Definition of Dawn Phenomenon

[In Response]

I was recently discussing Dawn Phenomenon and looked to diabetes.co.uk for a definition: https://www.diabetes.co.uk/blood-glucose/dawn-phenomenon.html

This description confused us as it appears to be contradicting itself

"The dawn effect therefore describes abnormally high early morning increases in blood glucose :

• Usually abnormally high blood glucose levels occur between 8 and 10 hours after going to sleep for people with diabetes"

Unless we go to bed very early (around 6pm), "early" morning is not "between 8 and 10 hours after going to sleep". The latter part suggests that DP occurs once we wake (how many people regularly sleep for more than 8, let alone 10 hours?) which I thought was Foot on The Floor. Whilst we could argue that FoTF is a variant of DP, this is definitely different to the rise many of us experience between 3am and 4am.

Have we misunderstood this?

 

[BarbaraG]

My BG typically starts rising around 4-5am - when I’m still asleep. It continues to rise after I get up, more so if I do resistance exercises rather than swimming.

My only question is what I should give as my “fasting glucose” number if asked. Is it what my Libre Freestyle shows in the depths of the night, when it’s at its lowest? Or what it is when I get up - which would be the first opportunity I would have to finger prick (if I were doing that, which I’m not.)

 

[lessci]

Mine is Definitely more towards foot to the floor - starts a steep rise about 30 minutes before I wake between 4:30 and 5am

 

[Rachox]

I find my glucose level stays the same after 7 hours sleep, even if I lie in bed awake for a bit. It only starts to rise when I get out of bed. So foot on the floor for me!

 

[In Response]

So? No one is finding the BG rising time has any relation to the time they went to sleep as the referenced article suggests?
If that is the case, is it possible to get the article updated to avoid any future confusion?
I tried to comment on the post but would need to create a Discus account just for that.

 

[lovinglife]

So? No one is finding the BG rising time has any relation to the time they went to sleep as the referenced article suggests?
If that is the case, is it possible to get the article updated to avoid any future confusion?
I tried to comment on the post but would need to create a Discus account just for that.

Hi @In Response

If you would like to email your suggestion directly to [email protected] then it will be seen by the correct team as moderators have no control or input to content on the main website

Hope that helps

 

[Melgar]

This is an interesting thread. My blood sugars start to rise just after 3am. That is the lowest point for me in 24 hrs. It rises to around 7mmol/ls and then when I get up there is a burst of blood sugar, it can go up to 9mmol/ls, This burst is usually when I'm make my first cup of tea, it then drops back. Sometimes I don't get a rise at all, not sure why. I think it is foot on the floor. I am a poor sleeper so it does not matter if I get up at 4:30am or 7, its the same pattern.

 

[Jaylee]

I’ve always thought it partly had something to do with REM sleep patterns. https://www.helpguide.org/harvard/biology-of-sleep-circadian-rhythms-sleep-stages.htm

There always seems to be a correlation with reported BG rises with some of the REM & “sleep state” graphs thrown around the net..
Though I can also have more memorable vivid dreams when I go low at these times too..
Normally a trigger dream wakes me if hypo & of course the low is due to too much basal.

 

[HairySmurf]

My amateur-hour take is that Dawn Phenomenon and Foot On Floor are separate but similar effects of the daily pattern of hormone secretion.

This is a list of the hormones that affect blood glucose: - Link

Of these, growth hormone secretion is known to be associated with sleep. Perhaps others are too. Asprosin is associated with fasting. Epinephrine (adrenaline) is associated with sudden action or exertion.

So perhaps sleep-associated growth hormone secretion can begin a rise in BG levels during the night. Perhaps asprosin secretion also starts up some time during the night once well into a fasted state. Perhaps a little spike of epinephrine on waking and getting out of bed causes Foot on Floor, and continued, elevated levels of asprosin through the morning cause the continued slow rise in BG until some food is eaten. Or perhaps some similar, continuously changing cocktail of hormones from very early morning through to midday causes both effects and is a little different for everybody.

 

[Lainie71]

Mine starts around 3am and will increase until I have a snack to put it in its tracks. However and this is weird, but in warmer weather and in summer, I can get up at 5am and I have been known to get a 4.6. This may be due to more hydration I really don't know but winter months I tend to be in the 6s or 7.5, if I have eaten peanuts

 

[In Response]

My amateur-hour take is that Dawn Phenomenon and Foot On Floor are separate but similar effects of the daily pattern of hormone secretion.

This is a list of the hormones that affect blood glucose: - Link

Of these, growth hormone secretion is known to be associated with sleep. Perhaps others are too. Asprosin is associated with fasting. Epinephrine (adrenaline) is associated with sudden action or exertion.

