Dawn phenomenen

Sal260

Member
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19
I have seen on a number of posts where people have successfully lowered BS and HbA1c scores that although their day time BS levels are much improved they still have that higher one in the morning. I’ve noted that this Dawn phenomenon is often cited as being the last to come down and can take a while.

Mine is now down in the 6’s after 6 months and was wondering how long is normal for it to lower fully? The rest of the day I seem to vary between 5.6 and 7 depending on time of day, meals etc

Thanksc
 
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ianpspurs

Oracle
Messages
16,420
Type of diabetes
Type 2 (in remission!)
Treatment type
Diet only
I have seen on a number of posts where people have successfully lowered BS and HbA1c scores that although their day time BS levels are much improved they still have that higher one in the morning. I’ve noted that this Dawn phenomenon is often cited as being the last to come down and can take a while.

Mine is now down in the 6’s after 6 months and was wondering how long is normal for it to lower fully? The rest of the day I seem to vary between 5.6 and 7 depending on time of day, meals etc

Thanksc
I don't think there is a specific time frame. If you read the threads on people's fasting levels - morning/DP - there is a big range of levels from people who have been doing this for years. Best way to look at this IMHO is, it is what it is. You are in the right place and doing all the right things - well done.
 
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ianf0ster

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Staff Member
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2,399
Type of diabetes
Type 2 (in remission!)
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Diet only
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exercise, phone calls
All you can do is to have good control of your daytime (after meal) Blood Glucose levels.
If you keep those down, then eventually your liver will probably decide you don't need a big a dump of glucose to enable you to hunt/gather your breakfast!
 

AloeSvea

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2,051
Type of diabetes
Type 2
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It can be more complicated than that, sadly. (Than just keeping carbs low, and post meal BGs good). I see my liver as hugely dysregulated - misreading signals and sending out wrong messages, hormones - and definitely wrong levels of glucose out of it into my bloodstream! Nothing logical about it, alas (ie not about aiding me to hunt and gather my breakfast). Some people's diabetes is like that. Totally mucked up blood glucose system!
 

caius2x8

Well-Known Member
Messages
111
Type of diabetes
Type 1
Treatment type
Insulin
I have seen on a number of posts where people have successfully lowered BS and HbA1c scores that although their day time BS levels are much improved they still have that higher one in the morning. I’ve noted that this Dawn phenomenon is often cited as being the last to come down and can take a while.

Mine is now down in the 6’s after 6 months and was wondering how long is normal for it to lower fully? The rest of the day I seem to vary between 5.6 and 7 depending on time of day, meals etc

Thanksc
 

Robbity

Expert
Messages
6,683
Type of diabetes
Type 2
Treatment type
Diet only
My advice - don't worry too much about what your liver's doing just keep control of your diet instead.

I don't bother too much about what my temperamental liver wants to donate to my well being in the mornings, and it can be quite unpredictable sometimes. But in general as long as I'm eating enough fats for my energy requirements, my liver is less likely to go overboard with any added glucose. Overall, liver dumps make very little difference to my HbA1c results - and just keeping my pre and post meal levels under control eating LCHF has enabled me to maintain low pre-diabetic HbA1cs for nearly seven years now.
 
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caius2x8

Well-Known Member
Messages
111
Type of diabetes
Type 1
Treatment type
Insulin
Insulin activity is desensitised by cortisone, a hormone we produce*(unless you have addison's disease) in response to low level stress. So the more cortisone, the less effective each unit of insulin. The daily profile of cortisone varies across the day..

From a peak level of cortisone at ~1030am, it drops to 1/3 the level of the peak by 9pm
There a two sharp, temporary increases of cortisone at midday and 6pm.
Between 9pm and 3am cortisone remains at its daily nadir.
From 3am to 1030 cortisone levels rise peakinmg at 1030am.
https://www.researchgate.net/public...dvances_in_hydrocortisone_replacement_therapy
https://www.researchgate.net/publication

Working on this, I started to see if my insulin needs (T1D) were in acccord with these observations. Although I haven't finished yet, as takes a fairly assiduous recording of everything, I can say by and large, Yes. And some , no, maybe ;-). Well I hope that clarifies everything.
Just joking.
Yes, because if insulin activity is densensitised by cortisone, would you expect you need the biggest doses of insulin around 1030am decreasing to lower levels by 9pm. My settings are:

U/hr Time band Units
0.7 0000-0530 3.85
1.15 0530-1130 6.9
1.85 1130-530 11.1
1.55 530-1000 7
0.925 10-1200 1.85
(Note the time brackets are not equally long so the rate is a better a comparator.)

which sort of agrees with the study on cortisone levels.
However matters are complicated by how much variation one has from a 50:50 reported ideal ratio of basal: bolus delivery of insulin eg one use a higher basal to offset post eating highs. Or a high bolus ratio to limit insulin driven appetite, at risk of of high blood sugar short and long term effects.
I find I use ~60% basal to 40 bolus as I am trying to lower carb intake, but set my basal as low as possible in order to try to not stimulate appetite :-/ but high enough to (try) and avoid getting about 10mM at any stage. I not terribly succcessful, Its a matter of constant vigilance and sustaining microadjustments. Looking over carb and bolus insulin intake is hefty task so I get back when I completed it, if I ever complete it .
 

caius2x8

Well-Known Member
Messages
111
Type of diabetes
Type 1
Treatment type
Insulin
My advice - don't worry too much about what your liver's doing just keep control of your diet instead.

I don't bother too much about what my temperamental liver wants to donate to my well being in the mornings, and it can be quite unpredictable sometimes. But in general as long as I'm eating enough fats for my energy requirements, my liver is less likely to go overboard with any added glucose. Overall, liver dumps make very little difference to my HbA1c results - and just keeping my pre and post meal levels under control eating LCHF has enabled me to maintain low pre-diabetic HbA1cs for nearly seven years now.

They're great levels. Can I borrow them please :)