Combating Dawn phenomenon

simply_h said:

Hello All,

Dawn phenomenon – As type 2, how can we combat this natural occurrence?

Is there anything we can do, to stop it having such a big effect on our blood sugars?

As I can go from 5.5mmol up to 7.5mmol in the space of an hour and I will not have even eaten, not a breakfast person, so my dinner in normally my 1st meal and before dinner I am about 5.7 to 6.5mmol.

Would small breakfast help (small peice of toast (8grams of Carb))??

As I am thinking that my after meal numbers are Ok-ish (there could always be better), but Dawn phenomenon must be dragging my HBA1c up… This is what I am thinking ect.

Any ideas.

Cheers
Simply_h

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I have this problem as well so will be very interested in the replies

Two points: your liver will go on dumping glucose until you eat something, so it's best not to miss breakfast. Eg, for my last blood tests my fasting BG was 4.8 at home; an hour later, in the surgery, it was 5.6.

If you can fit a small piece of toast in with your carb allowance, then fine, but check it doesn't make you go even higher! :shock: Yoghurt + berries, or eggs, might be better. Some people find a carby snack at bedtime (eg a buttered oatcake + cheese) can improve things in the morning, but it doesn't work for everyone. (Oatcake for carb; butter + cheese = fat to slow things down; cheese = protein for later.)

Secondly - as your control improves, so your DP will go down. When I first started testing (late 2010) I was usually in the late 6s/early 7s. Now I've lost 4.5 stone and am eating VLC, my fasting is never over 6 and usually late 4s/early 5s.

It does take time - don't be impatient. Your readings after eating are more important really - two hours after eating you should be back down just about where you were just before eating. If your test strips are limited, use them around your main meal.

I take my fasting test as a 'touch wood'. It reminds me that I'm Type 2 and must eat correctly for the rest of the day! :lol:

Viv 8)

Agree with Viv about brekky. Think you should have something light. As Viv knows, I disagree about the night snack, but that's just me, so try it. But even a tiny bit of anything at night puts my BG up and it stays up till morning - for overall average BGs, that's worse than a small rise at dawn. Try, eat, test is the system.

My breakfast is usually some pate with a little mayo wrapped in lettuce leafs and some macademia nuts and sorties cheese, also been lowering car seven more for dinner, last 2 days my levels have gone from 7.4-7.8 to 6.2-6.6. I have also introduced a little carbs at lunch which my body is happy with no big increases.

Hi - with a view to what Viviennem says about the pre bed oatcake....

I'm new to all this - just about a month into serious daily testing. My fasting blood has come down from always over 7, sometimes over 8 , to usually low to middle 6s.

Could someone please explain to me the logic behind the oatcake before bed? I am aware that not everything will work for everybody but I'd like to know why this could work. Is it because the liver doesn't 'panic' that there's no food in the system because of the carbs in the oatcake??? :eh:

Feel like a walking scientific experiment !!!!

Looking forward to replies and thanks in advance.

CathyN xx

There are two differtent events that can occur during the night. One is important for people on insulin or other strong sugar lowering drugs, as they can get night hypos so often have a snack before bed to stop sugars getting too low. For people on diet only or metformin, this isn't going to happen as such. If we do go low, then our livers will release glycogen to bring them back up. Some people on diet/metformin feel this may be averted by eating a small amount before bed. Danger is, we simply raise our BGs and they stay up all night because there's not a lot we're doing (most of the time!) until the morning. The dawn phenomenon is different; this is where the body knows we're getting up soon (through habit) and releases some glycogen to bring BGs up in preparation for the energy we are about to expend. Night time snacks are unlikely to prevent this in my opinion. I did ask an endocrinologist about this, and he said for someone on diet only/metformin, our BG is probably pretty much straight line during the night, unless you go to bed with really high BGs, so whatever you go to sleep with will be there most of the night until dawn phenomenon. Liver dumps are thus unlikely, so for that reason I don't eat before bed.

Thank you! Very clear and easy to understand.

Grazer said:

... I did ask an endocrinologist about this, and he said for someone on diet only/metformin, our BG is probably pretty much straight line during the night, unless you go to bed with really high BGs, so whatever you go to sleep with will be there most of the night until dawn phenomenon. Liver dumps are thus unlikely, so for that reason I don't eat before bed.

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This is interesting and sounds about right. Thank you, Grazer.

From my spreadsheet, across many hundreds of readings, my averages are:

DAWN >>> 7.3
Breakfast +2 >>> 7.2
Before lunch >>> 6.3
Lunch + 2 >>> 6.3
Before dinner >>> 6.0 (exercise greatest)
Dinner + 2 >>> 6.5
Before bed >>> 6.4

My deviations from these figure are quite tiny.

This translates to a HbA1c of 6.1%

It seems that the BG registers lower during the calorie (and carb) burning hours.

Is part of the problem that the 7 to 8 hours of inaction at night causes the problem in the morning?

I have tried varying Metforming timing but I do not think that it makes much difference to the dawn reading. I too would be disinclined to carb-up before bed.

One thing for sure, I do not live as a 5 person. An hour's intense swimming gets me down to 5.7 but it doesn't last for long.

My supposition is that the numbers are broadly linked to carb-burning.