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    • 19 hours, 15 minutes ago
      kristina blake likes your comment at
      How comfortable are you, on a scale of 1–5, with artificial intelligence (AI) being integrated into your diabetes technology?
      With all technical advancements there are good things and bad things. The bad things (unforseen consequences) could be deadly like Hallucinations for the user, getting over doses of insulin. So, carefully thought out guard rails need to be developed and thoroughly tested. A good thing must be the accumulation of scenarios that KSannie mentioned. However it can not be completely autonomous. The current accuracy of Dex G7 and other sensors introduce error in to the calculations. This is similar to "self driving cars." The Robo taxi experiments have shown the unusual events that could become dangerous. Either audible situation commands or textual inputs like "goin to bed" or "driving" or "exercising" may be required at the beginning for a new user. As an example, after wearing my smart watch for a year now, it recognizes exercising without me having to tell it I'm exercising. This drives a more advanced and improved user interface. The other perceivable advantage might be accumulating changes over time, such as sicknesses, weight gain or loss, or changes in activity. Changes in food intake might be difficult to overcome. Something like "Under my Fork" app. Personally, I would like to see a reminder to bolis before eating! With all that said, we do we need all that? Probably not. Evolution of modified closed loop control may eliminate the need for AI control. The reality may be somewhere in-between the two.
    • 19 hours, 16 minutes ago
      kristina blake likes your comment at
      How comfortable are you, on a scale of 1–5, with artificial intelligence (AI) being integrated into your diabetes technology?
      I believe that AI may very well become a great tool - but at this time it still makes too many errors for me to be confident in it.
    • 19 hours, 17 minutes ago
      kristina blake likes your comment at
      How comfortable are you, on a scale of 1–5, with artificial intelligence (AI) being integrated into your diabetes technology?
      Here's my concern. I've used AI when meeting new clients to take notes of my meetings while I'm talking with the client. Ostensibly, this frees me up from having to jot down notes while talking - allowing me to give my full attention to the conversation. (Very good benefit of AI) Then, when reviewing the notes, AI literally fabricated scenarios that weren't discussed (AI Hallucinations are a very bad side effect). Not knowing when AI will fabricate a fact pattern gives me great concern that AI will fabricate a glucose reading and then act on that hallucination. AI has great potential, but it's not ready yet.
    • 19 hours, 17 minutes ago
      kristina blake likes your comment at
      How comfortable are you, on a scale of 1–5, with artificial intelligence (AI) being integrated into your diabetes technology?
      I’m uncomfortable not knowing when and when it isn’t being used, but I’m not sure why really. A “singer” named Benny Rivers popped up in one of my feeds. I really liked the music, until I found out it was a total AI fabrication. Then I was uncomfortable. Why? I felt “taken”, like someone pulled a fast one on me, pulled the wool over my eyes. I liked the music less then. I didn’t like that I couldn’t find a tour date, things like that. But I was most uncomfortable not truly understanding why it made me uncomfortable. The music was still enjoyable.
    • 20 hours, 52 minutes ago
      Natalie Daley likes your comment at
      How comfortable are you, on a scale of 1–5, with artificial intelligence (AI) being integrated into your diabetes technology?
      Having recently dealt with ongoing tech issues involving our heat and electrical-use notifications for more than six months — and it’s still not fully resolved — I’m not always a fan of too much technology. That said, I am interested in advances like the Twist Insulin Pump potentially detecting scar tissue or helping with infusion-site issues. But then reality kicks in: taking devices off for MRIs, replacing failed equipment, and navigating Medicare when it’s primary insurance can become a nightmare of paperwork and delays. And honestly, AI in some call centers has been pretty frustrating. Sometimes it feels like no one can answer a real-world question anymore. I think we should tread lightly and make sure technology actually makes life easier for people living with T1D — especially older adults who already manage enough complexity every day. Some days I think about a less stress free life and going back to a syringe and insulin. over 45 years of doing that, and now 25+ of devices, I'm tired of the challenges in getting replacements, and scar tissue, and mail order supplies and on and on.
