Question

At a follow-up visit, Emily’s blood glucose records indicate that her levels have been consistently high when she wakes in the morning before breakfast. Describe the dawn phenomenon. Is Emily experiencing this? How might it be prevented?

Answer 1

The dawn phenomenon is the end result of a combination of natural body changes that occur during the sleep cycle and can be explained as follows:

Your body has little need for insulin between about midnight and about 3:00 a.m. (a time when your body is sleeping most soundly). Any insulin taken in the evening causes blood sugar levels to drop sharply during this time. Then, between 3:00 a.m. and 8:00 a.m., your body starts churning out stored glucose (sugar) to prepare for the upcoming day as well as releases hormones that reduce the body's sensitivity to insulin. All of these events happen as your bedtime insulin dose is also wearing off. These events, taken together, cause your body's blood sugar levels to rise in the morning .

Emily is experiencing the same.

Once it diagnosed as down syndrome, it can be corrected.

• Changing the time of takin the long-acting insulin in the evening so that its peak action occurs when blood sugars start rising
• Changing the type of insulin take in the evening
• Taking extra insulin overnight
• Eating a lighter breakfast
• Increasing morning dose of insulin
• Switching to an insulin pump, which can be programmed to release additional insulin in the morning