Sometimes Diabetes can be a frustrating beast. Dawn Phenomenon being a case in point. I know it exists, I’ve seen it on occasions, and it’s a pain in the bum when it happens. And pumping is supposed to make life easier with it.
But for pumping to make life easier with it, there needs to be some form of pattern. And that’s where the Diabetes monkey feels like he is playing games with me.
Okay, so I know that is Coco, the Monkey with Diabetes and not “The Diabetes Monkey” but it’s short notice and was all I could find… And I also know it’s not a he…. But back to the point!
I’ve observed that in the past, if I eat Carbs between about 7-8pm and bed, then I see DP kicking in just before I normally get up, about 20 minutes before the alarm goes off. Stupid o’clock in the morning, in other words. I also notice that at weekends, I see the same thing – my body dumping glucose into the system to get me up at around 4.30am, then stopping for a couple of hours before I get up again around 8am. But normally, this occurs with carb consumption.
Except that sometimes it doesn’t. Sometimes it seems to happen anyway, but the pattern there is less regular, and I’m trying to determine what it is. It might be related to exercise the night before. I think I see a trend there. It might be that wine the night before suppresses it… It could be something else!
But I also note that I observe DP more frequently on the pump than I noticed at that time in the morning on MDI, using Levemir as a basal. I suspect that this is likely to be due to the timing of the rise coinciding with the point at which the Levemir has the peak absorption rate, mostly eliminating a DP rise. With pumping Novorapid, there is no peak absorption rate, and I have to fine tune the delivery rates a couple of hours earlier to eliminate the effects. A side effect that I wasn’t expecting, but all perfectly manageable.
It all comes back to the only way to deal with this sometimes is the 3Rs – “Record, Review, React”. When things aren’t going according to plan, you have to go back to tracking inputs and outputs, comparing the results across multiple occasions and spotting trend patterns, then acting on them. And I think it’s this bit of managing diabetes that most people find the hardest. But that’s a post for another day!
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