Dawn Phenomenon

BrenDorset

Member
Messages
7
I recently crossed from prediabetic to diabetic which I was controlling by diet. I then had a distal pancreatectomy losing about a third of my pancreas. Postoperatively the hospital put me on Lantus 10 units but the surgeon says that it still might be possible to control by diet or I might find metformin more convenient to lantus injections (DVLA requires that drivers test blood sugar before and during driving). I said I would like to have a go at controlling by diet again. I am not taking anything and am having some success by reducing carbs but as I came off the insulin I notice that my morning blood sugar levels have risen from 7 to between 8 and 9 mmol/l. Evening levels seem unchanged, though still diabetic about 7 pre dinner and about 8 to 9 two hours after.

As I am improving my understanding of my response to food and reducing BMI (aiming for 24 but currently about 25 compared with 26 for most of the last ten years). I think I might manage to get off insulin injections except for the high levels in the morning. I suspect that switching to metformin will not prevent the morning rise - I would worry about taking metformin at night. Has anybody got an insight into what is generally called the Dawn Phenomenon?
 

LaoDan

Well-Known Member
Messages
993
Type of diabetes
Type 2
Treatment type
Diet only
Dislikes
The term “new normal “
Maybe get libre sensor, even if it’s just for a short time so you can see what’s going on while you sleep. I found my BG started to rise after I woke up. Still working on how to solve the issue, but I know what’s going on... at least when.. Working on doing morning exercises
 

JoKalsbeek

Expert
Messages
5,937
Type of diabetes
I reversed my Type 2
Treatment type
Diet only
I recently crossed from prediabetic to diabetic which I was controlling by diet. I then had a distal pancreatectomy losing about a third of my pancreas. Postoperatively the hospital put me on Lantus 10 units but the surgeon says that it still might be possible to control by diet or I might find metformin more convenient to lantus injections (DVLA requires that drivers test blood sugar before and during driving). I said I would like to have a go at controlling by diet again. I am not taking anything and am having some success by reducing carbs but as I came off the insulin I notice that my morning blood sugar levels have risen from 7 to between 8 and 9 mmol/l. Evening levels seem unchanged, though still diabetic about 7 pre dinner and about 8 to 9 two hours after.

As I am improving my understanding of my response to food and reducing BMI (aiming for 24 but currently about 25 compared with 26 for most of the last ten years). I think I might manage to get off insulin injections except for the high levels in the morning. I suspect that switching to metformin will not prevent the morning rise - I would worry about taking metformin at night. Has anybody got an insight into what is generally called the Dawn Phenomenon?
Never thought I'd actually recommend metformin, as I passionately hate the stuff, but.... That's exactly what it's for. It doesn't do anything about what you eat, so wouldn't be able to replace fast acting insulin, but the Lantus... Maybe... Met keeps your liver from dumping up to 75% of the glucose it'd otherwise pump into your bloodstream in the morning. Mind you, fasting blood sugars are the last to come down on a low carb diet, so it could well be half a year or a year before a low carb/keto diet would impact that much... But some see results sooner. Considering your pre and postprandials in the evening, I think it'll come down sooner rather than later, actually. Worth a shot. As long as you're not seeing double digits, I'd say, experiment?
 

JoKalsbeek

Expert
Messages
5,937
Type of diabetes
I reversed my Type 2
Treatment type
Diet only
I recently crossed from prediabetic to diabetic which I was controlling by diet. I then had a distal pancreatectomy losing about a third of my pancreas. Postoperatively the hospital put me on Lantus 10 units but the surgeon says that it still might be possible to control by diet or I might find metformin more convenient to lantus injections (DVLA requires that drivers test blood sugar before and during driving). I said I would like to have a go at controlling by diet again. I am not taking anything and am having some success by reducing carbs but as I came off the insulin I notice that my morning blood sugar levels have risen from 7 to between 8 and 9 mmol/l. Evening levels seem unchanged, though still diabetic about 7 pre dinner and about 8 to 9 two hours after.

As I am improving my understanding of my response to food and reducing BMI (aiming for 24 but currently about 25 compared with 26 for most of the last ten years). I think I might manage to get off insulin injections except for the high levels in the morning. I suspect that switching to metformin will not prevent the morning rise - I would worry about taking metformin at night. Has anybody got an insight into what is generally called the Dawn Phenomenon?
PS: You don't get hypo's on metformin, so overnight hypo's wouldn't happen. It would with lantus or gliclazide for instance.