Dawn Phenomenon

[toastaddict]

hi everyone. So my hb1ac levels have been creeping up towards diabetic range, and I've been trying to make some positive changes to diet, and testing my blood sugars regularly. One thing I've noticed, is that my BS levels throughout the day, and post-prandial, are pretty normal, even after meals with carbs. But when I check BS levels first thing in the morning, they are high... like, very high, usually they always start at around 7.4 (at around 6am) then creep up to around 8 or 8.1, 30 mins later. This is so confusing; I eat around 6.30pm the evening before, and when I've checked BS before bed they are normal. I've read that dawn phenomenon is a thing that potentially affects many people, not just diabetics, but I cant work out why it would raise my BS so high in this way. I've also just starting work on strategies to quickly reduce it, eating first thing, or light exercise, but I don't have the conclusive data yet on what's working well. Any thoughts or comments from the community would be most welcome, thank you!!

 

[SimonP78]

That's not particularly high! But then perhaps my T1 scaling is different

How quickly does it come back down?

Does this happen when you get up (which is usually called FotF - Foot on the Floor) or irrespective of whether you're still asleep or not (DP) - it seems quite late in the morning for the typical DP which tends to start in the small hours, but we're all different. Both are related to hormones, DP to growth hormone and other normal hormonal changes, FotF is caused by adrenaline (etc.) released as you get up and get ready for the day.

Some T2 diabetics find that eating something prevents the liver from continuing to produce glucose, though I will let someone who is T2 comment on the specifics. Gentle exercise will likely reduce/eliminate the effect - I get FotF and walking my primary school children to school (20min round trip) would be enough to knock this on the head (they are now at secondary school and require a car to get where they need to be, which also requires glucose to concentrate, but I also need some bolus.)

Just to add in, doing intense exercise the previous day will likely remove the DP/FotF effect, as will drinking copious amounts of alcohol. The former is probably better for you , but even that is hard to maintain as you need to do quite a lot (enough that you both raise muscle insulin sensitivity and deplete hepatic glycogen somewhat).

 

[toastaddict]

That's not particularly high! But then perhaps my T1 scaling is different

How quickly does it come back down?

Does this happen when you get up (which is usually called FotF - Foot on the Floor) or irrespective of whether you're still asleep or not (DP) - it seems quite late in the morning for the typical DP which tends to start in the small hours, but we're all different. Both are related to hormones, DP to growth hormone and other normal hormonal changes, FotF is caused by adrenaline (etc.) released as you get up and get ready for the day.

Some T2 diabetics find that eating something prevents the liver from continuing to produce glucose, though I will let someone who is T2 comment on the specifics. Gentle exercise will likely reduce/eliminate the effect - I get FotF and walking my primary school children to school (20min round trip) would be enough to knock this on the head (they are now at secondary school and require a car to get where they need to be, which also requires glucose to concentrate, but I also need some bolus.)

Just to add in, doing intense exercise the previous day will likely remove the DP/FotF effect, as will drinking copious amounts of alcohol. The former is probably better for you , but even that is hard to maintain as you need to do quite a lot (enough that you both raise muscle insulin sensitivity and deplete hepatic glycogen somewhat).

thanks Simon! so from what I can tell, it goes from around 7.4 at 6am, to 8 at 6.30, and then goes quite slowly down from there. I normally eat breakfast at 8.30, by then its still 7, something like that? but then eating seems to reset my body, BS levels wise! And while its elevated already when I wake, it seems to go up more with FotF... and yes, saying these measurements are 'high' is I suppose subjective - I call them high because I was expecting fasting BS levels of 5 or 6, something like that!

I have just started trying to eat something first thing, early days but that seems to bring levels down a bit quicker? I have tried exercise too but that seems to have a minimal effect. It would be fantastic to hear other peoples experiences of eating first thing.

Interesting what you say about exercise - I do exercise quite a lot, but I haven't noticed any effect on DP from an intense gym session. Will keep monitoring though. And yes, have also noticed that boozing much reduces the DP! but not sustainable to do that every day, lol! Jokes aside though, I have actually moderated my alcohol intake quite substantially in the last couple of years, and have a niggling suspicion this might have some correlation with elevated BS??

Generally, it was surprising to learn I was pre-diabetic because I exercise lots, my cholesterol and blood pressure are all normal and I would not be considered overweight by any metric.

Thanks again for your thoughts.

 

[SimonP78]

thanks Simon! so from what I can tell, it goes from around 7.4 at 6am, to 8 at 6.30, and then goes quite slowly down from there. I normally eat breakfast at 8.30, by then its still 7, something like that? but then eating seems to reset my body, BS levels wise! And while its elevated already when I wake, it seems to go up more with FotF... and yes, saying these measurements are 'high' is I suppose subjective - I call them high because I was expecting fasting BS levels of 5 or 6, something like that!

Sorry, I couldn't resist.

I have just started trying to eat something first thing, early days but that seems to bring levels down a bit quicker? I have tried exercise too but that seems to have a minimal effect. It would be fantastic to hear other peoples experiences of eating first thing.

For me the exercise type makes a difference - walking the kids works well, riding bike to work generates even more hepatic glucose. I guess if I could ride at lower power it would probably use up glucose without more being released. Not sure what to suggest, probably more T2 specific - I simply take insulin to deal with it.

Interesting what you say about exercise - I do exercise quite a lot, but I haven't noticed any effect on DP from an intense gym session. Will keep monitoring

For me it has to be something pretty drastic that I'm not used to. So after a few weeks off the bike (illness, weather, not enough time to ride to work), riding to work (40km round trip) clobbered my FotF the next day. In more normal times (as I ride >100km a week even in the off season) this would have no effect and I'd need to ride 100miles+ to get any effect. This is why it was only slightly tongue in cheek that neither the alcohol nor exercise things are sustainable. Perhaps the combination of some alcohol + a decent bit of exercise might work better

You also say you go to the gym - is this strength or aerobic work? Strength work often increases BG, while aerobic/endurance exercise reduces it. It's a sliding scale, where intense exercise (and nerves e.g. pre-match) creates more stress hormones so the liver helps out and the exercise itself burns glucose. So the longer the better generally (which also reduces the intensity). I've no real experience of the gym so can't comment regarding what it might do post-exercise, I'm sure there are others here would could though.

though. And yes, have also noticed that boozing much reduces the DP! but not sustainable to do that every day, lol! Jokes aside though, I have actually moderated my alcohol intake quite substantially in the last couple of years, and have a niggling suspicion this might have some correlation with elevated BS??

I think this is why I now get FotF when previously I didn't (or didn't notice it anyway.) I gave up completely post-lockdown (aside from a very occasional social pint or three.)