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Blood glucose first thing in the morning

Alineden

Well-Known Member
Messages
136
Location
West Cumbria
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Not much really
Morning all.

I am aware or the dawn phenomenon thing and I think I understand why it happens but is there anything I can actively do to get those numbers down.

Once again today I was 8.8 mmol/l when I got up and 90 minutes later it had only dropped to 8.6 mmol/l.

At what point does the liver dump happen. I'm up at 05:00 weekdays so it's not really practical for me to get up even earlier to exercise etc. Is there any dietary help I can try?
 
Hi, mine seems to happen immediately after getting up, I take my bg as soon as I open my eyes so I can post a reasonable number on the FBG thread hehe, this maybe slightly cheating but if I don't test straight away, by the time I get down a flight of stairs it has gone from say 6.5 to 7.5, by the time I've had my shower (which is as soon as I get down stairs) its generally 8.5. I drink a cup of coffee with milk before leaving for work and I'm at 9.0, this seems to be the case regardless of the time I get up, I think its my body reacting to me waking and starting the day.

During the rest of the day my bgs are great(for me) so its just the DP that is bad

DP is a tough thing to get right, when I was doing really well and got myself into the 4's all the time, I still had the morning bump so I stopped testing morning bgs as it started me off on a downer (again cheating)

Totally unhelpful and useless reply, sorry
 
Hi @Alineden. I think I remember reading that a study of Dawn Phenomenon found that the liver dump usually happens around 4am, so it may well be affecting you. It's quite common, non-diabetics get it too, so I wouldn't worry about it.

Some people on here find that eating your evening meal earlier, or eating a small protein snack, a bit of cheese or a few nuts, before going to bed can help reduce it.
 
Hi, mine seems to happen immediately after getting up, I take my bg as soon as I open my eyes so I can post a reasonable number on the FBG thread hehe, this maybe slightly cheating but if I don't test straight away, by the time I get down a flight of stairs it has gone from say 6.5 to 7.5, by the time I've had my shower (which is as soon as I get down stairs) its generally 8.5. I drink a cup of coffee with milk before leaving for work and I'm at 9.0, this seems to be the case regardless of the time I get up, I think its my body reacting to me waking and starting the day.

During the rest of the day my bgs are great(for me) so its just the DP that is bad

DP is a tough thing to get right, when I was doing really well and got myself into the 4's all the time, I still had the morning bump so I stopped testing morning bgs as it started me off on a downer (again cheating)

Totally unhelpful and useless reply, sorry
Hi Fenn. Not useless at all. Thanks for replying.
 
Hi @Alineden. I think I remember reading that a study of Dawn Phenomenon found that the liver dump usually happens around 4am, so it may well be affecting you. It's quite common, non-diabetics get it too, so I wouldn't worry about it.

Some people on here find that eating your evening meal earlier, or eating a small protein snack, a bit of cheese or a few nuts, before going to bed can help reduce it.
Hi Prem51. Is it not true to say though that whatever the reason for it, it's still a high level of glucose in the blood which can't be good. It's not ideal for me but can you actually use that glucose by exercising and burn it off so to speak. Or does it not work like that.
 
Is there any dietary help I can try?

Basically it is due to our liver pumping out glucose to prime us for the day. But because it is insulin resistant, it is not responding to the background insulin to hold the excess glucose.
1) Over time as we restore our insulin sensitivity it gets better...
2) If you want to speed up the process, have light early dinner. Essentially this gives us more time to use up any excess glycogen store in the liver. So less output.
3) Totally skipping dinner for a couple of days. That will completely discharge the glycogen store and quickly reset our baseline fasting glucose.

Which of the option depends on your lifestyle, medication etc...
 
Here is some examples..had a bowl of Chirashi Don for dinner, night time glucose remains elevated..

upload_2018-12-5_17-47-30.png

But a lighter, earlier dinner of prawn rolls gives a more stable night time and fasting glucose level...
upload_2018-12-5_17-48-55.png
 
Basically it is due to our liver pumping out glucose to prime us for the day. But because it is insulin resistant, it is not responding to the background insulin to hold the excess glucose.
1) Over time as we restore our insulin sensitivity it gets better...
2) If you want to speed up the process, have light early dinner. Essentially this gives us more time to use up any excess glycogen store in the liver. So less output.
3) Totally skipping dinner for a couple of days. That will completely discharge the glycogen store and quickly reset our baseline fasting glucose.

