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Am I diabetic due to dawn phenomenon ?

Discussion in 'Diabetes Discussions' started by stuffedolive, Apr 16, 2019.

  1. stuffedolive

    stuffedolive Type 2 · Well-Known Member

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    I am 62 and i've been T2 for 16 years without medication just keeping things under control through diet (LCHF) and exercise (lots). I've always the slim side and have always run and cycled. My food choices prior too diagnosis were always carb heavy to fuel the exercise. Since diagnosis my Hba1c readings have bounced around between 49 and 41.
    However, since I started testing (GP not interested in my having the kit so I bought it myself) I have noticed that my FBG is always high - normally between 6.5 and 7.5. Otherwise my BG response to food seems to be quite good. There are no massive spikes, but it also rarely gets below the 5.2-5.5 range.
    Am I just a fairly normal person that just happens to suffer from large liver dumps on waking, and that this then colours my Hba1c figures? Or are my 'bottom figures' too high too?
    I'll keep up the LCHF and the exercise as I don't particularly want to go on meds.
     
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  2. Guzzler

    Guzzler Type 2 · Expert

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    You have Diabetes due to insulin resistance, simply put.
    The HbA1c is just an average, it can't speak to dp or spikes etc.
     
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  3. britishpub

    britishpub Type 2 · Well-Known Member

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    No.
     
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  4. Bluetit1802

    Bluetit1802 Type 2 (in remission!) · Guru

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    A constant dawn phenomenon means you may have insulin resistance and/or a fatty liver. and this is why you have diabetes. Have you any idea when your DP starts and how long it takes for it to come down to normal? The longer it lasts the more resistance you will be. Perhaps you could do some experimental testing, or splash out on a Libre?

    Your lack of significant spikes after eating is down to the food you eat, ie. low carbs. What might happen if you ate a carby meal?

    Your HbA1c s of between 41 and 49 are equivalent to an average of between 6.8 and 7.9mmol/l as per our meters.
     
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  5. stuffedolive

    stuffedolive Type 2 · Well-Known Member

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    Thanks for the response. But surely IR will give me spikes, but I don't see any. I just see this peak in the morning and then a bit up and down during the day. :-/
     
  6. Guzzler

    Guzzler Type 2 · Expert

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    Two things cause T2. Hyperinsulinaemia and Insulin Resistance. If you did not have (above background) IR you would be non Diabetic. Could you say when you take your fasting readings and a give a typical day's menu, this may help us to help you improve your dp.
     
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  7. stuffedolive

    stuffedolive Type 2 · Well-Known Member

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    Good questions. I have noted that my FBG is better after a good night's sleep, but I'm a poor sleeper so this doesnt happen very often. I have experimented with carby (and even sweet!) meals and yes my BG goes up but it could hardly be described as a spike - it's never been over 10.
     
  8. kitedoc

    kitedoc Type 1 · Well-Known Member

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    Hi @stuffedolive, Well done on such a healthy lifestyle !!
    I wonder what you meant by LCHF diet? How many carbs per day?
    And if you go to the Home Page, question box upper right and type in Dawn phenomenon, you will see what
    the latest theory on it is.
    I test as a T1D for DP starting at about 4 am, hourly til breakfast. That lets me know if there is any BSL rise to
    abnormal levels not adequately covered by my insulin.
    I am assuming in T2D insulin resistance may do similarly in not necessarily allowing your BSL to be fully controlled.
    Something for your GP or specialist to opine upon !.
    You also mention checking BSLs after food but not the timing so it is difficult to know how they compare to the acceptable range of BSLs.
    Review of the Home Page, Living with Diabetes, and far left - Blood sugar ranges shows the ">90minutes after food" BSLs..
    As others have said HBA1C gives a viewpoint on the last 3 months of BSLs.
    You need to ask your GP or specialist what is the acceptable HBA1C range for you. On the Home page ther HBA1C level talked about is 48 mmol/l, but one has to wonder who make up this figure and why. It is not a non-diabetic level.
    And the American Diabetes Society have tended to dominate the discussion on what the HBAiC levels should be and the argument has never sounded thoroughly scientific to me. But that is just my viewpoint
    If your HBA1C is above acceptable range this might suggest there are departures from normal BSLs, which are telling -
    such as ? fasting levels and after food levels.
    Your doctor or nurse would need to help you decide on appropriate action from there !!
    Best Wishes.
     
