Traveling with dawn phenomenon

General
1

Well, I made it to San Fransisco! 2 months on the road, phew, it has been a trip. However I have made discovery that I wish I would have figured out about 2 weeks ago!

So for the past 2 weeks I have dealt with high sugars spiking at exactly the same time every night, 12am- my blood sugar is exactly 300. So at 11 pm every night I have been taking 5 units via syringe. So last night I was up real late  staring at my pump, perusing and reviewing through my basal rates for the umteenthmillionth time and I stopped at the 3am number.

My 3am rate it a lot higher because for a few hours because I have a fairly hefty "dawn phenomenon." As some of you may know the dawn phenomenon occurs in some diabetics. It is generally believed to be due to the natural overnight release of hormones growth hormones, cortisol, glucagon and epinephrine (and I dare say some other hormones due to stress)- that increase insulin resistance.

Unlike your sleep cycle which resets every 2 weeks your hormone cycles reset every few months! So while my sleep cycle has caught up with the 3 hour time difference from the east coast and the west coast- my hormone cycle hasn't!! So exactly the same time as Eastern time 3am/ 12am Pacific time I am having my spike!!  While I wish that I had discovered this earlier I am so happy to know it now!

So if you have the dawn phenomenon and travel far enough west by plane/car you can't just adjust the time on your basal rate you may also have to take into account that your hormone cycle changes much slower then the rest of you does! And keep your dawn effect dose at the same time.

The only worry some thing would be if i were to move out here- as my hormone cycle adjusts would I experience lows as my dawn phenomenon moves closer to dawn?

2

How was your dawn phenomenon before the trip? Was it happening in response to low blood sugars at night? If so it sounds like you will still get lows, but at the "new" time.  If you never had the lows before I wouldn't think they would start appearing.

3

No, it is perfectly consistent, and it is not lows that I am having it is highs.

My point about lows was if I adjusted to time change the higher insulin needs moving back towards 3:00am from 12:00am. then i could start going low around 1200 am when i no longer need the insulin that early.

4

Ah, sorry, there is one idea that the phenomenon happens due to a low at night and a massive overcorrection (tested for by monitoring at night). 

You might try some middle of the night testing to catch the shift in sugars before you get serious lows (if you do move out that way).  Any info as to how long the shift in hormones takes? You could try dividing it out and shifting your basal forward to prevent lows from occurring, better later than sooner (for example 2 months to adjust 3 hours results in a shift of XYZ minutes per week before the rise in sugars happens).  If you do stick with it to watch the shift it would be neat to see a graph, or see the results other people get.

5

Thank you so much for the input Eric, I will defiantly be using it! As for info as to how long the shift in hormones takes, I have none so far! I'll be sure to let you know as son as I get my hand on some research to find out.