A 7-year-old with type 1 diabetes is experiencing nightmares and rising morning glucose levels. What phenomenon is this child likely experiencing?

In the case presented, the child is experiencing nightmares and rising morning glucose levels, which aligns with the dawn phenomenon. This phenomenon occurs in individuals with diabetes, particularly type 1, where there is a natural increase in blood glucose levels in the early morning hours due to hormonal changes, primarily the release of counter-regulatory hormones like cortisol and glucagon.

These hormones can cause insulin resistance, and in the absence of adequate insulin, glucose levels can rise significantly. The occurrence of nightmares in this context may be related to nocturnal hypoglycemia, which can trigger a stress response leading to disturbed sleep and vivid dreams.

Understanding the dawn phenomenon is crucial because it emphasizes the need for appropriate insulin management to help control blood sugar levels effectively during the night and into the morning. Adjustments in insulin dosing or timing may be required to mitigate this effect, helping to provide more stable glucose readings throughout the night and minimizing potential complications associated with elevated sugar levels.