    • 20 hours, 53 minutes ago
      Natalie Daley likes your comment at
      How comfortable are you, on a scale of 1–5, with artificial intelligence (AI) being integrated into your diabetes technology?
      With all technical advancements there are good things and bad things. The bad things (unforseen consequences) could be deadly like Hallucinations for the user, getting over doses of insulin. So, carefully thought out guard rails need to be developed and thoroughly tested. A good thing must be the accumulation of scenarios that KSannie mentioned. However it can not be completely autonomous. The current accuracy of Dex G7 and other sensors introduce error in to the calculations. This is similar to "self driving cars." The Robo taxi experiments have shown the unusual events that could become dangerous. Either audible situation commands or textual inputs like "goin to bed" or "driving" or "exercising" may be required at the beginning for a new user. As an example, after wearing my smart watch for a year now, it recognizes exercising without me having to tell it I'm exercising. This drives a more advanced and improved user interface. The other perceivable advantage might be accumulating changes over time, such as sicknesses, weight gain or loss, or changes in activity. Changes in food intake might be difficult to overcome. Something like "Under my Fork" app. Personally, I would like to see a reminder to bolis before eating! With all that said, we do we need all that? Probably not. Evolution of modified closed loop control may eliminate the need for AI control. The reality may be somewhere in-between the two.
    • 20 hours, 54 minutes ago
      Natalie Daley likes your comment at
      How comfortable are you, on a scale of 1–5, with artificial intelligence (AI) being integrated into your diabetes technology?
      Sorry. I'm not sold on AI. I don't trust the people making it. There are too many reasons it could go wrong and be disasterous (just read the above comments). I'm not opposed to computers helping with things such as Control IQ, but when the computer starts doing the thinking, I think we've crossed the line. An aside: I've listened to AI music, and I think it sounds impersonal. It lacks a humanness. I don't find it pleasant to listen to. I've heard horror stories about AI being used by the military, with the end result being nuclear holocaust. I am a hard NO to AI. I gave it a "5".
    • 20 hours, 58 minutes ago
      Natalie Daley likes your comment at
      How comfortable are you, on a scale of 1–5, with artificial intelligence (AI) being integrated into your diabetes technology?
      I am comfortable using AI as a helpful tool, while fully cognizant of hallucinatory tendencies. If I may paraphrase a famous writer about a week ago analyzing universities (as well as AI): “the over-intellectualized nature of academic culture—the idea that all inquiry should be depersonalized, dispassionate, data-driven, objective. Being a good person is more about having the right emotions, perceptions, and intentions toward others in the concrete circumstances of life than it is about logic-chopping games and dry dissertations.” 𐚁
    • 22 hours, 3 minutes ago
      Kathy Hanavan likes your comment at
      How comfortable are you, on a scale of 1–5, with artificial intelligence (AI) being integrated into your diabetes technology?
      With all the deliberately misleading information out there, AI cannot discriminate. And, each patient is completely different in their rate of things like food digestion or insulin absorption. AI really is not up to this. And it cannot differentiate between highs due to stress of traveling, which go down as soon as I arrive, and highs due to illness, which can stay high for days, and gradually taper to normal at some variable rate. Once I was high due to illness, got better and then worse. I am afraid of getting too much insulin. It lasts 5 hours in the blood, including the basal amount. And the AI not being able to correct fast enough.
    • 22 hours, 3 minutes ago
      Kathy Hanavan likes your comment at
      How comfortable are you, on a scale of 1–5, with artificial intelligence (AI) being integrated into your diabetes technology?
      I believe that AI may very well become a great tool - but at this time it still makes too many errors for me to be confident in it.
    • 22 hours, 3 minutes ago
      Kathy Hanavan likes your comment at
      How comfortable are you, on a scale of 1–5, with artificial intelligence (AI) being integrated into your diabetes technology?