So perhaps sleep-associated growth hormone secretion can begin a rise in BG levels during the night. Perhaps asprosin secretion also starts up some time during the night once well into a fasted state. Perhaps a little spike of epinephrine on waking and getting out of bed causes Foot on Floor, and continued, elevated levels of asprosin through the morning cause the continued slow rise in BG until some food is eaten. Or perhaps some similar, continuously changing cocktail of hormones from very early morning through to midday causes both effects and is a little different for everybody.

Did your amateur hour find anything to justify the reference to 8 to 10 hours after going to sleep?

 

[HairySmurf]

Did your amateur hour find anything to justify the reference to 8 to 10 hours after going to sleep?

I would be shocked if any clear-cut 8 to 10 hour timeframe applies to a broad range of people, given the wide variety in people's sleep and eating patterns.

 

[Ushthetaff]

My bs definitely rises as I get out of bed ,

 

[ATB123]

For me, the rise doesn't happen until I've been up and about for an hour or two, then it will start climbing and will go way up to 11 or 12 before I either inject and eat or do a small correction if I'm not hungry. No rise during the night, in fact my Libre line is almost flat

 

[Jaylee]

For me, the rise doesn't happen until I've been up and about for an hour or two, then it will start climbing and will go way up to 11 or 12 before I either inject and eat or do a small correction if I'm not hungry. No rise during the night, in fact my Libre line is almost flat

What time do you retire to bed when this happens?

I might bed down at 11pm get 7 hours sleep start to get a FotF in the first hour prepping for work, then a further rise driving to place of work before I action on it? (Sometimes I’ve corrected just before setting off.)
That covers 9 possibly 10 hours after my head hit the pillow…
It also depends on what I’m expecting the day’s graft to throw at me..?

 

[ATB123]

What time do you retire to bed when this happens?

I might bed down at 11pm get 7 hours sleep start to get a FotF in the first hour prepping for work, then a further rise driving to place of work before I action on it? (Sometimes I’ve corrected just before setting off.)
That covers 9 possibly 10 hours after my head hit the pillow…
It also depends on what I’m expecting the day’s graft to throw at me..?

Usually go to sleep about midnight, wake up around 7ish, but the rise doesn't start till 9ish. If I'm at home I will just have some breakfast and inject, if at work and first break isn't till 11, I will correct. Bodies are such strange things, seems like our all do things differently

 

[SimonP78]

Exercise will reduce or eliminate both my dawn phenomenon (i.e. gentle rise from ~3am) and foot on the floor (I see the very strong upward trend on the CGM once I've put the kettle on.)

Interestingly the gradual dawn phenomenon part doesn't occur at all if I've done any reasonable exercise (say an hour of cycling or a couple of hours of badminton) in the preceding days (so perhaps 3 or 4 days at a guess), but the dawn phenomenon is only reduced if I either restart exercise after a break or do lots of exercise (e.g. very long ride) while also doing normal exercise (and in the latter case my DP goes away completely and tapers back in over a couple of days.) Once I get used to the (normal) exercise, the foot on the floor annoyingly goes back to normal.

I think what I'm calling DP is actually a combination of a very slight BG rise caused by hormones but also the fact that when I don't manage to exercise (work, weather, slipped on my daughter's book and fell down the stairs - ouch!) I will run higher across the day so should really take more basal. It just so happens that my residual bolus tapers off around 3am (as I usually split dose for supper and often do a correction dose before bed), which otherwise hides the fact that the large rises I'm seeing now are probably mainly down to requiring more basal (or exercise!)

 

[MissMuffett]

I don’t know what my DP is up to. I take my FBG as soon as I’ve washed my hands and then if I take it again 10 minutes later it’s gone down by at least 1mmol for instance this morning it was 7.5mmol at 7:10, I took it again at 7:20 and it was 6.1! It then starts to rise after about 20 minutes. I’d have no change if that mammoth was waiting for me outside my cave!

 

[Jaylee]

Usually go to sleep about midnight, wake up around 7ish, but the rise doesn't start till 9ish. If I'm at home I will just have some breakfast and inject, if at work and first break isn't till 11, I will correct. Bodies are such strange things, seems like our all do things differently

Though we are different, there does seem to be a correlation within 10 hours of starting the sleep cycle. (Eyes closed & imobile.)

In answer to the initial question. Upto 8 to 10 hours after getting my head down with some category of liver dump? I see no issue or loose any sleep with the wordybits…

 

[ATB123]

Though we are different, there does seem to be a correlation within 10 hours of starting the sleep cycle. (Eyes closed & imobile.)

In answer to the initial question. Upto 8 to 10 hours after getting my head down with some category of liver dump? I see no issue or loose any sleep with the wordybits…

Interesting. I find it difficult to sleep earlier than midnight, but if I do get my head down a couple of hours earlier I shall watch for an early morning rise!