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

[ickihun]

I am confused and frustrated by my (DP). I am due a HBA1c test in two weeks time and I know my morning readings are going to spoil my hard work at keeping my BG down throughout the day. I have tested, tested, tested, low carbbed, fasted and stood on my head since diagnosis last august. My readings throughout the day range from 5.2 to 8 after my evening meal then dropping to around 6 or lower before bed.. My awaking reading has never been below 7.5 and as high as 9.9. I have fallen out with liver, putting all the blame on it but now wonder if I should be pointing the finger at my pancreas, or could it be a combination that both my unwilling organs should be in the dog house. I now wonder if I should eat small and regular lchf that way my stomach might like me again, at least one out of three is good..... I know I joke here, but that's the only way I can cope with my diagnosis. I am scared, my mum, brother, and twin sister all have type 2, my nan lost her sight through diabetes. I am trying to control this without meds .... maybe this will change after my January blood test.

@Ange G stick to good lchf small frequent food. Supper of alcohol or cheese or nuts or cream. Find what works for you. Good luck
Ps. Fasting diet are for weight loss and if done serverely it mighthelp with insulin resistance eventually.
Liver blocks work now!

 

[Ange G]

Thanks ickihun for your advice, I see something on the forum that works for someone like fasting and I try it, then move straight onto something else, Holland & Barrett's profits must up because I've got one of every type of supplement to improve your BG. I think I need to analyse more of my monitor readings and link with what I have eaten or exercised. Additionally, I will try not to stress too much when there is just no reason for my readings to shoot up. I am a little under the weather with a cold and on antibiotics for an infected cycst the size of a plum in my groin however I am thankful that it did not turn out to be a testicle that thought I had grown, lol. Oh!!! this diabetic thing is a blinkin nuisance, I hate not being in control. The only good thing so far is finding this forum and all the lovely people here.

 

[KeithSimpson001]

I am confused and frustrated by my (DP). I am due a HBA1c test in two weeks time and I know my morning readings are going to spoil my hard work at keeping my BG down throughout the day. I have tested, tested, tested, low carbbed, fasted and stood on my head since diagnosis last august. My readings throughout the day range from 5.2 to 8 after my evening meal then dropping to around 6 or lower before bed.. My awaking reading has never been below 7.5 and as high as 9.9. I have fallen out with liver, putting all the blame on it but now wonder if I should be pointing the finger at my pancreas, or could it be a combination that both my unwilling organs should be in the dog house. I now wonder if I should eat small and regular lchf that way my stomach might like me again, at least one out of three is good..... I know I joke here, but that's the only way I can cope with my diagnosis. I am scared, my mum, brother, and twin sister all have type 2, my nan lost her sight through diabetes. I am trying to control this without meds .... maybe this will change after my January blood test.[/QUOTE

I have the same problem before breakfast & I believe it is my liver dumping glucose in quantities that I am no longer able to control. One option is to eat breakfast as soon as you get up to stop the liver dumping glucose as quickly as possible but whenever you do have breakfast, it is from a high starting point & with glucose still being dumped, you are more or less gauranteed a double digit high after breakfast. In my case that has been 13 to 14 after 1h & still over 10 after 2h. In the end I asked my GP for insulin [Novorapid] in order to bring down my glucose levels before breakfast which continues working after to limit the high. I found that overcoming this high fasting glucose level can take as much as 10 units & 3 hours to work, with no danger of a hypo despite not eating anything. To put it in context, just 2 units when not in a fasting situation can produce a hypo unless taken in conjunction with eating something. I can only suggest that others may not have this problem because they are still able to produce enough insulin to control what is being dumped by the liver or that they have a less productive livers but I suspect there is also more complexity at work with so many hormones interacting. However, you have experienced the same thing that I have regarding two differing glucose level behaviours, depending whether it is before or after breakfast. Probably your GP won't want to give you insulin & indeed I first tried Metformin but the day after I started Metformin I developed Raynaud's syndrome [painfully cold hands & feet] which only reversed 6 months after I stopped taking Metformin. Metformin didn't have any effect on my fasting levels either, only after breakfast could you see any improvement. So be warned & don't be fobbed off, insulin doesn't have the side effects of medication & it allows you to relax a little regarding what you eat.

