Dun Dun Dun!! That is my foreboding music. Imagine it in your mind.
Definition of Dawn Phenomenon: High blood sugars in the morning hours due to the release of certain hormones during the night (glucagon, epinephrine, cortisol, and other growth hormones). We know kids do most of their growing during the night. It makes sense these growth hormones would be released in the nighttime which proves to be counter effective with their insulin--they aren't recieving enough from either their basal rates w/ the pump or from their Lantus. In people without diabetes there is a compensation with insulin from the pancreas so blood sugar levels remain stable. In people with diabetes, however, we can't predict whats going on so the result is high blood sugars and, in my house, a very frustrated, sleep deprived mamma.
We really struggle with this with Syd. The morning time seems to always have high numbers. BUT, I'm happy to say that I THINK we have figured out a solution to our problem...even if it's only temporary. One of the biggest hurdles we face is the spike in numbers after breakfast. Soooo I have tweaked her basal numbers during the night so she is running a little higher. She will then wake up a little higher (150s-200ish). BUT this allows us to give her insulin about 30-45 minutes BEFORE she eats w/out worrying about a low. By this time the insulin has a head start (it works slower than food in getting through the body) and helps to offset the spike in sugars.
We have our bad days still but, overall, we have seen a great improvement in her numbers during the morning time. Not perfect, but better. Of course, as with anything T1 related, it will not last forever. But, for now, we are going to enjoy it!! We have also found that increasing her fat intake and fiber in her breakfast helps to offset the post breakfast spikes. So a couple links of turkey sausage and a slice of double fiber whole wheat bread = much improvement.
Do any of you guys struggle w/ the dawn phenomenon? What tricks have you used to conquer it?
2 weeks ago