Dawn phenomenon - is it really 02:00 - 08:00?

[DavidGrahamJones]

The dawn phenomenon, sometimes called the dawn effect, is an early-morning (usually between 2 a.m. and 8 a.m.) increase in blood sugar (glucose) relevant to people with diabetes. It is different from chronic Somogyi rebound in that dawn phenomenon is not associated with nocturnal hypoglycemia.

I've quoted wikipedia which may not be the best source but it's close to everything else I've read.

I have been pretty good with the low(er) carb thing for about 4 years where even my GP puts well done in my notes. Just before Christmas my HbA1c was well into the 50s so not good.

I've cut right back on the cheese, yoghurt and cream (I also gained 11kgs, GP HAD said I didn't eat enough), my only treats as it were and source extra calories that I won't miss. The mixed nuts have gone as well, doesn't seem like anything dreadful but I'm struggling to find sources of anything that might elevate BG (fats shouldn't normally, but I have read that they do when carbs are low).

One thing I have noticed is that my readings are high in the morning, usually double figures, but they don't always drop when I've eaten something and certainly don't when I haven't eaten. This morning is a good example 08:00 10.2, no breakfast as I had an appointment which I did not want to be late for. 14:00 when I got home 12.0 ??? Then I just had chicken and steamed veg and by 16:00 it had dropped to 7.0. I need to get my Libre set up and I need to make sure I don't skip breakfast.

So, does the dawn phenomenon really only occur between 02:00 - 08:00

 

[Diamattic]

I dont always get DP, when i do it is usually strongest around 6am.

It is possible to just have variable insulin sensitively, or variable carb sensitivity throughout the day this would cause peaks like your mentioning.

 

[Bluetit1802]

I don't get DP over night at all. I go to bed mid to low 5's and get up the same. I hardly ever vary more than plus or minus 0.2mmol/l. I don't get up until at least 8-30 to 9am. Once I'm up and about I start to rise to the low to mid 6s until maybe an hour before lunch when I drop back to the low to mid 5s. This happens with or without a zero carb breakfast (except for a dash of milk in my tea) When I was having yogurt and berries for breakfast it was even worse - 7s. so I no longer eat carbs at breakfast. It also climbs if I do any strenuous housework.

Example this morning, according to my Libre
Straight out of bed - 5.3
then steady rise with no food, just tea
6.2
6.1
6.4
6.7
6.9 (doing housework)
6.9
6.8
6.4
6.2
6.2
6.0
5.7

 

[Jaylee]

DP for me normally happens in that "scrabble" just after I've woken up. I don't do breakfast. So, on waking on a work day? I could have a respectable 4.8 or 5. OK? Nice. Get ready for work. Get the dog out for a walk carrying something incase I drop..? No need! Get back feed the hound test before I leave for work glugging half a cup of coffee on the way out & its 6.8 or 7.2..
All in a 2.5 hour slot from 5.30 am waking..

I see it as a fight or flight response? I suppose the same could happen asleep during a bad dream.. Lol I don't dream.

 

[daisyduck]

I'm sure I get DP several times in the night. I don't sleep well and wake 4 or 5 times a night feeling hot and slightly odd.. I usually just throw the covers off for a minute or two and then doze off again.
It's not the menopause and hot flushes.. been there and done that after an early hysterectomy.. these feel different.

 

[Speedbird]

I'm sure I get DP several times in the night. I don't sleep well and wake 4 or 5 times a night feeling hot and slightly odd.. I usually just throw the covers off for a minute or two and then doze off again.
It's not the menopause and hot flushes.. been there and done that after an early hysterectomy.. these feel different.

Same here daisyduck. When I was first diagnosed I went straight to lchf way of eating and all was fine but it seems to have started up again. Not to the same degree, thank goodness, but it disrupts my sleep.
We have supper about 6pm so quite early I think. Nothing to eat then until my first coffee about 12 hours later.
I may have to eat less or experiment in some way. My BS this morning was 8.1!

 

[tim2000s]

So, does the dawn phenomenon really only occur between 02:00 - 08:00

Simple answer, "No"! The rise can continue as long as there is a trigger for it. This may be not eating breakfast or not having insulin. Add to that what's often called "Waking Phenomenon" which is where you get a sudden spike when you stop being horizontal and it can all get a bit complex.

 

[Bluetit1802]

"Waking Phenomenon" is clearly what I have then. Trust me to be complex.

 

[GrantGam]

Likewise, I suffer from DP and also a "waking rise". The latter requires a 2u bolus to compensate for the anticipated rise, along work a correction for the already high BG caused by DP.

Not the best thing to deal with really, especially on MDI...

 

[CherryAA]

I'm sure I get DP several times in the night. I don't sleep well and wake 4 or 5 times a night feeling hot and slightly odd.. I usually just throw the covers off for a minute or two and then doze off again.
It's not the menopause and hot flushes.. been there and done that after an early hysterectomy.. these feel different.

