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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)?
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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.
I experience the dawn phenomenon sometimes (maybe 50%), but “feet on the floor” about 100% of the time.
I use a pump so basal is automatically adjusted for that.
I increase my pump basal rate around 4am to look after this.
I generally try to deal with the dawn phenomenon with an increased basal rate.
I bulus in the morning but not to counteract the dawn phenomenon. That’s just when I bolus.
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.
I’m on MDI, so I wait until I’m ready to have breakfast, usually 1 to 2 hours after I wake up.
My Omnipod basal settings are configured to reduce the effect of Dawn phenomenon.
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.
I’ve adjusted my pump basal rate to do that. No need to bolus for it.
Since I’m on a pump, my basal is increased to offset dawn phenomenon
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.
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.
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.
No because my pump is set up with a basal to do that.
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.
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
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.
My pump setting is a bit higher in the am for just that reason.
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.
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.
Ugh. What I ATE the night before.
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.
Tandem’s Control IQ set on ‘sleep’ takes care of the dawn phenomenon while I’m still asleep.
I find that is true for me too. Gotta love that feature of the Control IQ!
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.
My basal is set higher at 4 a.m. to counteract the Dawn Phenomenon.
I’m not up early enough to ever see the Dawn phenomenon 🙂
Becky Hertz. Hahahaha……….
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.
My evening dose of Lantus usually drops my blood sugar between the hours of 3AM and 7 AM.
No, my basal is set to cover it.
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.
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.
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.
My Treseba covers real good. In fact I drop a little at 6am.
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.
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.
Using a pump the basal properly adjusted has taken care of this. I am just starting to use the Tandem sleep mode.
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.
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.
Yes my bs usually rises about 30 points in the morning
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. 💣
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.
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.
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.
Lately, my waking up BG has been “LO”, so I am usually drinking juice!
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
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.
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!!!
I give a temp basal increase.
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?
My pump settings take care of the rise.
Never. If basal rates are set appropriately for that time of day, it isn’t necessary.
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.
Temp Bolus some delivered now some delivered 2 hours later