      I am comfortable using AI as a helpful tool, while fully cognizant of hallucinatory tendencies. If I may paraphrase a famous writer about a week ago analyzing universities (as well as AI): “the over-intellectualized nature of academic culture—the idea that all inquiry should be depersonalized, dispassionate, data-driven, objective. Being a good person is more about having the right emotions, perceptions, and intentions toward others in the concrete circumstances of life than it is about logic-chopping games and dry dissertations.” 𐚁
    • 22 hours, 41 minutes ago
      John Barbuto likes your comment at
      How comfortable are you, on a scale of 1–5, with artificial intelligence (AI) being integrated into your diabetes technology?
      Sorry. I'm not sold on AI. I don't trust the people making it. There are too many reasons it could go wrong and be disasterous (just read the above comments). I'm not opposed to computers helping with things such as Control IQ, but when the computer starts doing the thinking, I think we've crossed the line. An aside: I've listened to AI music, and I think it sounds impersonal. It lacks a humanness. I don't find it pleasant to listen to. I've heard horror stories about AI being used by the military, with the end result being nuclear holocaust. I am a hard NO to AI. I gave it a "5".
    • 22 hours, 41 minutes ago
      John Barbuto likes your comment at
      How comfortable are you, on a scale of 1–5, with artificial intelligence (AI) being integrated into your diabetes technology?
      With all the deliberately misleading information out there, AI cannot discriminate. And, each patient is completely different in their rate of things like food digestion or insulin absorption. AI really is not up to this. And it cannot differentiate between highs due to stress of traveling, which go down as soon as I arrive, and highs due to illness, which can stay high for days, and gradually taper to normal at some variable rate. Once I was high due to illness, got better and then worse. I am afraid of getting too much insulin. It lasts 5 hours in the blood, including the basal amount. And the AI not being able to correct fast enough.
    • 22 hours, 44 minutes ago
      John Barbuto likes your comment at
      How comfortable are you, on a scale of 1–5, with artificial intelligence (AI) being integrated into your diabetes technology?
      I believe that AI may very well become a great tool - but at this time it still makes too many errors for me to be confident in it.
    • 22 hours, 44 minutes ago
      John Barbuto likes your comment at
      How comfortable are you, on a scale of 1–5, with artificial intelligence (AI) being integrated into your diabetes technology?
      Here's my concern. I've used AI when meeting new clients to take notes of my meetings while I'm talking with the client. Ostensibly, this frees me up from having to jot down notes while talking - allowing me to give my full attention to the conversation. (Very good benefit of AI) Then, when reviewing the notes, AI literally fabricated scenarios that weren't discussed (AI Hallucinations are a very bad side effect). Not knowing when AI will fabricate a fact pattern gives me great concern that AI will fabricate a glucose reading and then act on that hallucination. AI has great potential, but it's not ready yet.
    • 22 hours, 46 minutes ago
      Mike S likes your comment at
      How comfortable are you, on a scale of 1–5, with artificial intelligence (AI) being integrated into your diabetes technology?
      Here's my concern. I've used AI when meeting new clients to take notes of my meetings while I'm talking with the client. Ostensibly, this frees me up from having to jot down notes while talking - allowing me to give my full attention to the conversation. (Very good benefit of AI) Then, when reviewing the notes, AI literally fabricated scenarios that weren't discussed (AI Hallucinations are a very bad side effect). Not knowing when AI will fabricate a fact pattern gives me great concern that AI will fabricate a glucose reading and then act on that hallucination. AI has great potential, but it's not ready yet.
    • 23 hours, 9 minutes ago
      Lawrence S. likes your comment at
      Do you have a management plan if you test positive for ketones? Please share more in the comments.
      Sure, if you can call it a plan to flush with liquids and take electrolytes and insulin as needed.
    • 23 hours, 9 minutes ago
      Lawrence S. likes your comment at
      Do you have a management plan if you test positive for ketones? Please share more in the comments.
      Inject. Inject. Inject. All other considerations are secondary, tertiary, or way down the list. Why would anyone ever rearrange the deck chairs on the Titanic? Might as well strike up the band to play Nearer My God to Thee!. ☹