Which of the option depends on your lifestyle, medication etc...
Hi Kokhongw thanks for the reply. So if the liver dump is sleep dependant would a night shift worker experience it at say 17:00 if that was the time they wake up?
 
Hi Kokhongw thanks for the reply. So if the liver dump is sleep dependant would a night shift worker experience it at say 17:00 if that was the time they wake up?

Liver dumps can happen at any time of the day or night. "Dawn Phenomenon" is a bit of a misnomer. It is a natural phenomenon that is needed to keep us alive at times when we have insufficient fuel in our bodies, hence it happens at times of fasting such as overnight, and at any other times when our body thinks we are low on fuel. Members of this forum have tried many different things to try and stop it, mostly unsuccessfully. With me personally it happened after I was up and dressed. I was able to stop mine by having very minimal carbs to eat for breakfast, eating breakfast immediately after getting up and before any showers or other activities, and sticking to protein and fat. My breakfasts were/are just a coffee with cream or a soft boiled egg and cup of tea. I should qualify this by saying my liver dumps were fairly insignificant. Others have different approaches. It is trial and error. You can't beat nature!
 
Liver dumps can happen at any time of the day or night. "Dawn Phenomenon" is a bit of a misnomer. It is a natural phenomenon that is needed to keep us alive at times when we have insufficient fuel in our bodies, hence it happens at times of fasting such as overnight, and at any other times when our body thinks we are low on fuel. Members of this forum have tried many different things to try and stop it, mostly unsuccessfully. With me personally it happened after I was up and dressed. I was able to stop mine by having very minimal carbs to eat for breakfast, eating breakfast immediately after getting up and before any showers or other activities, and sticking to protein and fat. My breakfasts were/are just a coffee with cream or a soft boiled egg and cup of tea. I should qualify this by saying my liver dumps were fairly insignificant. Others have different approaches. It is trial and error. You can't beat nature!
Hi Bluetit1802. So what would be the expected blood/glucose level first thing in the morning for someone that didn't have insulin resistance?
 
Many people will disagree with the concept but I completely eliminated dawn phenomenon by finding my body’s requirement for protein and not exceeding it. If I eat too much protein today I will have raised glucose tomorrow morning. Protein should only be used for building and repairing the body, and the body has no mechanism with which to store excess (unused) amino acids, so if you consume too much then some of it will end up being converted to glucose so that it may be used for energy or converted into fat through de novo lipogenesis. That’s the theory anyway and it’s proven to be accurate and effective for me. Also weight training is a good idea because it helps deplete glycogen stores, and muscle mass is a glucose sponge.

I also don’t personally agree that dawn phenomenon shouldn’t be a concern. Yes it is true that glucose is elevated in the morning in everyone. Hormones are released that signal the liver to manufacture glucose in order to help us wake from sleep and start the day. This is normal but it creates a real problem for diabetics because they are insulin resistant. The problem is twofold - firstly the insulin is ineffective at clearing the flood of glucose from the blood. Secondly the liver is also insulin resistant so continues to dispense it. The whole process is like a runaway train. If you can’t find a way to prevent it happening for you, then the best way to mitigate it is to eat as soon as possible. Ideally not sugar puffs :D

It’s a contentious subject and others may disagree but this is my experience.
 
My morning BG depends heavily on what I ate the day before, and the consistency of what I ate before. I find 4-5 balanced meals, with protein, roasted/boiled root vegetables, and some fruit with every meal, and my BG stays stable throughout the day, and the fasting BG moves way down out of "diabetes" level, or pre-diabetes, below 5.5. If I eat inconsistently, or eat more things like bread. rice, bigger protein meals, more fat, the day before, then I'm up in the "diabetic" range. I say it in inverted commas because I am able to get my fasting BG regularly in "normal" range through proper eating and sleeping schedule. I will be making a separate post about this. Magnesium the night before also makes a big difference to my morning fasting BG - ie magnesium lowers it. Exercising in the evening, or drinking alcohol, makes my morning BG rise. So it would be useful to know what you eat, and what your daily and especially evening routines are.

