Totally Baffled???

[Ninabean]

Diagnosed pre diabetic in February. Went strict low carb/healthy fat (under 60g most days) then had a holiday and wasnt great and now struggling to get back into it.
So i have started testing more frequently to try to kick start me.
Fastings always between 6&7 even after a 16 hour fast.
Last night i had a large meal of salmon and celeriac dauphinois (also chocolate) and after 2 hours my glucose was 6.2. So during the day and whilst eating my glucose is pretty normal. But the fasting readings are getting me down ans confused. Its helping me focus and i will try to stick to lower carbs again now. I have read about dawn phenomenon in diabetics but found no real solution.
All thoughts welcome thanks

 

[DCUKMod]

Diagnosed pre diabetic in February. Went strict low carb/healthy fat (under 60g most days) then had a holiday and wasnt great and now struggling to get back into it.
So i have started testing more frequently to try to kick start me.
Fastings always between 6&7 even after a 16 hour fast.
Last night i had a large meal of salmon and celeriac dauphinois (also chocolate) and after 2 hours my glucose was 6.2. So during the day and whilst eating my glucose is pretty normal. But the fasting readings are getting me down ans confused. Its helping me focus and i will try to stick to lower carbs again now. I have read about dawn phenomenon in diabetics but found no real solution.
All thoughts welcome thanks

Many people have many views on DP, so I mnight as well share mine.

Firstly, it is noteworthy that the fasting blood score is often the last one to come into line when we grasp control ouf our condition, so stick with it. Some people find it eventually comes into line with the rest of their day and others not. When I was starting out, I had ranges for each meal/testing time. In other words, my "usual" blood score on waking would be between x and y. before and after lunch slightly different, and before and after dinner, lowest of all.

Of course, things vary from day to day as sleep, exercise, the weather, being under the weather (or not) and stress can impact our scores, and that list is in no way exhaustive.

As for DP; mine was never very extreme, but in reality is it your body preparing you for the day. It is recognising you're about to get up and at 'em, and drops some glucose into your blood stream, to energise you.

Where does the glucose come from? Your liver stores (and opologies if I'm being to basic on this). Next you eat or drink, your liver will claim back it's resources - a bit like a rechargeable battery would when plugged in after use.

So, all in all, for me, I see dawn phenomenon as pretty useful, in that it keeos my liver ticking over and my glucose stores as sort of cycled over time.

I appreciate I might feel differently if my DP were much more extreme, but for now, I'd suggest you relax a bit about it and see where the journey takes you.

Good luck with it all, and well done for grasping control.

 

[kitedoc]

Hi @ Ninabean,
I agree with DCUKMod.
If you are really keen you could try testing at 4 am and agin just before breakfast and see how your readings compare. $ am is often toted as the time that the Dawn phenomenon starts.
Another, but unrelated time to test is about 3 to 3 1/2 hours after a meal. From what I have read sometimes blood sugars at this timing can be low. And often hunger sets in !! If this is happening you might need to seek nurse/dietician advice.
Best Wishes.

 

[Guzzler]

Hi @ Ninabean,
I agree with DCUKMod.
If you are really keen you could try testing at 4 am and agin just before breakfast and see how your readings compare. $ am is often toted as the time that the Dawn phenomenon starts.
Another, but unrelated time to test is about 3 to 3 1/2 hours after a meal. From what I have read sometimes blood sugars at this timing can be low. And often hunger sets in !! If this is happening you might need to seek nurse/dietician advice.
Best Wishes.

I'm not sure why seeking the advice of a nurse or dietician is necessary simply because one may feel hungry after a short period without eating. Three to three and a half hours is a very short space of time, we sleep for much longer than that.

It must be remembered that Liver Dump aka DP can happen at any time of the day.

 

[ErylV]

Diagnosed pre diabetic in February. Went strict low carb/healthy fat (under 60g most days) then had a holiday and wasnt great and now struggling to get back into it.
So i have started testing more frequently to try to kick start me.
Fastings always between 6&7 even after a 16 hour fast.
Last night i had a large meal of salmon and celeriac dauphinois (also chocolate) and after 2 hours my glucose was 6.2. So during the day and whilst eating my glucose is pretty normal. But the fasting readings are getting me down ans confused. Its helping me focus and i will try to stick to lower carbs again now. I have read about dawn phenomenon in diabetics but found no real solution.
All thoughts welcome thanks

Are you drinking coffee before taking your morning reading as this can raise your blood sugar by one or two points..

