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Dawn Phenomenen

smc4761

smc4761

Well-Known Member
Messages
1,042
Type of diabetes
Type 1
Treatment type
Insulin
Looking for some advice and if anyone has experienced similar situation

About 10 weeks started low carb diet, having around 5 g of carbs for breakfast, Granola and milk. Lunch is usually only around 10/15 g of carbs. Evening meal is around 15 g of carbs, with a snack of crackers and cheese around 7.30 at night. I take the appropriate amount of Novo rapid to cover for this. As well as 20 units of Levemir in morning and 24 units Levemir at bedtime

BG from around lunchtime is usually good around 5/6/7 until bedtime. Bed is usually a BG of around 6

I recently got a Freestyle Libre, so when I wake up during night I will do a quick scan. Around 2am BG may have gone up 1 step, if I wake around 4.30am its gone up by about 2/3 steps and on rising at 7 am it can be up as much as 5 steps.

So pretty sure that is dawn phenomenen

This has only started in past 6 weeks or so around same time I started to low carb. My previous overnights were usually pretty good with little variation from bedtime to getting up. Previously I would be eating 50/60 g of carbs at lunchtime and evening meal.

Could the low carbing be causing this. I have tried adjusting basal insulin but made no difference
 
Dawn Phenomenon is likely to be causing the rise when you get up.
However, it is unlikely to cause 1/2/3 unit rise between 2am and 4:30am.
I think (and I emphasise this is a "think") you may need more basal over night. This may result in a need for less bolus during the day.
Have you done a basal test during the day?
 
helensaramay said:
Dawn Phenomenon is likely to be causing the rise when you get up.
However, it is unlikely to cause 1/2/3 unit rise between 2am and 4:30am.
I think (and I emphasise this is a "think") you may need more basal over night. This may result in a need for less bolus during the day.
Have you done a basal test during the day?
Click to expand...

I agree with this. Logically, if your carbs have gone down, your liver is going to be pumping out more glucose, which may mean your basal doses need recalculating as well as your boluses (boli?). In any case, no harm in rechecking your basal. (Not that low carbing isn't causing the issue, but I'd rule out basal problems first.)
 
Previously I would take 23 units of basal morning and night. I have adjusted this down to 18 in morning and 28 in evening but to no avail.

My BG is typically around 10 when I get up at 7 am have breakfast and this will rise to around 12 by 9am before dropping back all day, 8 by 12.30, 7 by 3pm and finally 5.5 by 5.30pm. It stays pretty good until bed at 10.30pm when it is around 6, By 2am it has risen slightly may be 7 then by 4.30/5 am its up to 9.5 and finally 10 by 7am

Getting really frustrated as this rarely happened before low carbing. On the plus side I have lost almost a stone and I am actually enjoying the diet, eating much better, fresher food
 
Hi @smc4761,
1) If you have not been using the Libre before this I guess you may not know if something similar but less dramatic in blood sugar levels is happening at night /early morning?
2) Also I am guessing you started on the low carb diet to see whether your BSL control would be better rather than to lose weight?
So..if you are losing weight on this diet from you started in the normal weight range for height could the 'stress' of this push up the cortisol levels from the adrenal gland causing raised BSL.
3) since about ? 50% of the protein we eat is converted to glucose from 4 + hours after the meal perhaps you are having a larger amount of protein with your evening meal and this is pushing up BSL overnight. If you were to try having more protein, say for breakfast and less for evening meal that could at least help rule this in or out as a possible cause.
Best Of luck !!
 
kitedoc said:
Hi @smc4761,
1) If you have not been using the Libre before this I guess you may not know if something similar but less dramatic in blood sugar levels is happening at night /early morning?
2) Also I am guessing you started on the low carb diet to see whether your BSL control would be better rather than to lose weight?
So..if you are losing weight on this diet from you started in the normal weight range for height could the 'stress' of this push up the cortisol levels from the adrenal gland causing raised BSL.
3) since about ? 50% of the protein we eat is converted to glucose from 4 + hours after the meal perhaps you are having a larger amount of protein with your evening meal and this is pushing up BSL overnight. If you were to try having more protein, say for breakfast and less for evening meal that could at least help rule this in or out as a possible cause.
Best Of luck !!
Click to expand...

Thanks for such an informative reply.

My BG in mornings prior to low carb were always around 7 --9, going to bed with a BG of around 6--8, so not a huge change overnight

I started the low carb diet to help improve my BSL and also to lose weight. I am a bit overweight coming in at around 15.5 stones prior to low carb when I was normally 14.5--15 stone. My BMI is around 30

Evening meals is normally chicken/pork/beef/ sausages with veg, eg cauli, broccoli, onion, cabbage, carrots, peas etc and normally taken around 6pm. Thereafter all I have is crackers and cheese around 7.30
 
smc4761 said:
Thanks for such an informative reply.

My BG in mornings prior to low carb were always around 7 --9, going to bed with a BG of around 6--8, so not a huge change overnight

I started the low carb diet to help improve my BSL and also to lose weight. I am a bit overweight coming in at around 15.5 stones prior to low carb when I was normally 14.5--15 stone. My BMI is around 30

Evening meals is normally chicken/pork/beef/ sausages with veg, eg cauli, broccoli, onion, cabbage, carrots, peas etc and normally taken around 6pm. Thereafter all I have is crackers and cheese around 7.30
Click to expand...
Thznkyou @smc4761, So the timing of your protein protein intake at 7 pmish tends to put doubt on the possibility of protein being a cause of highish BSL in the early mornings but it might be worth trying the switch of evening protein intake to breakfast time just to make sure and if your dsn agrees !! It may also be that once you have lose some more weight things might settle out as your insulin resistance may lessen with that weight loss.
I hope that all helps and fingers crossed !!!
 
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