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Type 2 Dawn phenomenon - hrmph!

ShelleyDubs

Well-Known Member
Messages
70
Type of diabetes
LADA
Treatment type
Insulin
Will it ever go away? I’m a diet only, well-controlled, 3 years diagnosed T2. I don’t eat late, have a keto diet, and although exercise is somewhat lacking recently with lockdown, I’m not overweight, and my morning waking numbers are STILL in the high 6s fasting. They drop back to between 4-5 during the day. It’s so frustrating. Anyone have any tips, advice or anecdotes to share before I go slightly mad? Thanks, all.
 

I have exactly the same, and no longer worry about it in the slightest.
I see others on the forum worriting about their fasting blood glucose rising from 4.6 yesterday to 4.8 today, and just shrug.
Each to their own.
If my body gave a 5.8 in the mornings it would be amazing.
My morning numbers are roughly the same as yours, although I v rarely see a 4.

One excellent thing I have found after years of vlc and keto is that while I may wake up on a 6.5, it no longer rises dramatically into the 8-11 range with 'foot on floor' syndrome. That happened for a long time, but now I just scoot along in the 6s and early 7s without food, and dip lower into the 5s if I do eat - so long as that food is keto either protein or fat, or both.

Having said that, my standard deviation (according to the Libre) is fab. Well chuffed with that. If my bg varies more than 1.5mmol/l during the day, then that is unusual, and usually chocolate related

So, as I say, each to their own.
 
We definitely need to do our best to keep our overall glucose levels under control, but not get to the point where we end up obsessed by them.

I'd tend to agree with what @Brunneria says, and I just let my liver do its job - if it thinks I need a glucose "wake up boost" then so be it that's what I get, and my early morning levels vary accordingly. I've sometimes seen low fives and an occasional high seven but usually average somewhere around mid sixes, where my body seems most comfortable.

Ever since I've been testing (over six years now) I've seen my glucose levels gradually decrease during the day - unless I'm ill or stressed etc. I've eaten a low carb/ketogenic diet since diagnosis which keeps my overall levels at the low end of pre-diabetic, and I work on the principle that I should take note and attend to the levels I can control, and leave those a.m. ones that I can't to nature - my liver and pancreas have now had over 3/4 century's worth of experience in doing their jobs.
 
I have been controlling my diabetes for over 8 years and still have dawn phenomena. It hasn't gone away. My body just feels the need to liver dump first thing.

We are all different, and the liver dump hasn't affected my later daily readings.
 
Some years ago I read an explanation of this, that sort of made sense to me. I can't provide any links to who wrote it or where I read it.
The gist of it was that the difference between a reading in the high 4's or low 5's and a 6 something is just a small amount of glucose. Your body doesn't see it as a problem and is quite happy to trundle along at that level without releasing any insulin. When you eat something your levels rise a little more causing your pancreas to wake up and supply the insulin to deal with it, which lowers your levels back into your comfort zone.
 
my fbs hovers around 6.0 to 6.7 occasionly dips to mid to high fives i dont test that often during the day but normally mid fives at mid day and 17 30 hours.. im okay with that..
 
Thank you everyone. Sometimes you just need the reassurance of others. You’re all so right - the numbers aren’t really bad, and I should let my body do its thing! I’m interested to know how eating may bring DP to a halt, and how a small rise in BG doesn’t trigger an insulin response. Anyone got more on this? I can’t help being a little obsessive about my numbers it seems!
 
I found that my BG doesn’t go up until after I wake up, I’m betting it’s my morning coffee causing an increase in cortisol.. I thought about quitting for a couple weeks to test my theory, but, nah....
 
I'm finding more changes to my BG levels than ever in the last 2 weeks since having a mild heart attack. I'm also noticing all sorts of other nasties like meals that used to work like a charm suddenly raise me to levels I haven't seen since first diagnosed. Ditto for the time it's taking to return to baseline, etc. At the moment I'm putting it down to a combination of stress hormones being released at all sort of odd times due to wildly fluctuating oxygen saturation levels, plus general stress from poor sleep and other factors. Unfortunately my stress hormones are under the control of my failing lungs and heart - not much I can do about it except double-down on diet (which is pretty scary considering the 6kgs I've lost in the past year without even trying. Logically I should be getting the best BG levels of my life being slimmer than I was after having my tonsils out and being unable to eat for a week at age 14! However, not everything can be controlled by diet <shock, horror>. As much as we like to pretend, everything in life is not under our control.

Like Brunneria the "foot on floor"syndrome is real for me, and not just as part of dawn phenomenon. It happens every time I get up from sitting or lying down. My heart starts racing or skipping, my oygen plummets, I get even more breathless despite having my oxygen firmly in place. Stress is an amazing thing and the body is a finely tuned instrument, even if in my case it's causing collateral damage trying to keep me alive. Naught I can do about it except magically become a Zen master overnight, which is pretty unlikely at this late stage of my life
 
I read somewhere that a carb/protein snack like half an apple and a few bites of cheese before bed can help smooth that out. It seems to work for me, but not as consistently as I’d like. I’m still playing with it to get it dialed in.
 
