Diabetes tips

Strategies for Dawn Phenomenon and Type One Diabetes

March 15, 2024

One of our newsletter readers recently sent us this message: "I use the Dexcom G6 and Tandem t:slim X2 pump. I have dawn syndrome and my BG #'s are fine when I wake up in the morning and before I even have breakfast, my numbers start going up FAST. My CGM and pump don't seem to be able to keep up and by the time I get to lunch, my BG's are up to almost 200. Any suggestions on what to do?"

What is the Dawn Phenomenon?

Between the hours of 3 and 8AM, hormones, including cortisol and growth hormone, signal the liver to release large amounts of glucose into the blood stream to provide the body with energy to wake up. For people with a working pancreas, the beta cells respond with an increase in insulin in order to keep blood sugar steady. With diabetes, the body isn't naturally balancing out the sugar with insulin so many people experience a rise in blood glucose levels in the morning hours.

Tips for managing dawn phenomenon:

  • Watch what the automation is doing. If your blood sugar is below 100 during the early morning hours, your pump will likely suspend or lower your background insulin to keep it in range at that moment, but that can set you up to spike higher later once the hormones hit and/or you eat breakfast
  • Support your insulin sensitivity. Recognize that this time of the day has naturally occurring factors that are making you insulin resistant and strategize accordingly (drink water upon waking, try to get in low-stress movement (like a walk) around breakfast, adjust your insulin rates/ratios).
  • Notice how external stress might also be factoring in. You already have higher levels of cortisol at this time naturally - do you also have adrenaline kicking in? Are you rushing out the door? Doing a high impact workout? Dreading going to work? These lifestyle factors can also contribute to insulin resistance in the morning.