 

[Bluetit1802]

There isn't a hard and fast solution to Dawn Phenomenon. There isn't intended to be one. It is a natural phenomenon that happens to everyone, including non-diabetics. If our livers never dumped any stored glucose, we would die. That is why it happens - to stop our blood glucose levels going too low. It is more obvious in diabetics that have insulin resistance, and the worse the IR the higher the blood glucose will get and the longer it will last.

Once our livers have dumped, our pancreas is triggered to release insulin to push this glucose into our cells for energy and to tell the liver it can stop dumping. If we are insulin resistant, the released insulin cannot do its job, so the glucose stays in the blood stream and the liver keeps dumping. The pancreas senses this and keeps on producing more and more insulin and eventually there is enough to overcome the problem.

Get rid of the insulin resistance, and you get rid of the higher morning glucose.

 

[kitedoc]

I'm not sure why seeking the advice of a nurse or dietician is necessary simply because one may feel hungry after a short period without eating. Three to three and a half hours is a very short space of time, we sleep for much longer than that.

It must be remembered that Liver Dump aka DP can happen at any time of the day.

Hi @Guzzler, The premise for the 'unrelated matter' of testing 3 to 31/2 hours after a meal is that in pre-diabetes and T2D there is a mistiming of insulin release, so that after a meal the blood glucose rises more quickly than the person's own insulin does and then the insulin surge overshoots sometimes causing a low blood sugar sometime after the peak blood sugar, hence the occasional test at 3 to 31/2 hours may catch the hypo. Why is this important.? The hypo may cause hunger and resultant food intake which then adds to weight gain = vicious circle. If this is happening and is identified to the doctor an appropriate dietary modification may help e.g lower carb &/or lower GI and GL. etc
The DP was named for its timing. Other cortisol surges at other times may have different causes. Not enough is known about it.
I hope that clarifies things somewhat !!

 

[Guzzler]

Hi @Guzzler, The premise for the 'unrelated matter' of testing 3 to 31/2 hours after a meal is that in pre-diabetes and T2D there is a mistiming of insulin release, so that after a meal the blood glucose rises more quickly than the person's own insulin does and then the insulin surge overshoots sometimes causing a low blood sugar sometime after the peak blood sugar, hence the occasional test at 3 to 31/2 hours may catch the hypo. Why is this important.? The hypo may cause hunger and resultant food intake which then adds to weight gain = vicious circle. If this is happening and is identified to the doctor an appropriate dietary modification may help e.g lower carb &/or lower GI and GL. etc
The DP was named for its timing. Other cortisol surges at other times may have different causes. Not enough is known about it.
I hope that clarifies things somewhat !!

I am aware of everything you commented on, however, I still question the need to see a medic about hunger considering the quality of the advice in general given by
Nhs HCPs. Surely a lot depends on the individual? When people are forced to turn to the internet for answers because their HCPs do not have the time or the inclination to give good, sound advice/information on how to tackle the pitfalls of diet wrt Diabetes then even the simplest answers can be unforthcoming.

Edited to add. All this rests on how much nutritional training is given to HCPs which remains woefully poor even for non Diabetics.

 

[kitedoc]

I am aware of everything you commented on, however, I still question the need to see a medic about hunger considering the quality of the advice in general given by
Nhs HCPs. Surely a lot depends on the individual? When people are forced to turn to the internet for answers because their HCPs do not have the time or the inclination to give good, sound advice/information on how to tackle the pitfalls of diet wrt Diabetes then even the simplest answers can be unforthcoming.

Fair enough, but is the quality of info for a pre-diabetic likely to be as comprehensive and relevant to their actual position on the continuum as it is for a T1, T1.5, T2, T3 D etc ?

 

[kitedoc]

Fair enough, but is the quality of info for a pre-diabetic likely to be as comprehensive and relevant to their actual position on the continuum as it is for a T1, T1.5, T2, T3 D etc ?

Also unless one is a registered health professional we can suggest but not provide professional advice or opinion, deferring to registered health professionals helps to cover that.