The issue at night, is that the body burns fat more than glucose (free-fatty acid metabolism). So you move away from glucose metabolism towards fat metabolism - this is called the randle cycle, or "glucose-fatty acid cycle", you can google it for more info.

So your body is not able to make use of glucose, hence why it rises in the blood through gluconeogenesis while you sleep (the liver senses the lack of glucose in the cells and creates it, in a broken feedback loop). The longer the nights, ie the more darkness, you may find that this gets worse (ie over winter).

Do you notice you have foamy urine when you pee in the morning? This is caused by raised fatty acid levels in the urine - the fat effectively is saponified by the force of the urine hitting the water, hence it foams up (in the same way that soap is created).

So you can (a) teach the body to metabolise glucose and store glycogen better throughout the day by having fewer wild fluctuations in BG - this is through smaller, more consistent meals, and for me at least, by having no grains and lower fat in meals and (b) use various supplements to help move shift the randle cycle towards oxidation of glucose over fat.

Insulin is not the only substance that controls BG - the insulin industry wants us to believe it is. Things like magnesium, potassium, etc also have huge influence on BG. And they're easy to test. Take some potassium or magnesium in the day, and check morning BG levels. Or eat foods with more potassium and magnesium.

High aldosterone creates insulin resistance too. Have you ever had a blood test of aldosterone?
 
Many people will disagree with the concept but I completely eliminated dawn phenomenon by finding my body’s requirement for protein and not exceeding it. If I eat too much protein today I will have raised glucose tomorrow morning. Protein should only be used for building and repairing the body, and the body has no mechanism with which to store excess (unused) amino acids, so if you consume too much then some of it will end up being converted to glucose so that it may be used for energy or converted into fat through de novo lipogenesis. That’s the theory anyway and it’s proven to be accurate and effective for me. Also weight training is a good idea because it helps deplete glycogen stores, and muscle mass is a glucose sponge.

I also don’t personally agree that dawn phenomenon shouldn’t be a concern. Yes it is true that glucose is elevated in the morning in everyone. Hormones are released that signal the liver to manufacture glucose in order to help us wake from sleep and start the day. This is normal but it creates a real problem for diabetics because they are insulin resistant. The problem is twofold - firstly the insulin is ineffective at clearing the flood of glucose from the blood. Secondly the liver is also insulin resistant so continues to dispense it. The whole process is like a runaway train. If you can’t find a way to prevent it happening for you, then the best way to mitigate it is to eat as soon as possible. Ideally not sugar puffs :D

It’s a contentious subject and others may disagree but this is my experience.
Thanks for that Jim Lahey. I am probably consuming too much protein as I attempt to live low carb. I wonder if a simple test where I didn't eat any protein for a day then tested my blood first thing the following morning would offer some proof of the effects of protein.

I think I've got this worked out now. If I never eat and never sleep my Blood/Glucose will never go high
 
Hi Kokhongw thanks for the reply. So if the liver dump is sleep dependant would a night shift worker experience it at say 17:00 if that was the time they wake up?

I don't have an answer to that. But night shift workers have disrupted circadian rhythm and that will also impair their glucose metabolism. We are actually very light sensitive and design to function optimally following the sun.

I was diagnosed about 1 year after my first born...and I believe the year long night feeding and disrupted sleep cycle was the straw that broke the camel's back...
 
My morning BG depends heavily on what I ate the day before, and the consistency of what I ate before. I find 4-5 balanced meals, with protein, roasted/boiled root vegetables, and some fruit with every meal, and my BG stays stable throughout the day, and the fasting BG moves way down out of "diabetes" level, or pre-diabetes, below 5.5. If I eat inconsistently, or eat more things like bread. rice, bigger protein meals, more fat, the day before, then I'm up in the "diabetic" range. I say it in inverted commas because I am able to get my fasting BG regularly in "normal" range through proper eating and sleeping schedule. I will be making a separate post about this. Magnesium the night before also makes a big difference to my morning fasting BG - ie magnesium lowers it. Exercising in the evening, or drinking alcohol, makes my morning BG rise. So it would be useful to know what you eat, and what your daily and especially evening routines are.

The issue at night, is that the body burns fat more than glucose (free-fatty acid metabolism). So you move away from glucose metabolism towards fat metabolism - this is called the randle cycle, or "glucose-fatty acid cycle", you can google it for more info.