    • 23 hours, 10 minutes ago
      TEH likes your comment at
      How comfortable are you, on a scale of 1–5, with artificial intelligence (AI) being integrated into your diabetes technology?
      With all the deliberately misleading information out there, AI cannot discriminate. And, each patient is completely different in their rate of things like food digestion or insulin absorption. AI really is not up to this. And it cannot differentiate between highs due to stress of traveling, which go down as soon as I arrive, and highs due to illness, which can stay high for days, and gradually taper to normal at some variable rate. Once I was high due to illness, got better and then worse. I am afraid of getting too much insulin. It lasts 5 hours in the blood, including the basal amount. And the AI not being able to correct fast enough.
    • 23 hours, 10 minutes ago
      Lawrence S. likes your comment at
      Do you have a management plan if you test positive for ketones? Please share more in the comments.
      It would depend on the symptoms and vary.
    • 23 hours, 11 minutes ago
      TEH likes your comment at
      How comfortable are you, on a scale of 1–5, with artificial intelligence (AI) being integrated into your diabetes technology?
      I am comfortable using AI as a helpful tool, while fully cognizant of hallucinatory tendencies. If I may paraphrase a famous writer about a week ago analyzing universities (as well as AI): “the over-intellectualized nature of academic culture—the idea that all inquiry should be depersonalized, dispassionate, data-driven, objective. Being a good person is more about having the right emotions, perceptions, and intentions toward others in the concrete circumstances of life than it is about logic-chopping games and dry dissertations.” 𐚁
    • 23 hours, 12 minutes ago
      Lawrence S. likes your comment at
      How comfortable are you, on a scale of 1–5, with artificial intelligence (AI) being integrated into your diabetes technology?
      With all the deliberately misleading information out there, AI cannot discriminate. And, each patient is completely different in their rate of things like food digestion or insulin absorption. AI really is not up to this. And it cannot differentiate between highs due to stress of traveling, which go down as soon as I arrive, and highs due to illness, which can stay high for days, and gradually taper to normal at some variable rate. Once I was high due to illness, got better and then worse. I am afraid of getting too much insulin. It lasts 5 hours in the blood, including the basal amount. And the AI not being able to correct fast enough.
    • 23 hours, 12 minutes ago
      TEH likes your comment at
      How comfortable are you, on a scale of 1–5, with artificial intelligence (AI) being integrated into your diabetes technology?
      2 It already is. But needs to be checked occasionally. I don't want a person inside me every five minutes.
    • 23 hours, 16 minutes ago
      KCR likes your comment at
      How comfortable are you, on a scale of 1–5, with artificial intelligence (AI) being integrated into your diabetes technology?
      Here's my concern. I've used AI when meeting new clients to take notes of my meetings while I'm talking with the client. Ostensibly, this frees me up from having to jot down notes while talking - allowing me to give my full attention to the conversation. (Very good benefit of AI) Then, when reviewing the notes, AI literally fabricated scenarios that weren't discussed (AI Hallucinations are a very bad side effect). Not knowing when AI will fabricate a fact pattern gives me great concern that AI will fabricate a glucose reading and then act on that hallucination. AI has great potential, but it's not ready yet.
    • 23 hours, 21 minutes ago
      Lawrence S. likes your comment at
      How comfortable are you, on a scale of 1–5, with artificial intelligence (AI) being integrated into your diabetes technology?
      Here's my concern. I've used AI when meeting new clients to take notes of my meetings while I'm talking with the client. Ostensibly, this frees me up from having to jot down notes while talking - allowing me to give my full attention to the conversation. (Very good benefit of AI) Then, when reviewing the notes, AI literally fabricated scenarios that weren't discussed (AI Hallucinations are a very bad side effect). Not knowing when AI will fabricate a fact pattern gives me great concern that AI will fabricate a glucose reading and then act on that hallucination. AI has great potential, but it's not ready yet.
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    Do you give a bolus right after waking up in the morning to counteract the dawn phenomenon (an abnormal early-morning rise in blood glucose)?