 

[DavidGrahamJones]

At Last! I have put my Freestyle Libre sensor on, no idea why I hesitated but I was certainly helped by all the videos available, words seem to just confuse me these days.

What an eye opener, a revelation!

Very respectable single digit numbers AFTER dinner at 19:30, but then at 24:00 (asleep by then) it starts creeping up until I woke at 02:00 when it had reached 12. I ate some nuts and a 0% fat no added sugar yoghurt and went back to sleep. Woke at 04:00 it had dropped to 8 and was stable for a few hours then woke up and it's going up before breakfast. Just going o check my eggs.

Interesting game this diabetes lark. If only . . . . . 20 years ago when I was first diagnosed, I could have achieved so much more with the right directions.

 

[ickihun]

At Last! I have put my Freestyle Libre sensor on, no idea why I hesitated but I was certainly helped by all the videos available, words seem to just confuse me these days.

What an eye opener, a revelation!

Very respectable single digit numbers AFTER dinner at 19:30, but then at 24:00 (asleep by then) it starts creeping up until I woke at 02:00 when it had reached 12. I ate some nuts and a 0% fat no added sugar yoghurt and went back to sleep. Woke at 04:00 it had dropped to 8 and was stable for a few hours then woke up and it's going up before breakfast. Just going o check my eggs.

Interesting game this diabetes lark. If only . . . . . 20 years ago when I was first diagnosed, I could have achieved so much more with the right directions.

Excellent liver block!
Now. Do it again this morning and inbetween lunch and dinner. Low carb snacks with fat rather than protein. As protein can still be stored as glucose.
The aim is to do it without thinking. 3 mths it takes to concrete a new habit.
I'm with you all the way.

 

[ickihun]

I'm getting my cream and coffee out for my liver block snacks!
It worked superbly last time.
My hba1c will have increased this time but my next one should prove the point again.
I just need to be consistant and not waver, nor listen to ill advice from dieticians.

 

[ickihun]

Had 5 mixed nuts with decaf coffee no cream. Nuts instead.
Working on reducing my insulin need again too. Its a great feeling to know I can make a difference to my fight for excellent control.

 

[Bluetit1802]

@DavidGrahamJones Well done for taking the plunge. You now have 2 weeks to see what is happening and when, and to experiment with possible solutions.

When you export your log you will see all the 15 minute readings and will be able to trace when you started to rise, what effect the midnight snack had between eating it and your next scan at 4am and what was happening after that. Maybe you have already done this. I find these 15 minute readings the most educational.

 

[ickihun]

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.

I agree. However some peoples cycle is misfiring or too short and have 2 or 3 cycles per day, instead of one.
Shift workers and new mums/dads have forced sleep patrerns and interferred cycles.

 

[donnellysdogs]

My DP and WP change according to shifts hubby works.... if its PM its later, f its AM Shift it will jyst be earlier. I think it goes a bit more on the time after we have started to sleep.

My body does not know on a Sunday night whether hubby is getting up earlier or later... but it does know when I go to sleep earlier or later.

I can time my DP and WP more now from the time I go to sleep...

Incidentally I now have chai tea (2 specialobes only for the specific spices and black tea)... I also add extra turmeric,cinammon; ginger and black pepper in as well.

Since doing this extra spice in tea my daily background insulin needs have dropped...very noticeable difference.

Has anybody else noticed this from extra specific spices?

 

[DavidGrahamJones]

When you export your log you will see all the 15 minute readings and will be able to trace when you started to rise, what effect the midnight snack had between eating it and your next scan at 4am and what was happening after that. Maybe you have already done this. I find these 15 minute readings the most educational.

The information is invaluable, I'm doing the usual finger stabbing for comparison and although there's a difference and not always in the same direction, the regular 15 minute readings are brilliant. I'm almost tempted to spend all my pocket money on the sensors, but I'm hoping to see a pattern and take action accordingly.

The interesting thing is that my meals don't have much impact in the first 1, 2, 3 or 4 hours. The highs are typically happening after I go to bed but not always.