So your body is not able to make use of glucose, hence why it rises in the blood through gluconeogenesis while you sleep (the liver senses the lack of glucose in the cells and creates it, in a broken feedback loop). The longer the nights, ie the more darkness, you may find that this gets worse (ie over winter).

Do you notice you have foamy urine when you pee in the morning? This is caused by raised fatty acid levels in the urine - the fat effectively is saponified by the force of the urine hitting the water, hence it foams up (in the same way that soap is created).

So you can (a) teach the body to metabolise glucose and store glycogen better throughout the day by having fewer wild fluctuations in BG - this is through smaller, more consistent meals, and for me at least, by having no grains and lower fat in meals and (b) use various supplements to help move shift the randle cycle towards oxidation of glucose over fat.

Insulin is not the only substance that controls BG - the insulin industry wants us to believe it is. Things like magnesium, potassium, etc also have huge influence on BG. And they're easy to test. Take some potassium or magnesium in the day, and check morning BG levels. Or eat foods with more potassium and magnesium.

High aldosterone creates insulin resistance too. Have you ever had a blood test of aldosterone?
Torchman2 that's very interesting. I'll have to take a bit of time to digest and look up some of what you have said there. Thanks for the reply.
 
Thanks for that Jim Lahey. I am probably consuming too much protein as I attempt to live low carb. I wonder if a simple test where I didn't eat any protein for a day then tested my blood first thing the following morning would offer some proof of the effects of protein.

I think I've got this worked out now. If I never eat and never sleep my Blood/Glucose will never go high

No I wouldn’t go that far. You need protein. Also it will be quite elastic if your current glycogen stores and glucose levels in the entire body aren’t already running on fumes. Firstly I would try lots of gentle but meaningful exercise. Lots of brisk walking, and weight training if you’re willing and able. The weight training especially will help use up some reserves and also allow your body to use more of the protein that you do eat in repairing and rebuilding muscle tissues.

Definitely don’t try cutting out protein at this stage, but perhaps stick to a known number so you have a reference going forward. I’m only 63kg so my requirement is small. I don’t count it but I am mindful of only eating around 20-30g with each meal. Remember also that nature generally packages protein and fat together, so try not to eat a large meal consisting mostly of protein and little fat. Ideally they should be consumed together. And mostly fat.

As I say, I know many will disagree, but speaking only for myself, I have used all of the above techniques to gain rock solid glucose stability throughout the day and a total absence of the dawn phenomenon. The absence of dawn phenomenon will also be helped along by the improved insulin sensitivity that my plan affords me. Of course, it may not work for you. Also to add that the golden rule in the search for glucose stability is never to change too many things at once.
 
Hi Bluetit1802. So what would be the expected blood/glucose level first thing in the morning for someone that didn't have insulin resistance?

They would be looking at somewhere between 4 and the low 5s.

If you use fats that come from protein sources you get the best of both worlds. Foods such as eggs, cheese, meat and oily fish. I have never moderated my protein. I eat now what I have always eaten. Completely unrestricted.
 
They would be looking at somewhere between 4 and the low 5s.

If you use fats that come from protein sources you get the best of both worlds. Foods such as eggs, cheese, meat and oily fish. I have never moderated my protein. I eat now what I have always eaten. Completely unrestricted.
Isn't it quite difficult though to get plenty of fat without overdoing the protein?

I typically have roast chicken and salad from the canteen for my lunch at work. It is a lot of protein but not much fat so I keep a bottle of avocado oil in my draw and put some on my salad. So yeah I'm increasing the fat a little but maybe I should reduce the protein. Perhaps replace the chicken with avocado, cheese and nuts. Although saying that on testing cheese does seem to raise my BG.
 
Isn't it quite difficult though to get plenty of fat without overdoing the protein?

I typically have roast chicken and salad from the canteen for my lunch at work. It is a lot of protein but not much fat so I keep a bottle of avocado oil in my draw and put some on my salad. So yeah I'm increasing the fat a little but maybe I should reduce the protein. Perhaps replace the chicken with avocado, cheese and nuts. Although saying that on testing cheese does seem to raise my BG.

I just use very fatty meats and cook them in heaps of duck fat and butter. Chicken breast for example makes way for thighs. They taste better anyway, as does everything that’s drowned in fat :D
 
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