    Home > LC Polls > Do you give a bolus right after waking up in the morning to counteract the dawn phenomenon (an abnormal early-morning rise in blood glucose)?
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    If you wear a CGM, how many times in the past month have you had to change your sensor more than 24 hours before its session expired?

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    If you wear an insulin pump that has the capability to give extended boluses, on average how often do you give an extended bolus? Share in the comments how you decide when to give an extended bolus!

    Sarah Howard

    Sarah Howard has worked in the diabetes research field 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 Marketing Manager at T1D Exchange.

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Their collective expertise is central to our mission of improving outcomes for all people living with T1D.  “We’re excited to be working with our advisors given their deep expertise across a broad range of areas in T1D,” said Dave Walton, CEO of T1D Exchange. “Their involvement magnifies our reach, knowledge, and impact. These advisors are shaping the future of diabetes care — driving innovation across research, clinical practice, and quality improvement.”    Meet the Medical & Research Advisory Team  The T1D Exchange Medical and Research Advisory Team brings together four leading endocrinologists, each offering a unique perspective and shared commitment to advancing T1D care:    Jenise Wong, MD, PhD Pediatric endocrinologist at UCSF Benioff Children’s Hospital and Professor of Pediatrics in the Division of Endocrinology at the University of California, San Francisco Focus areas: Diabetes technology adoption and usability; health equity and access to care and technology; community-based and peer-support interventions; culturally responsive care          Jennifer Sherr, MD, PhD Pediatric endocrinologist at Yale Medicine and Professor of Pediatrics in the Division of Endocrinology at Yale School of Medicine in New Haven, Connecticut Focus areas: Clinical trials in diabetes technology (CGM and AID systems), disease-modifying treatments and immunotherapies, and emerging technologies and medications, including continuous ketone monitoring and nasal glucagon     Viral Shah, MD Adult endocrinologist at Indiana University Health and Professor of Medicine in the Division of Endocrinology and Metabolism at Indiana University School of Medicine in Indianapolis, Indiana Focus areas: Diabetes technology and adjunctive therapy trials; translational and data-driven research; T1D complications and bone health         Nestoras Mathioudakis, MD, MHS Adult endocrinologist at Johns Hopkins Medicine and Associate Professor of Medicine at Johns Hopkins University School of Medicine in Baltimore, Maryland Focus areas: AI-driven clinical support tools; EMR-based data analytics for clinical decision making; data-driven quality improvement; health equity in T1D care        This accomplished team’s expertise spans adult and pediatric endocrinology, research, and quality improvement affiliated with leading institutions nationwide. Collectively, they have authored over 500 diabetes publications and secured research funding from organizations such as the National Institutes of Health, Helmsley Charitable Trust, the American Diabetes Association, and Breakthrough T1D — while remaining actively engaged in both clinical care and research.  “These individuals represent an impressive body of work while remaining deeply involved in the day-to-day realities of diabetes care,” said Walton. Their expertise covers the full spectrum of T1D care — from AI and predictive analytics to complication prevention, automated insulin delivery, continuous glucose and ketone monitoring, GLP-1 treatments, health equity, mental health, autoantibody screening, and disease prevention.    Turning insight into impact  The team’s work goes beyond research, focusing on translating insights into real-world practice. By leveraging data to scale best practices, the goal is to drive meaningful, measurable change across clinics and communities.  “Our advisors will help to extend our impact — whether through QI strategy, research innovation, funding opportunities, or new data-driven solutions,” said Walton. “We want to take what’s working at individual centers and spread that as broadly as possible.”   He added, “As a Collaborative, we’re also focused on advanced population health strategies such as exploring predictive data models to identify risks earlier and intervene before complications even begin to happen.”    The power of the T1D Exchange Quality Improvement Collaborative  Central to this work is the T1D Exchange Quality Improvement Collaborative (T1DX-QI) — a nationwide network of clinics working together to improve care through shared data, benchmarking, and evidence-based practices.  “I’m thrilled to serve as a Medical Advisor for T1D Exchange, because I’ve seen firsthand the impact this network can have on patient care,” said Dr. Nestoras Mathioudakis. “T1D Exchange is the premier organization for quality improvement in type 1 diabetes, with unparalleled assets like a large EHR database and robust patient registry.”  He added that he is excited to apply his expertise in EHR research and big data analytics to generate real-world evidence across diagnosis, management, and outcomes.  Dr. Viral Shah echoed that perspective, reflecting on T1DX-QI's evolution: “I have been involved with T1D Exchange since its early days and have had the privilege of witnessing how it has transformed the quality of diabetes care across the United States. I’m delighted to return as a Medical Advisor.”  He emphasized the importance of accelerating impact. “I look forward to working closely with the team to accelerate the evidence generation and to help translate these insights to improve patient care.”   Dr. Jenise Wong highlighted the visible impact of T1DX-QI on the delivery of care. "I’m truly honored and grateful to be working with T1D Exchange as a Medical Advisor. 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    57 Comments

    1. Daniel Smith

      This is a misleading question. The immediate rise on wake up is called foot on the floor. Dawn phenomenon is a rise in blood sugar several hours before you get out of bed.

      3
      5 years ago Log in to Reply
      1. Karen Milton

        I experience the dawn phenomenon sometimes (maybe 50%), but “feet on the floor” about 100% of the time.

        5 years ago Log in to Reply
    2. Larry Martin

      I use a pump so basal is automatically adjusted for that.

      5 years ago Log in to Reply
    3. Daniel Bestvater

      I increase my pump basal rate around 4am to look after this.

      1
      5 years ago Log in to Reply
    4. Shannon Barnaby

      I generally try to deal with the dawn phenomenon with an increased basal rate.

