Hi
@Cana, According to my diabetes education, and to put the liver thing perhaps into better context: ( not as professional advice or opinion.
Our livers store some glucose from each meal. That storage is used between meals to help keep the blood glucose above a minimum level .
Why? because the brain primarily uses glucose as it fuel and gets very tetchy if the level of glucose is too low in the blood. Glucagon, a hormone made near insulin-producing cells is released when blood glucose level falls too low and influences the liver to release some stored glucose into the blood stream to correct the too-low level. Adrenaline, released during an emergency can also cause release of glucose from the liver, as a fuel source for action.
Other hormones have an influence on the effectiveness of insulin. It is all a very complex interplay of various mechanisms trying to maintain or bringing back equilibrium. Equilibrium is like riding a bike fast enough to maintain balance where various factors seek to destabilise that state and one's responses to re-stabilise things..
The Dawn Phenomenon (DP) is not fully understood but does involve a hormone called cortisol, the body's stress manager. If say, cortisol is released at 4 am as a wakeup prep, it does reduce the effectiveness of insulin. No problems with a non-diabetic because any sugar stabilising need is automatically dealt with by insulin release from the pancreas gland.
In diabetes that insulin response is either fairly absent, not timed well enough or only partly adequate (except if some one is using an insulin pump +/- CGM technology). So the relative insulin resistance caused by cortisol and the liver release of glucose (ungloriously called a liver dump) causes a high or higher than usual early morning/fasting blood glucose level.
Why are some diabetics more plagued than others by the DP is not understood.
Other causes of high BSLS particularly first thing in am: dietary excess the evening before, in T2D where endogenous (own insulin from one's pancreas) insulin deficiency is imminent, in T1D, insufficient insulin acting overnight, use of inactivated insulin, or rebound effect from a night-time hypo.
General stress, seasonal change and weather change may cause release of cortisol and high BSLs.
Infection causes increase in insulin resistance as the body fights the infection plus increased cortisol release.
So in one word the answer to your question in the whodunit is 'The Liver" with "Cortisol" and close second !! Best Wishes.
).
)