I have the same symptoms, It seems fairly standard that a low carb diet can lead to sleeplessness, as I have seen that referenced in few places,

I have a freestyle monitor so test when I wake up , the end result is that I can see the readings through the night when this happens I have checked each time and my blood sugars haven't moved at all.

Thus I do think that the sleeplessness is connected to the diet in some way, but I'm not sure its got anything to do with the blood sugar readings. Maybe we could discuss privately what we are eating - because I absolutely recognise your desciption and its annoying me too.

 

[ickihun]

The dawn phenomenon, sometimes called the dawn effect, is an early-morning (usually between 2 a.m. and 8 a.m.) increase in blood sugar (glucose) relevant to people with diabetes. It is different from chronic Somogyi rebound in that dawn phenomenon is not associated with nocturnal hypoglycemia.

I've quoted wikipedia which may not be the best source but it's close to everything else I've read.

I have been pretty good with the low(er) carb thing for about 4 years where even my GP puts well done in my notes. Just before Christmas my HbA1c was well into the 50s so not good.

I've cut right back on the cheese, yoghurt and cream (I also gained 11kgs, GP HAD said I didn't eat enough), my only treats as it were and source extra calories that I won't miss. The mixed nuts have gone as well, doesn't seem like anything dreadful but I'm struggling to find sources of anything that might elevate BG (fats shouldn't normally, but I have read that they do when carbs are low).

One thing I have noticed is that my readings are high in the morning, usually double figures, but they don't always drop when I've eaten something and certainly don't when I haven't eaten. This morning is a good example 08:00 10.2, no breakfast as I had an appointment which I did not want to be late for. 14:00 when I got home 12.0 ??? Then I just had chicken and steamed veg and by 16:00 it had dropped to 7.0. I need to get my Libre set up and I need to make sure I don't skip breakfast.

So, does the dawn phenomenon really only occur between 02:00 - 08:00

Yes and no.
Yes it happens in times of long periods of rest from eating and no because it can happen anytime, anytime you are 'fasting'.
Everyone's bodies are different so whenever its their time of rest can cause the liver to act. Alcohol in some can block that mechanism.
I say liver because some medical notes state organs and muscles release not just the liver. I am heavily muscularly dense so I dump from a height!

 

[ickihun]

Same here daisyduck. When I was first diagnosed I went straight to lchf way of eating and all was fine but it seems to have started up again. Not to the same degree, thank goodness, but it disrupts my sleep.
We have supper about 6pm so quite early I think. Nothing to eat then until my first coffee about 12 hours later.
I may have to eat less or experiment in some way. My BS this morning was 8.1!

Anyone with sleep disturbance should get their thyroid checked. Please.

 

[Bluetit1802]

I scanned my sensor immediately before getting out of bed this morning. It was 5.1.
It is currently 7.4. All I had was a boiled egg. No exercise other than general pottering about.
Not good. Back to no breakfasts tomorrow.

 

[GrantGam]

I scanned my sensor immediately before getting out of bed this morning. It was 5.1.
It is currently 7.4. All I had was a boiled egg. No exercise other than general pottering about.
Not good. Back to no breakfasts tomorrow.

I never have breakfast and always require a 2u correction for my "waking rise".

A lot of forum members have positive results if they eat very soon after waking up. Personally, breakfast or no breakfast - my numbers still climb...

Basically, if you're anything like me - skipping breakfast will still leave you with a higher than ideal BG, but with added hunger also

 

[douglas99]

I used to skip breakfasts when my diet was terrible.

Now I find having breakfast is key, and it was also vital to establishing a routine when I sorted my diabetes out.
Having said that I don't stress if I go up slightly after eating it.
'Normal' non diabetics do.

 

[novorapidboi26]

The dawn rise in my opinion is connected to our internal body clock.......

the hormone release will happen before your body clock believes you will get up....

so this exact time of it can be influenced in the long term...

 

[GrantGam]

The dawn rise in my opinion is connected to our internal body clock.......

the hormone release will happen before your body clock believes you will get up....

so this exact time of it can be influenced in the long term...

I agree, but I'm not entirely sure what you're last sentence means?

Sure, DP is a result of the release of glycogen, cortisol, etc. It's my understanding that this "bodily repair/rejuvenation" happens during sleep. So to change the timing of when DP presents is only possible by going on the night shift?

 

[PseudoBob77]

DP is not the correct term. It is part of the daily cortisol cycle which in turn triggers a process called gluconeogenesis where the liver secretes glucose as a result of increased cortisol just before waking, hence increasing blood sugar levels to start the day.

 

[novorapidboi26]

I mean that as you go through life your internal clock can change.....

if like as you say, you start night shift or back shift.....

the clock is changeable and therefore so is the DP....

 

[Tabbyjoolz]

Now I'm back on the Bulletproof Coffees of a morning, my DP seems to be flattening out. I still get a rise but nowhere near as bad as before. The only time it shoots up if I've had a particularly bad night's sleep, which seems to make some sense.