      1
      5 years ago Log in to Reply
    5. Yaffa Steubinger

      I bulus in the morning but not to counteract the dawn phenomenon. That’s just when I bolus.

      5 years ago Log in to Reply
    6. Sahran Holiday

      Years ago we thought I was having predawn rises. When I was injecting. It was just NPH not lasting. Switched prebedtime to longer acting helped a lot. Now Omnipod basal takes care of it. Technology rules.

      5 years ago Log in to Reply
    7. Britni

      I’m on MDI, so I wait until I’m ready to have breakfast, usually 1 to 2 hours after I wake up.

      5 years ago Log in to Reply
    8. Sondra Mangan

      My Omnipod basal settings are configured to reduce the effect of Dawn phenomenon.

      5 years ago Log in to Reply
    9. Mig Vascos

      Always give myself .8 of a unit + any adjustment my pump indicates, which still keeps me under 1 unit. Then I can have my coffee with 2 sugar cubes and my meds. It works well.

      5 years ago Log in to Reply
    10. David Smith

      I’ve adjusted my pump basal rate to do that. No need to bolus for it.

      5 years ago Log in to Reply
    11. Cyndi Evans

      Since I’m on a pump, my basal is increased to offset dawn phenomenon

      5 years ago Log in to Reply
    12. Mig Vascos

      To clarify my previous response. The .8 of a unit I get has nothing to do with the dawn syndrome. Im on control IQ and my night basals are set to do that . I do that early bolus for starting the day and the sugar in my coffee.

      5 years ago Log in to Reply
    13. kristina blake

      The other answers reflect y strategy, I increase my basal around 4:00 am to cover DP. I do have 0.6 units to cover the first cup of black coffee. Another benefit of pumping, the tailor-made insulin delivery.

      5 years ago Log in to Reply
    14. Eve Rabbiner

      The beauty of using a pump is that you can adjust your basal rates for your different needs throughout the day. Bolusing for morning coffee or meal is a whole other thing.

      1
      5 years ago Log in to Reply
    15. Tina Roberts

      No because my pump is set up with a basal to do that.

      5 years ago Log in to Reply
    16. TEH

      I’m on the 670G, and bolis for 10g of carbs to cover my morning coffee, the very second thing I do every morning. My BG will take off if I don’t. It took me a while to come around to dong this. How can a cup of coffee have 10 g of carbs? Additionally I have to offset high carbs breakfast foods (e.g. cerial) with some protein in the morning.

      1
      5 years ago Log in to Reply
    17. Joan McGinnis

      I dont worry a biut that as my output is tuned to deal with dawn phenom it’s to take my breakfast bolus 29 min ahead of eating

      5 years ago Log in to Reply
    18. connie ker

      I didn’t experience pre dawn phenomenon for several years after diagnosis. Now that I am a senior, sometimes I have this where sugars just keep rising. Since I do MDI, I inject the short acting Humalog and drink coffee until the numbers come down. That’s when I eat breakfast. This happened this morning, so your question was very timely for me.

      5 years ago Log in to Reply
    19. Ceara Glasgow

      My pump setting is a bit higher in the am for just that reason.

      5 years ago Log in to Reply
    20. Abigail Elias

      My pump’s basal rate is programmed to increase in steps starting around 4 am to counter the dawn phenomenon (I used to experience). In addition, though I’m not sure how the algorithm works, my tandem t:slim x2 pump’s Control IQ function has a “sleep” function option that appears to be working well to keep my BG level steady throughout the night, including early morning hours.

      5 years ago Log in to Reply
    21. Patricia Dalrymple

      I said other because I bolus as soon as I get up but that’s because I eat as soon as I get up. My morning BG is really dependent on what I are the night before and how well I bolused for that.

      1
      5 years ago Log in to Reply
      1. Patricia Dalrymple

        Ugh. What I ATE the night before.

        5 years ago Log in to Reply
    22. Marvin Shotkin

      1. The dawn phenomenon is not abnormal; it occurs in non-diabetics as well.
      2. I have adjusted my early morning basal rate to account for it.

      1
      5 years ago Log in to Reply
    23. Janis Senungetuk

      Tandem’s Control IQ set on ‘sleep’ takes care of the dawn phenomenon while I’m still asleep.

