Is the Dawn Phenomenen inevitable ?

[gardel0]

Can anyone enlighten me on the Dawn Phenomenen and diabetes 2?

I have achieved excellent results during the day with two meals only....breakfast and lunch (no snacks)...with readings constantly below 6 )(M/Mol) for these two events, both pre and post prandial.

However, just as insistent is my first fasting blood sugar level at between 6 and 7 (M/Mol). these readings are taken at any time between 6, 7, 8 and 9 a.m. following my last meal the previous day at mid-day. Sometimes I have re-taken readings some 2 hours later without eating or drinking only to find the blood sugar level rising. Once a week I can get a reading of 5 something and once a week I can get a reading of 7.1 both instances of nothing to eat after my low carb mid-day the previous day.

1) Is the rise inevitable?
2) Is it possible to average out the three readings and take that as a reading?
3) Is it possible to take a meal that gives a good mid-day reading but taken at night to get the same reading in the early morning?

My doctor took a recent HB1AC blood sample and gave me an excellent report from the hospital test notwithstanding that my
fasting blood sugar level was 6.1 at the time of sampling.

On reading through this my first reaction is if the HB1AC is satisfactory to the doctor is there any point in continuing with my own daily tests? After all if my previous HB1AC readings at 3 monthly intervals were as good as the latest one, even if the blood sugar level was over 6 (M/Mol) at the time of sampling, then he would not have diagnosed pre diabetes2 in the first place.
The point is the doctor's HB1AC test is oblivious to my own testing regimen so does this make my own testing irrelevant now that my blood sugar is regarded by my doctor as normal!!!!!? and my diet is stable if I stick to it. Confusing.

Any advice and observations would be most welcome.

 

[britishpub]

I'm not sure the correct term would be inevitable. It is a natural function of your Liver and part of the way the body has evolved to ensure you have enough energy after you have fasted overnight.

 

[kokhongw]

It took me about 3 months to get fasting BG < 6mmol although pre/postmeal normalize within 2 weeks of low carb. After that it remains pretty constant < 6mmol daily. I no longer test 8-10 times a day...only fasting and bedtime.

As long as our liver is clogged up by fats it will not be able to clear the excess glucose fast enough. But over time as you continue with your intermittent fasting, it will allow the liver fats to be used up and your fasting glucose will improve.

 

[gardel0]

It took me about 3 months to get fasting BG < 6mmol although pre/postmeal normalize within 2 weeks of low carb. After that it remains pretty constant < 6mmol daily. I no longer test 8-10 times a day...only fasting and bedtime.

As long as our liver is clogged up by fats it will not be able to clear the excess glucose fast enough. But over time as you continue with your intermittent fasting, it will allow the liver fats to be used up and your fasting glucose will improve.

Thank you for sharing this with me in such a positive manner.

I would like to pursue your comment further. My results seem to mirror your own. I must admit I replaced carbs with fats to
get my blood sugar levels down which now looks like putting a fire out with petrol. Your comment about fats clogging up the liver intrigued me. Is it the residue of fats AND THE VARIOUS FATS CONSUMED IN THE DAY BEFORE that are giving me an unstable reading first thing in the morning because different oils and fats work at different rates or is it older fats that are the problem? I must admit I use vegetable oil or butter ghee which is a hard fat used in Indian cooking. I restrict my protein to cheese, fish and chicken....no red meats. I take medication for high cholesterol.

Given that my last meal is mid-day and the fats have from 12 mid-day until 6 am (18 hours fasting) to dissolve, in your opinion is it the fat issue that is affecting the unpredictable early morning blood sugar level and requires investigation?

I must confess I have not monitored fats but I feel that there must be an explanation/cause for each change in early morning blood sugar level reading since I am fasting for 18 hours. As my normal daily readings are predictable where carbs are involved is it likely that the previously uncharted fats are causing the unpredictable early morning readings?

Many thanks for the input.

 

[kokhongw]

Is it the residue of fats AND THE VARIOUS FATS CONSUMED IN THE DAY BEFORE that are giving me an unstable reading first thing in the morning because different oils and fats work at different rates or is it older fats that are the problem?

Typically it is NOT due to the various fats consumed. Dietary fats (fats that we eat) don't cause the build up of fats around our organs as much as carbs do. This is because fats don't trigger the surge in insulin which turns excess glucose to fats. Most of us T2D would also have Non-Alcoholic Fatty Liver condition that is undiagnosed.
http://www.docsopinion.com/2015/12/08/low-carb-diet-to-treat-non-alcoholic-fatty-liver-disease/

Your current low carb diet causing the body to remove the excess glucose in the blood and the 18 hour fast helping to remove the glycogen store in the liver which will then switch the body into the nutritional ketosis mode and will eventually burn off the excess fats around the pancreas and liver. This can happen within 8-12 weeks. The time frame depends on your condition and lifestyle.