Exercise makes a big difference if I start the day doing something like golf or a walk (same thing the way I play golf), I get really good numbers all day. Another thing that is interesting (to me) is that I'm currently having Hyperbaric Oxygen Therapy (self funded, but subsidised). Initially it was to help alleviate the constant pain in my leg and upper arm muscles, (HbOT gives people with MS more energy). I had read some Japanese research that found HbOT reduced insulin resistance in the short term. I can now see that my BG drops the minute I start breathing oxygen and starts going up as soon as I stop, to the minute. Maybe I need some oxygen at home?

As an additional benefit I sleep a lot better as well, still waking for bathroom visits, but I sleep much deeper and have even nodded off in the afternoon for a couple of hours deep sleep with dreams and everything.

I have an appointment with my GP in early February because whatever happens I may need further medication, maybe not (my preference obviously), at least it's up for discussion. What worries me is that without the Libre the doctor may have said start on the Gliclazide again and if I took during the day I would probably go very low during the day, possibly hypo, but still high at night. The HbA1c might show a better number than 58 mmol/mol (12/12/16) but I'd still be spiking high at night.

Definitely need to work out a strategy because even the snack before bed isn't 100% effective.

 

[Bluetit1802]

Have you done any research on the effect of protein? If you eat too much, more than your body needs, some of this excess will convert to glucose but not immediately like carbs do. It can take hours for this to happen, even a day sometimes. I'm not saying this is the cause of your night time highs, but it may be worth considering.

 

[DavidGrahamJones]

I'm not saying this is the cause of your night time highs, but it may be worth considering.

I'll definitely look at that. I believe that fat will also convert to glucose but nowhere as readily as carbs.

 

[donnellysdogs]

Nuts used to have a longer lasting effect on putting up my bloods.

Other fats and protein did too. Well into the early hours of the morning. Belly pork rashers even at lunchtime would affect me. Same with peanuts that on one occasion I ate pre gym workout and played havoc later..

I think having a really itemised log book can help enormously. I have an A4 shett of paper with everything on it ie exercise, daily activity, all food, all meds, all bloods, bolus, etc even cos of my bad stomach.. bowel movements! Meds are because they change so much with me and I'm hugely intolerant. Ie just stopped my cancer tablet couple weeks ago due to horrendous side effects and my bloods and basal insulin needs plummeted...
The most detailed log sheets help me to recognise difficult foods, meds easier...

 

[ontario_ogirl]

I never get it. I go to bed mid 4's to mid 5's and wake up mid 4's to mid 5's. During the night it's anything between those numbers. I do fast from my last meal at 430 pm to when I get up, 7 am so a good 15 hours before I eat again. Big breakfast, most carbs of the day, then medium lunch and smallest meal of the day is dinner. Works for me. My A1c has been 4.7 the last two times I checked. Maybe for some it's late protein rises? I mean if you eat at 9 pm and get DP at 2 am as someone mentioned, could be late spike?

 

[donnellysdogs]

I have never ate later than 6pm and mine I know is based from time I drop off to sleep.

However..... as I cant tolerate cancer tablet I decided to add more spices in to my chai tea. It already has cinammon etc in it. I add in extra turmeric, extra cinammon, extra ginger and black pepper.

Have added extra cinammon in since 5th January.

The first week of adding this in and coming off my cancer tablet threw me in to hypo's. being on tresiba I have had to give time to lower and correct the hypos.

Last night I decided to basal test until 6pm tonight.
I have already dropped basal ftom 11.5 and now down to 9.5 since 5th.

Yesterday morning and this morning I have had the best results on mdi with my bloods in the mornings.

Today:7am 5.3
8am 7.4
9am 6.6
10am 6.7
11.30 5.9
12.00 5.9
1pm 5.7
2pm dropped to 4.7 and needed to drive so ate and stopped testing.

I truly believe that the anti cancer tablet created even more hell for me but also the cinammon (even though I'm a type 1) has greatly reduced my DP and WP. My tea last night was 3 teaspoons of homemade curry sauce, broccoli and courgette.

Just three months ago I was having to have 4 injections before getting out of bed, starting at 4am. This morn I just had my tresiba and 2.5 units of novorapid...

There is only these two factors different. The tablet I only had for a year and although DP and WP got worse during that time, I have always had the problem for 30+ years.

I tried tresiba before too and it was decided it wasnt suitable, so the only real significance in this is the cinammon. I have had turmeric and ginger for 15 months...