      2
      5 years ago Log in to Reply
      1. ConnieT1D62

        I find that is true for me too. Gotta love that feature of the Control IQ!

        5 years ago Log in to Reply
    24. Loren Goetsch

      I must be an odd one. I’ve never had my BG rise in the morning. I always have had my drop in the morning.

      5 years ago Log in to Reply
    25. Pauline M Reynolds

      My basal is set higher at 4 a.m. to counteract the Dawn Phenomenon.

      5 years ago Log in to Reply
    26. Becky Hertz

      I’m not up early enough to ever see the Dawn phenomenon 🙂

      2
      5 years ago Log in to Reply
      1. AnitaS

        Becky Hertz. Hahahaha……….

        5 years ago Log in to Reply
    27. Thomas Cline

      I answered “NA” since I always eat immediately after rising and of course bolus for that, not for any “dawn phenomenon.” Since I wake up several times each night, I always correct for any abnormal rise during the night. They are pretty unpredictable.

      1
      5 years ago Log in to Reply
    28. Sharon Lillibridge

      My evening dose of Lantus usually drops my blood sugar between the hours of 3AM and 7 AM.

      5 years ago Log in to Reply
    29. Kristine Warmecke

      No, my basal is set to cover it.

      5 years ago Log in to Reply
    30. Derek West

      Using the 670g linked to the sensor I cannot adjust the bolus rate so I give myself about 0.4 as if I am eating 2 gr cho. I have recently started not eating breakfast because my BS gets way too high by mid morning, even if I wait 30 minutes after bolusing for breakfast carbs, plus that comes close to the 7-11 diet.

      5 years ago Log in to Reply
    31. Stephen Woodward

      This question is a poorly written question since Dawn Phenomenon only occurs at night while you sleep. When you wake there is another rise that may occur called feet on the floor. These are completely different and the question infers that on a pump you would use a bolus instead of the appropriate management fir DP, increased basal. However, if managing FOTF the boys is appropriate when you wake up.

      2
      5 years ago Log in to Reply
      1. persevereT1D52

        I agree. My DP can be managed by CIQ. But I also have FOTF and the only way to combat it is to bolus before I get out of bed.

        5 years ago Log in to Reply
    32. Bonnie kenney

      My Treseba covers real good. In fact I drop a little at 6am.

      5 years ago Log in to Reply
    33. casey shane

      Control Iq on my tandem T-slim X2 and the sexy dexy g6 do an excellent job at suspending/decreasing my basal overnight well I’m asleep and getting low, and before I rebound into a morning high corrects before I’m usually up.

      5 years ago Log in to Reply
    34. KSannie

      I do not have a morning rise in blood sugars every day, only once in awhile. It is usually due to stress. If it starts to rise, I use a bolus.

      1
      5 years ago Log in to Reply
    35. Donald Stitt

      Using a pump the basal properly adjusted has taken care of this. I am just starting to use the Tandem sleep mode.

      5 years ago Log in to Reply
    36. M C

      If up early, with BG where I want it to be, often putting in insulin for breakfast about 20 minutes before eating, can often defeat the rising BG levels. If up a bit later, or delayed getting to breakfast (so haven’t yet bolused) the BG numbers will have begun rising, so I will bolus then, in addition to what I typically take for breakfast. On the very rarest of occasions, usually because I’ve bolused in the middle of the night, after checking BG and it being a bit higher than I’d like, I will wake to a normal BG, take the amount needed for breakfast, and the ‘dawn phenomenon’ experienced on many mornings doesn’t occur.

      5 years ago Log in to Reply
    37. Karen Milton

      Even if my glucose level is perfect, I still give myself one unit of Novolog because experience has taught me that my glucose level will start to climb as soon as I get out of bed.

      5 years ago Log in to Reply
    38. Robert Farley

      Yes my bs usually rises about 30 points in the morning

      5 years ago Log in to Reply
    39. Ahh Life

      I never experienced the dawn phenomenon until being diabetic for 40 years. Then, for some reason, the growth hormones causing dawn phenomenon kicked in causing me to simply “run out of gas” at the early 0300-0500 hours. Why growth hormones kick in at middle age is anybody’s guess.