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  9. stuffedolive

    stuffedolive Type 2 · Well-Known Member

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    I take my FBG as soon as I get out of bed. I have experimented with different menus over the years including VLC. My graphs show that my Hba1c correlates with my weight (64kg lowest to 74kg highest in the last 15 yrs) currently 70kg. My weight however seems to correlate with how dedicated I am to low carbing.
     
  10. stuffedolive

    stuffedolive Type 2 · Well-Known Member

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    Yeah when I test around a meal I test before and then 1 and 2 hrs later. So typically I might go from say 5.8 to mid 8's after 1 hr then 6's after 2 hrs. For a high carb load, even sweet meal (very rare) it might still be over 8 after 2 hrs.
    On my current diet I have 40-100g carbs depending on what's happening.
     
  11. Bluetit1802

    Bluetit1802 Type 2 (in remission!) · Guru

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    As I said earlier, you don't see significant spikes because you eat low carb foods, but you must be seeing some higher levels for long enough to see those HbA1c results. Averages of between 6.8 and 7.9mmol/l imply you exceed these levels for a lot of the time.
     
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  12. Rustytypin

    Rustytypin Prediabetes · Well-Known Member

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    Hi @stuffedolive , your situation is similar to mine. FBG in the low 6's, pre evening meal BG around 5, 2 hrs after, usually mid 5's. On the odd occasion that I have tested in the wee small hours, (about 4 - 5 AM) BG has been mid 5's. Only vary rarely do I go above 7 FBG. Predicted A1c is about 34, yet lab results have been as high as 44.
    Sorry I don't have a solution, I have spent over 2 years trying to work it out!
     
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  13. stuffedolive

    stuffedolive Type 2 · Well-Known Member

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    Basically , I need to test more, yes?
     
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  14. Jim Lahey

    Jim Lahey I reversed my Type 2 · Well-Known Member

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    Dawn phenomenon is a clear indicator of hepatic and systemic insulin resistance. Your liver is supposed to secrete glucose in the morning but it’s also supposed to stop doing so in the presence of elevated blood insulin. Coupled with insulin resistance in the whole body, you have an out of control freight train loaded with sugar.

    If you are experiencing elevated blood glucose concentration in the mornings then you are very likely insulin resistant, insulin deficient, or both. A small rise is normal in many, but shouldn’t really be above 5.5mmol/L
     
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  15. Bluetit1802

    Bluetit1802 Type 2 (in remission!) · Guru

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    Yes! Until you know what is causing this.
     
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  16. stuffedolive

    stuffedolive Type 2 · Well-Known Member

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    Thanks Jim, raised FBG was what got me diagnosed as T2 back in 2004 when I had repeated readings over 7. However, I have managed to stay off the meds for 15 years, but I don't want to slide down the slope which my GP has called inevitable, but I intend to prove him wrong !

    I did wonder whether my poor sleeping patterns might be a factor. I wake around 3am for an hour (I don't get out of bed as this would wake Mrs Stuffedolive) and again around 6.30. Could I be getting 2 dawn glucose dumps every day? Could this explain why my FGB is much lower if I have slept through?
     
  17. stuffedolive

    stuffedolive Type 2 · Well-Known Member

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    I'll need to source a cheaper supply of testing strips then :-(
     
  18. Jim Lahey

    Jim Lahey I reversed my Type 2 · Well-Known Member

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    There are many cogs in the machine. Multiple factors will have positive and negative impacts.
     
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  19. kitedoc

    kitedoc Type 1 · Well-Known Member

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    Perhaps ask your GP about causes of early morning wakening - that may help to solve it !!
     
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  20. Traceymac23

    Traceymac23 Type 2 · Well-Known Member

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    @Rachox has some good sources?
     
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