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Dawn Phenomenon ???

I

iwhoadmin

Member
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22
Hi
I am hoping to get peoples insights on this new issue I have developed. Dawn Phenomenon. I am fairly new (less than 2 months into Tresiba. At first it seemed to be working well. But recently I have noticed my BG was 11.1 mmol/l (200 dl) in the mornings. With no food since 4 pm the previous evening. Is this something that happens because of the new insulin ? I was previously on Lantus and aside from the occasional lows at night, it was ok. I am trying to avoid taking Novolog to correct this as I go bike riding evey morning for 45 minutes and that usually has an impact and do not want to go low on the road. Would love input from others who are familiar with Dawn Phenomena.

Thank you
 
I take Novolog at bedtime to combat this issue and am able to exercise in the morning as coffee causes my liver to dump glycogen from the previous day's carbs. 2 cups of coffee will immediately send me from 5mmol up to 13 mmol. Exercise afterwards increases the efficacy of the novolog in my body that is tapering off, so it corrects the sugar nicely.

I can eliminate dawn phenomenon without Novolog with a no-carb diet but I don't often have the discipline to achieve it. No-carb to me is just veggies, dairy, tofu, nuts and seeds, and a bit of fruit.

This year I changed up the protocol by taking 500mg metformin HCL at bedtime, and am able to reduce my Novolog by 1/2.
 
polarsun said:
I take Novolog at bedtime to combat this issue and am able to exercise in the morning as coffee causes my liver to dump glycogen from the previous day's carbs. 2 cups of coffee will immediately send me from 5mmol up to 13 mmol. Exercise afterwards increases the efficacy of the novolog in my body that is tapering off, so it corrects the sugar nicely.

I can eliminate dawn phenomenon without Novolog with a no-carb diet but I don't often have the discipline to achieve it. No-carb to me is just veggies, dairy, tofu, nuts and seeds, and a bit of fruit.

This year I changed up the protocol by taking 500mg metformin HCL at bedtime, and am able to reduce my Novolog by 1/2.
Click to expand...
I decided to review my diet and excluded all cheeses as I had been doing previously. And this time I also eliminated most artificial sweeteners. Last night was just great and how my overnights used to be. A significant improvement.
BG between 6.3825 mmol/l(115dl) and 8.0475 mmol/l(140dl) overnight. I will see how this progresses but this was an easy way to deal with something that concerned me.
 
iwhoadmin said:
I decided to review my diet and excluded all cheeses as I had been doing previously. And this time I also eliminated most artificial sweeteners. Last night was just great and how my overnights used to be. A significant improvement.
BG between 6.3825 mmol/l(115dl) and 8.0475 mmol/l(140dl) overnight. I will see how this progresses but this was an easy way to deal with something that concerned me.
Click to expand...

Hello, could you please provide some insights about why cheese has a negative effect?
 
From

Dairy Consumption and Insulin Resistance: The Role of Body Fat, Physical Activity, and Energy Intake - PMC

The relationship between dairy consumption and insulin resistance was ascertained in 272 middle-aged, nondiabetic women using a cross-sectional design. Participants kept 7-day, weighed food records to report their diets, including dairy intake. ...
www.ncbi.nlm.nih.gov www.ncbi.nlm.nih.gov


"Milk and dairy products have been identified as potent insulin secretagogues, as their consumption stimulates acute hyperinsulinemia [27–31]. The hyperinsulinemia resulting from milk and dairy consumption may be considered a beneficial and even protective effect for regulating blood glucose levels, particularly in individuals with elevated levels or those with T2DM [32]. However, consumption of milk and dairy products and the resultant hyperinsulinemia may produce less-than-desirable long-term effects in healthy individuals, including insulin resistance. Research in humans [33] and in rats [34] suggests that regular hyperinsulinemia can lead to insulin resistance"
 
iwhoadmin said:
From

Dairy Consumption and Insulin Resistance: The Role of Body Fat, Physical Activity, and Energy Intake - PMC

The relationship between dairy consumption and insulin resistance was ascertained in 272 middle-aged, nondiabetic women using a cross-sectional design. Participants kept 7-day, weighed food records to report their diets, including dairy intake. ...
www.ncbi.nlm.nih.gov www.ncbi.nlm.nih.gov


"Milk and dairy products have been identified as potent insulin secretagogues, as their consumption stimulates acute hyperinsulinemia [27–31]. The hyperinsulinemia resulting from milk and dairy consumption may be considered a beneficial and even protective effect for regulating blood glucose levels, particularly in individuals with elevated levels or those with T2DM [32]. However, consumption of milk and dairy products and the resultant hyperinsulinemia may produce less-than-desirable long-term effects in healthy individuals, including insulin resistance. Research in humans [33] and in rats [34] suggests that regular hyperinsulinemia can lead to insulin resistance"
Click to expand...
That is interesting. Two points come to mind for me;
The study does not appear to be counting cheese as dairy : from the article
The American Dietetic and American Diabetes Associations (ADA) Exchange Lists do not include cheese in the dairy category because the macronutrient composition of cheese differs significantly from other dairy foods, as defined above.

As a T1 who is partially prone to dawn phenomena (and loves cheese) I wonder if the study is relevant to T1s or just T2s?
 
Hi,

It is great that you have been able to get your sugars more under control in the mornings via diet alone, but for me personally that would work for a week, then I would just crave cheese and give in to temptation. I just love a good strong cheddar and I do not think (personally) I could give that up long term and would instead be looking at other ways of keeping your sugars in check first thing in the morning.

I too have this problem in the morning where my sugars spike but recently I have started to increase my Lantus on a day-to-day basis and the last few days I have been taking 30 units instead of the 26 units I had been taken for a number of years.

I have also learnt over the years that before I can personally say something is working categorically for me, I need to replicate the low sugars in the morning for about a week, as there has been many of time in the past when I thought I'd cracked it, only for my sugars to be rising a couple of days later first thing in the morning.

What has also worked for me more times than not is to give myself a small dose of Lantus at 9:00 PM on top of the large dose I have at 9:00 AM that morning, it does mean an extra injection, but it seems to work for me. if I take 30 units in the morning, I will take 5 units in the evening to give you some idea of my dosage.

I am not suggesting by any means that you should follow this advice, you stick what works for you and if that is giving up cheese and sweeteners forever that's great for you, but for me personally I would probably crack after a few weeks :)

Good luck, I really mean that, there seems to be a lot of people in the same boat as us with these spikes in the morning.

If I find myself a solution I will be back and let you know. Still in trial-and-error stage, also have some Tresiba in the ref that I want to try too next weekend in place of Lantus.

Thanks
 
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