      Control IQ now corrects that quite handily. (👍≖‿‿≖)👍 👍(≖‿‿≖👍)

      However, after 0530, other things happen cited here as FOTF by Stephen Woodard. For that I will bolus a unit every hour or so for 3 hours, but also being sure to eat as the insulin stacks up somewhat. It is still a high-wire balancing act where we hope we don’t fall or get blown off the wire. 💣

      5 years ago Log in to Reply
      1. AnitaS

        I have been diabetic for close to 50 years and I still get dawn phenomena. They say it usually affects young people, but all of our bodies do different things.

        5 years ago Log in to Reply
    40. Retired and glad

      I’ve put a small boost in my basal rate starting at 3 AM since that when I’ve noticed the numbers begin to rise.

      5 years ago Log in to Reply
    41. Brian Kitt

      Interesting, I’ve only heard about the dawn phenomenon in relation to my breakfast bolus which can rarely stay under 200 even with Medtronic 770g. With a time in range of 70%+ and my card carb ratio at breakfast all the way down at 4.5. I may have to experiment, carefully of course, with a some insulin before breakfast in the morning.

      5 years ago Log in to Reply
    42. Jodi Greenfield

      Lately, my waking up BG has been “LO”, so I am usually drinking juice!

      5 years ago Log in to Reply
    43. AnitaS

      Since I am on a pump, a bolus to counteract a high sugar upon waking isn’t necessary. I just increase my basal rate starting about 3am to counteract the dawn phenomenon

      1
      5 years ago Log in to Reply
    44. Wanacure

      I’m on multiple daily injections, not a pump. I use exercise, finger pokes & Dexcom & low carb diet & always carry sugar cubes. Six units glargine (Lantus) at 6 am and 6 pm functions as my “basal.” At 4 or 5 am I bolus 0.5 unit lispro (Humalog) to handle dawn phenom. Then I practice yoga and/or other exercise, then at about 6:30 am bolus another 2 units lispro for breakfast. At 11 am – noon I bolus another 2 units lispro for lunch. 6 pm: another 2-3 units lispro before dinner. Then I fast for 12 hours.

      Sometimes I need to tweak by changing meal time 20-30 minutes and/or by changing time or amount of bolus by 1-3 units and/or 4-12 grams carbohydrate (1-3 sugar cubes).

      If I add 40’ aerobic 3x/week + 70’ weight training 2x/week, I hope I remember to lower glargine doses!

      Stress, the weather, number of hugs/day (currently zero), number of laughs/day, $ spent vs $ income, daily feeling gratitude time, totally unexpected events beyond (??) my control (US neo-colonialism? nuclear war threat? global warming? ever widening wealth gap? computer glitches?) can throw a monkey wrench into my quest for “normal” blood glucose levels

      “Man proposes, Buddha/Allah/Shiva/Gott laugh.”

      The Tao/Zoraster/Odin/quantum physics are indifferent.

      1
      5 years ago Log in to Reply
      1. ConnieT1D62

        Whew!!! Talk about a fully engaged diabetes 24/7 thinks and act like a pancreas mind set. We all do it and many of us know exactly where you are coming from, but I am exhausted just reading your post! Have you ever considered using a closed loop smart pump? Might lessen the load of the constant 24/7 physical/emotional/mental stress a bit.

        May all the forms of the God Source/Force be with you in all of your efforts and endeavors!!!

        5 years ago Log in to Reply
    45. Adam Wright

      I give a temp basal increase.

      5 years ago Log in to Reply
    46. Amber Bedford

      Is dawn phenomenon a thing for pump users or only for those who cannot adjust basals hourly to compensate for rises or drops in bgs?

      5 years ago Log in to Reply
    47. clhefner

      My pump settings take care of the rise.

      5 years ago Log in to Reply
    48. Janet Wilson

      Never. If basal rates are set appropriately for that time of day, it isn’t necessary.

      5 years ago Log in to Reply
    49. Cheryl Seibert

      After I retired, I had to start prebolusing about 30 min ahead of breakfast. When working, I went right from morning meal to a hot shower which improved insulin absorption and eliminated the majority of the rise. I’m a brittle diabetic so my dawn phenomenon is very steep (50-80 points or more per 30 mins). The drop is just as fast.

      5 years ago Log in to Reply
    50. Donna Clemons

      Temp Bolus some delivered now some delivered 2 hours later

      5 years ago Log in to Reply

    Do you give a bolus right after waking up in the morning to counteract the dawn phenomenon (an abnormal early-morning rise in blood glucose)? Cancel reply

    You must be logged in to post a comment.




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