Liver - Dawn Effect

TROUBR

Well-Known Member
Messages
203
Type of diabetes
Type 1
This is probably going to seem like a silly question but it was something that struck me yesterday and I still can't work out the answer. I am still suffering from being higher in the morning than I was when I went to bed and am currently trying different things to fix this.Now as I understand it this is probably because when I was asleep I went a bit low and my liver helped to correct my by dumping any stored glucose from the day. Now if this is what happens at night why can't it do the same during the day and prevent me having a hypo in the daytime? :?

Also I read somewhere that this dawn effect is not so likely on the new insulin types like Lantus (which I am on) so not sure what is actually happening to me!

See - a very silly question and I have most probably completely misunderstood the whole way it works.

Louise
 

Tinkerbelly

Well-Known Member
Messages
51
Hi Louise

Lantus can be a weird insulin to use at times. The reason why your bg is up in the morning is probably due to one of two things, it's either because of the dawn effect or because you are not injecting enough Lantus to see you through the night. If you are not eating any carb before bed, I should have a go at eating a small amount to see what effect that has. I would not think though that you are going hypo in the night. I would guess that you are not injecting enough Lantus so eat some carb and basal a bit more. This should do the trick.

You asked a good question as to why the liver can't compensate to prevent hypos and I don't know the answer to that but maybe diabetesgeek will know
 

bonerp

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398
I'm guessing its because your body is in repair mode at night so everything gets shut down to recover. The dawn phenomenome(?!) (as I understand it) isnt because you go low during the night but because you get a hormone hit early in the morning ready to wake you up and kick start you into the day. Thats why (most of us!!!) naturally wake up at a reasonable time - its your wake up juice.

I'm now on a pump having used to have been on lantus and I know my BGs are stable through the night but I still have to increase my basal rate up to 100% from 3am to 7am to counter the DP first thing!
 

Dennis

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2,506
Type of diabetes
Type 2
Treatment type
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Hi Louise,
Bonerp beat me to it with his response. There's actually 2 things that can occur during the night that both have the effect of leaving you with a higher BS level in the morning than you went to bed with.

One of these is the Somogyi effect (named after Dr Michael Somogyi who discovered it). This is where the body senses that glucose levels are dropping to hypo levels and in response the liver pumps glucose into the bloodstream from its stored supply of glycogen. This generally results in overcompensating, leaving you with blood glucose at almost hyper levels (so is somethimes called the "bounce" or "rebound" effect). This is actually less common than many people imagine and is usually the result of having too much circulating insulin during the night)

The other one is the "Dawn Effect" where the body during the night automatically releases glucose into the blood, but as part of its normal functioning rather than in response to a specific trigger like a hypo. There are two ways in which this natural glucose release occurs:
- for about 4 hours after you have eaten your liver extracts some of the glucose in your blood and stores it as glycogen. After 4 hours (provided nothing else has been digested) the glycogen starts to be converted back into glucose in the blood. This dumping of glucose can continue for up to 12 hours, but it stops as soon as you eat something. The effect can be reduced by eating a low-carb high protein snack just before you go to bed (like a handful of nuts, a piece of cheese or ham (babybell size), or even a piece of lower carb fruit like an apricot or plum).
- during the night our bodies release hormones that help maintain and restore our body cells. These hormones (growth hormone, cortisol and catecholamines) also cause the glucose level to rise.
In both cases people with diabetes often don't have enough circulating insulin to keep this natural increase of glucose under control, so the result is a higher glucose reading in the morning.

Unfortunately in the UK the difference between the two (hypo response and normal hepatic glucose production) is not widely understood and they both tend to get lumped together under the heading "Dawn Effect", when in fact they are two very different things that just happen to have the same outcome of a high morning BG level.
 

sugarless sue

Master
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As a night worker ,I've noticed my BS shoot up about 01.00hours.I usually eat around 0.300hours.So is that the Dawn effect or the Somogyi that shoots it up at 01.00?
 

lionrampant

Well-Known Member
Messages
562
Eat some cheese, preferably the crumbly white tangy kind, just before bed. It helps me with dawn highs. Then again so does red wine.