How to fix the dawn phenomenon

Lately, I’ve been sleeping in a lot, and I’ve noticed that my blood sugar tends to rise in the hours before waking. Since diagnosis with type 1 diabetes, I’ve woken up at 7 am and taken double my regular insulin dose to account for feet on the floor syndrome. With feet on the floor, blood sugar rises after you get out of bed, so it’s easier to deal with than blood sugar that rises while you’re still asleep – an effect known as the dawn phenomenon.

So, what causes the dawn phenomenon? As far as we know, it’s due to an early morning release of growth hormone, glucagon, and cortisol. These hormones are counter-regulatory to insulin and cause the liver to release glucose. The physiological process of glucose release in the morning happens in all people, regardless of diabetes or not. For diabetics, the problem is no insulin production, so you have to inject it. If you’re still asleep though, this is difficult to do, so you get the unpleasant surprise of a morning glucose spike.

There are a couple of ways to get around the dawn phenomenon. One is with an insulin pump, where you can set a higher insulin dose in the hours before waking up. The other is to get up early in the morning before glucose levels get a chance to rise. In other words, you change the problem from the dawn phenomenon to feet on the floor. It’s one of the reasons why it pays off to be an early riser if you have type 1 diabetes. As a bonus, you get more out of the day. My best blogging tends to happen before midday, so it’s not all bad. Back to setting the alarm clock for 7 am.