Dawn Phenomenon
Italian_Buju
Posts: 8,030 Member
Is this a problem for anyone else? Cuz it is driving me MAD!!!
Ok, here is the situation.....
For a long time now, I have been tinkering with my evening Levemir shot (under a DRs care), to try and get my morning readings down. And I think I finally have it.....so, if I take 60 units of Levemir before bed, my bloodsugar with be roughly the same in the AM as it was when I feel asleep.
Here is the issue:
I wake up about 7am.....but CANNOT eat breakfast when I first wake up, so, I eat everyday around 10am. So, if my bloodsugar is normal in the AM, I take 10 units of rapid, to keep it normal. If it is high, I take a correction dose, of about 10 units + the number.....for example, if my morning reading was 12.2 I would take 22 units.
My DR does not like this.....we talk about it ALL THE TIME....she says, I should only take rapid with food, and not to correct and never in the AM when I am not eating. I say, if I do not correct, I feel crappy, and that makes no sense to stay like that....PLUS, if I am normal in the morning, and do not take any, but the time breakfast rolls around, I am high. She says I should eat as soon as I wake up. I say, impossible.....I finally made it a habit after many years of not eating for hours and hours and hours, to actually have breakfast, but when I first wake, I like to clean up myself and have tea and such before I eat....even if I am hungry upon waking, I still can't make myself eat right off the hop.
Yesterday was a perfect example. I had to go to the DR first thing at 9am, and get blood work done. When I woke at 7am, my bs was 6.9, I did not take anything. By the time I got to the DRs just two hours later, it was 10.9.
Sorry for the long post, I hope I am explaining this right.....anyone else have this problem? For those of you that do not eat right away, do you take anything upon waking? Thanks
Ok, here is the situation.....
For a long time now, I have been tinkering with my evening Levemir shot (under a DRs care), to try and get my morning readings down. And I think I finally have it.....so, if I take 60 units of Levemir before bed, my bloodsugar with be roughly the same in the AM as it was when I feel asleep.
Here is the issue:
I wake up about 7am.....but CANNOT eat breakfast when I first wake up, so, I eat everyday around 10am. So, if my bloodsugar is normal in the AM, I take 10 units of rapid, to keep it normal. If it is high, I take a correction dose, of about 10 units + the number.....for example, if my morning reading was 12.2 I would take 22 units.
My DR does not like this.....we talk about it ALL THE TIME....she says, I should only take rapid with food, and not to correct and never in the AM when I am not eating. I say, if I do not correct, I feel crappy, and that makes no sense to stay like that....PLUS, if I am normal in the morning, and do not take any, but the time breakfast rolls around, I am high. She says I should eat as soon as I wake up. I say, impossible.....I finally made it a habit after many years of not eating for hours and hours and hours, to actually have breakfast, but when I first wake, I like to clean up myself and have tea and such before I eat....even if I am hungry upon waking, I still can't make myself eat right off the hop.
Yesterday was a perfect example. I had to go to the DR first thing at 9am, and get blood work done. When I woke at 7am, my bs was 6.9, I did not take anything. By the time I got to the DRs just two hours later, it was 10.9.
Sorry for the long post, I hope I am explaining this right.....anyone else have this problem? For those of you that do not eat right away, do you take anything upon waking? Thanks
0
Replies
-
I don't have direct experience with Levemir as I'm on a pump. From my days of MDI w/NPH it seems odd to me that you have to take 10 units of rapid acting after awakening to keep your glucose levels in range. I don't know if Levemir has peeks and valleys the way NPH did, but if it does that could explain the 10 unit necessity. Could be that another insulin would work better for you, I simply can't say and your Doc should be able to.
Speaking of your Dr, if I were you I would try another one. It doesn't seem like you and she are on the same wavelength. I've had that before and it's certainly less than optimal.
Hopefully someone else can provide more insight. Best wishes to you.0 -
I'm on the insuline pump too. But just as Keith said, when I was using NPH at nights, I did not take my fast-acting insulin in the morning until I was ready to eat.
I agree that you may want to look for another doctor, as yours doesn't seem to be listening to you.0 -
Levemir's duration of action is anywhere from 12 to 24 hours depending on how much depot you inject. It does tend to have a little bit of a peak in the 8 to 10 hour range, but not as much as NPH.
It is very common to have the Dawn Phenomenon, which is caused by the naturally higher levels of cortisol secretion in the morning. It is important to differentiate your morning hyperglycemia from the Smogoyi effect. The Smogoyi effect or rebound is when you have nocturnal hypoglycemia (often while you're sleeping and goes unnoticed) which your body over corrects with glucagon, cortisol and adrenalin and you end up with hyperglycemia in the morning.
As long as you have a correction scale you use for your rapid acting insulin, and you are careful about insulin stacking, it is reasonable to correct your morning hyperglycemia. It is definitely important to work with you physician about how to do that properly.0 -
My Dr is actually pretty amazing....this is the only thing we do not see eye to eye on. I would not give her up for the world.
I started wondering about lows at night, as I had three good nights, with mornings of 6-8, and the last two mornings, my blood sugars were about 14.
I have woken up having a low in the middle of the night before, I do not see how I could be sleeping through it though....
Does this happen to anyone else?0