 

[gardel0]

Typically it is NOT due to the various fats consumed. Dietary fats (fats that we eat) don't cause the build up of fats around our organs as much as carbs do. This is because fats don't trigger the surge in insulin which turns excess glucose to fats. Most of us T2D would also have Non-Alcoholic Fatty Liver condition that is undiagnosed.
http://www.docsopinion.com/2015/12/08/low-carb-diet-to-treat-non-alcoholic-fatty-liver-disease/

Your current low carb diet causing the body to remove the excess glucose in the blood and the 18 hour fast helping to remove the glycogen store in the liver which will then switch the body into the nutritional ketosis mode and will eventually burn off the excess fats around the pancreas and liver. This can happen within 8-12 weeks. The time frame depends on your condition and lifestyle.

Many thanks for your enlightened reply. It would appear that for many years of abuse I had consumed over a kilo of carbs per week in the form of porridge, bread, cakes, biscuits, rice, pasta and potato which I now gather from your notes was building up a residue of excess fats around the liver, accelerated by retirement and not walking to and from my workplace, just waiting to pop it's head up over the parapet and alert the doctor with his HBA1C probe. My sudden draconian approach to eliminate all of these carbs at a stroke choked off the supply and my system is now slowly processing the backlog around the liver. My timeline would appear to be longer than yours but perhaps that is not surprising given how long it had taken me to build up that toxic reserve and here we are talking years.

Although my no carb regimen started in September 2015, when I bought my meter, I understand from you that it is just a matter of keeping to the regimen and watching the space. I am pleased with this explanation as there seems to be no way I can affect the early morning readings ( although I had switched taken my pills from night to mid-day as I was advised statins can add to the problem and this gave me a couple of points reduction). I take it that my high cholesterol level (normalised by statins) comes from a different source and not this stockpile around the liver?

Am I correct in thinking that the fluctuation in my early morning readings following no dietary change after mid-day, is due to the variables like varying domestic activity affecting the removal of the build up? My first alert reading was 10.9 (M/Mol) now 5.1 (M/Mol) except for the early morning readings >7.0 (M/Mol) now in the lower 6s (M/Mol). Does this mirror your experience?

One last point. My last HBA1C reading by the doctor elicited a remark of "brilliant,". Could this, being an average reading, be the result of 5.1 (M/Mol) low and say 6.5 (M/Mol) high being averaged out to overide the early morning reading which as far as HBA1C is concerned 7.0 (M/Mol) does not exist!

Kindest regards.

 

[kokhongw]

You are most welcome. Glad you find the explanation helpful.

The effects(is it really harmful and life threatening)/source(does it come from our diet) of cholesterol is a contentious one. Personally I had decided that it is the lesser evil compared to high glucose and circulating insulin. So I didn't dwell much on it and focus solely on normalizing my glucose level and take that as a proxy for my insulin level.

Am I correct in thinking that the fluctuation in my early morning readings following no dietary change after mid-day, is due to the variables like varying domestic activity affecting the removal of the build up? My first alert reading was 10.9 (M/Mol) now 5.1 (M/Mol) except for the early morning readings >7.0 (M/Mol) now in the lower 6s (M/Mol). Does this mirror your experience?

Yes that is how I understand it and close to my own experience as well.

One last point. My last HBA1C reading by the doctor elicited a remark of "brilliant,". Could this, being an average reading, be the result of 5.1 (M/Mol) low and say 6.5 (M/Mol) high being averaged out to overide the early morning reading which as far as HBA1C is concerned 7.0 (M/Mol) does not exist!

Yes the HbA1c is a test that measures the percentage of glycated hemoglobins present. So if the duration of high readings are brief, than the overall effects of your well controlled glucose level will have a higher weightage and contribute to a lower HbA1c reading.

 

[happier than you]

Is there a difference between t1 and t2 with regards to high first readings? Do different things cause them? I'm trying not to say "early morning"...i presume the actual time is irrelevant? What i mean is, if you work nights and get up at 6pm...presumably the 6pm reading would be the same as other peoples morning reading? Diabetes doesn't know the time, does it??

I'm getting high first readings constantly (around 10.0) and i'm completely at a loss as to whether i'm going hypo during the night then rebounding or just going higher just before i wake up. I've tried staying awake all night, but it doesn't work because my blood glucose doesn't act the same. Something happens when i'm asleep, that doesn't happen when i'm not.

 

[Magisham]

Is there a difference between t1 and t2 with regards to high first readings? Do different things cause them? I'm trying not to say "early morning"...i presume the actual time is irrelevant? What i mean is, if you work nights and get up at 6pm...presumably the 6pm reading would be the same as other peoples morning reading? Diabetes doesn't know the time, does it??

I'm getting high first readings constantly (around 10.0) and i'm completely at a loss as to whether i'm going hypo during the night then rebounding or just going higher just before i wake up. I've tried staying awake all night, but it doesn't work because my blood glucose doesn't act the same. Something happens when i'm asleep, that doesn't happen when i'm not.

My partner is Type 2. He has been getting very high morning readings recently as well, around 10, then 11 this morning. We both stay up late, so get up late (the joy of being retired!), so he is doing his blood around 10.30am, before he eats or takes any medication. When he is up during the night sometimes he takes his blood at times like 5am and they are okay. He took it last night at about 9.45pm, which was 2 hours after dinner, and he was 5.4. We are very careful with what we eat and have cut out as many carbs as possible......no potatoes or root veg, no pasta, no rice, no bread or anything made of flour. Just don't know what we are doing wrong.