“Dawn phenomenon” is not a phrase that’s used to describe someone who wakes up each morning with a certain vigor and urge to immediately start enthusiastically dancing (even though it does kind of sound like it should describe that).
No, “dawn phenomenon” as I know it, and as many other T1Ds know it, is a term that describes an abnormal early-morning blood sugar spike, usually occurring within the first hour or so of a person with diabetes waking up.
And it seems to be something that my body is dealing with lately, much to my annoyance.
Since I moved to Virginia, my overnight blood sugars have been pretty stellar. I think this is mostly due to the fact that I’ve cut back on my pre-bedtime snacking, though it might also be a result of some anticipated changes in my blood sugar patterns because of the move. Whatever the case may be, I won’t complain about waking up to blood sugars within 80 to 100 mg/dL most mornings. It’s a great way to start the day, and since I begin most of my days with a fasting workout, it’s an even better feeling to know that my blood sugars won’t – or shouldn’t – fluctuate for the duration of my exercise. Rather, my CGM graph will stay nice and flat while I workout, and I don’t need to worry so much about what my blood sugar is doing for that period of time.
But another trend has emerged since my move to Virginia, and that is…you guessed it, dawn phenomenon. I’ll still wake up with excellent blood sugars and workout first thing, but the only difference is that now, my CGM shows my blood sugar slowly but steadily climbing up while I workout.
I’m trying to make sense of this sudden change, and I’m reacting to it by pre-bolusing for breakfast as often and for as long as possible (which just means that I take insulin that both corrects my blood sugar and covers my breakfast, then wait at least 20 minutes before eating anything). Mainly, I’m just hoping that it’s short-lived. Whether or not dawn phenomenon becomes a new normal for me, it is a good reminder that diabetes has an agenda of its own sometimes. I could have the exact schedule, with the same meals at the same times every single day with the same activity levels, and diabetes could still decide to throw me for a loop with a random low or high blood sugar.
It’s just up to me to figure out how to handle it.
Hugging the Cactus 
I’ve always hated a sudden and unexplainable change in sugar levels, high or low. A lot of times a change of higher levels can be attributed an infection or illness that has not yet manifested with any other symptoms. The lows however are much harder to figure out and they are the ones that scare me the most. The Dawn phenomenon is caused by the human liver going on a cleaning spree in the early hours of the day and cleaning the insulin out of the blood stream. That is how one of my doctors explained it to me. As a non-insulin producing person, I have to add extra insulin to make up for it when a norm can do it automatically. Good luck on your Sherlock Holmes quest for answers.
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