Hi @ShelleyDubs. I'm sorry I didn't notice this thread earlier. I am very interested in the Dawn Phenomenon (DP)as it has been a stick on my prediabetic-levels-back for as long as I have been trying to get better, and from using my BG meter could see what a big impact on my blood glucose system my impaired fasting blood glucose has.

My understanding is - it's because the otherwise finely tuned blood glucose regulation system is not signalling properly, - in the liver regarding reading a normal BG level, and responds to (mis) perceived lowering levels by releasing its stored glucose, when in fact you do have normal or above normal levels already, and then insulin resistance on top of that means the higher than normal blood glucose levels remain higher until (or sadly - if!) the insulin can do its job, that you have higher than normal fasting blood glucose. Called 'impaired fasting blood glucose' , or 'impaired fasting glycemia' or IFG, in the scientific literature.

And yes, part of diabetic dysregulation that can differ widely between people. Also, it seems, in how long on the diabetic journey (the endgame being non-diabetic if possible!) one can have a properly functioning liver in this regard, in terms of releasing stored glucose appropriately, seems to differ widely between people.

I myself do wonder (along with the sick fat cell theory and study findings of course) if it is to do with exactly how many sick fat cells the person has, and how sick (inflamed, and how large) and where they are located that could be deciding factor, when it comes to DP overrelease problems. One imagines then that it is liver fat cells that are the culprit? But we don't really know. Fat cells have a life span of 10 years, roughly, so - it might be that you have to wait until your sick fat cells have been replaced with enough healthier new fat cells for the DP probs to die down, or - preferably - out! Then only time will tell.

In the meantime - yes - do everything you can to have healthier new fat cells! And help your liver read your BG levels correctly, and if eating some high fat food (cheese?) at night, or drink a little Apple Cider Vinegar (another possible way that has been studied and is thought to be somewhat effective) - then go for it.
 

Exercise and not drinking any alcohol are the most important factors to reduce your blood sugar levels.
 
Um, I beg to differ @Droyston. I am pretty active and rather on the fit side for a middle aged old broad, with good musculature (for an old broad). It should be - I work hard at it. Exercise makes very little impact on my FBG and DP, when it is playing havoc with my blood glucose regulation system. It does do a magnificent 'mop up' of post meal blood glucose, and, I am quite certain - in keeping my cardio vascular system functioning hopefully well. What exercise does not do is effect my too high FBG, when I am over my 'personal fat threshold', is my belief. (And I am always over that except for brief moments in time.)

As for alcohol - well well well. Alcohol is actually a help in lowering a too high fasting blood glucose, as, apparently, when imbibed at night (as it most often is?) the liver is kept busy filtering out the alcohol, and does not overrelease the stored glucose in the morning, at least to the same dysregulated level. In short, you could be forgiven for seeing alcohol as a treatment alternative for lowering your FBGs! There is the, ah, side effect, though, of contributing with overuse of alcohol, to the ill-health of your liver - which cannot be good for us, or not optimum? at least? Alcohol does also act as a relaxant, and stress is a contributing factor to high blood glucose. My own way of looking at this conundrum is it is a balance only the individual can come to a decent reckoning with! This is where that old saying 'everything in moderation' could come well in handy! With feel good substances that have the additional benefit of keeping your liver in check re FBGs.

Bear in mind - metformin performs the same function - I have read it being described as turning off the on switch in the liver re releasing the stored glucose. Obviously that is not the real process, but there is probably a very complicated flow chart (OK - there would absolutely be a very complicated flow chart - they are online if you want to take a look...) with a lot of chemical/hormonal acronyms to describe the reality! Such is the real complexity that is diabetes.
 

Metformin and alcohol are a bad mix for your liver.

You may very well differ. Great if you do.

I thought that I differed and that I could control alcohol. I almost ruined my health and potentially shortened my life by trying. I am now 60.
 
Yes, I hear you @Droyston. Quite right - I didn't mention the potentially addictive/highly addictive nature of alcohol which is something, a big thing, to bear in mind when using alcohol for enjoyment and relaxation, and possibly as a liver glucose release control!

I don't take metformin at the same time as drinkng alcohol personally - I have a very strong non-medication perspective/base, especially regarding a metabolic dysfunction, but I recognise the good work metformin does, and the help and aide many high blood glucose/diabetes sufferers get from medications generally. But I do remember the admonition not to drink alcohol whilst taking metformin in the written material when I was prescribed the drug, now that you mention it.I was pretty surprised! So many folks take metformin, and ditto on the alcoholic beverages stakes. It would be good to hear more about this. I am considering taking metformin myself, at least for a period, to see what happens when the liver 'switch is turned off' by the drug, and I hadn't considered the alcohol issue. Thanks for bringing it up Droyston - I had forgotten that detail! (A new thread somewhere here might be a good and interesting thing?)
 
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