs are higher in the morning for food eaten.
I probably have, but now no since I’m on a pump. However my early morning basal (3-5 am) is not significantly different than those around it.
I did for a great many years, but haven’t for the last 15 or 20. (I’m 70)
Since being on a pump/CGM, I don’t experience dawn phenomenon any more, but I need to be careful with morning exercise because of the increased insulin I get from 3-5 AM. I drop pretty quickly if I don’t eat a snack.
The Dexcom G6 and Tandem w/CIQ have finally eliminated that problem
Yes. Since starting Control-IQ that hasn’t been an issue.
My BG almost always rises. So I have the basal rate on my pump to increase beginning at 5:30 AM. The effect is that my morning BG usually stays stable until whatever time I choose to eat breakfast and take the mealtime bolus.
I used to but not anymore with Tandem Control IQ. Without Dexcom G6 and CIQ, most likely I would still be experiencing dawn phenomenon.
Feet on the floor,
Watch the BG soar!
The control IQ keeps me flatline from about 2200 hours to 0530 hours. Then the fun begins. I have been advised NOT to cover it with basal but to use corrective doses. Between the growth hormone factors and the gastroparesis random number generator factors, I am having an exciting every-day-is-new-on-the-roller-coaster experience. Ain’t life fun? 🙈 ⚠
This is not DP, which only occurs during sleep. You are describing feet on the floor and are doing what I do if this happens.
I use to have a pretty severe one but then menopause hit and now it’s not so bad.
I have my basal set higher to cover it so since being on Tandem it is not an issue. If I don’t do much or eat breakfast I can straight line up to 12:00 noon before it starts to come down.
MM automode compensates.
This is a very poorly written question as can be seen by the comments. DP happens only while sleeping and that should have been in the question to eliminate the “feet on the floor” syndrome which only happens after you wake.
Dawn Phenomenon
https://www.diabetesdaily.com/learn-about-diabetes/understanding-blood-sugars/is-my-blood-sugar-normal/high-blood-sugar-hyperglycemia/fixing-high-morning-blood-sugars-dawn-phenomenon/
https://beyondtype1.org/dawn-phenomenon/
Yes, dawn phenomenon is pretty constant and I have it programmed into basal. As others are mentioning foot on the floor can be a real pain to deal with.
After reading comments, it looks like mine is not dawn phenomenon. It is always when I awake.
Since starting on a CGM in 2012, I’ve had a very quick, severe morning rise 5am-6am timeframe (I’m a morning person, so no surprise). I also have a natural rise at 11am and 10pm for some reason. I’m currently 90-93% in range so my endo is happy with the short-term(30-60 min) rise in the morning. I plummet soon after… prebolusing, basal corrections, carb ratio adjustments make no difference. The only thing that eliminates it is a hot shower immediately after eating or getting up and moving around, as opposed to sitting and reading the paper 🙁
I am the reverse !! I wake up because of a LOW BG… I have a snackThen I go back to bed for a few hours more.
It’s really hard to tell, because there are so many things that could make my blood sugar rise at any time.
That’s what the higher early morning basal rate is programmed for. Correct basal rate means no hyperglycemia.