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Keto and Dawn Phenomenon!

MrsHutt

Well-Known Member
Messages
58
Type of diabetes
Type 2
I have been LCHF for years and generally good at keeping numbers down. I have also done Keto before. After a 'bad' summer; holidays, illness and an operation I thought I would go Keto for now. I have been on under 20g carbs this week and in ketosis for a few days. I have lost 5lbs! Hooray! BUT the dreaded Dawn Phenomenon has returned (it has happened before as well). What can you do if you are Keto to prevent this? A T2D on the 'usual' diet might be advised to have a glass of milk and a couple of digestives at bedtime - obviously a no-no on Keto! I can't go back to sleep once I wake but I can't carry on with 3 hours sleep a night!

Is this a familiar situation to anyone? Any ideas of how to solve/prevent this? I do take magnesium supplements
 
Not sure what you mean by the "dawn phenomenon'.. for most of us it's a high Fasting Blood Glucose.. Are you waking up early?
 
As a long time type 1 , had it for 48 years, my experience of the dawn phenomenon is that as soon as you get up your body must release stores of glucose to help the getting up process. I can wake with a good result of about 6 but my levels rise even with a no carb breakfast, so a small dose of insulin is needed to maintain. I find eating at least 20g carbs a day is about right.
 
I get Dawn Phenomenon but it doesn't stop me sleeping. When it was really bad I did used to wake up with a 'hot flush' moment but quickly went back to sleep - but that tropical moment has stopped (or I manage to sleep through it).
 
bulkbiker said:
Not sure what you mean by the "dawn phenomenon'.. for most of us it's a high Fasting Blood Glucose.. Are you waking up early?
Click to expand...
Some people call it a 'liver dump' and my understanding is that your BG goes low so your liver goes 'eek, have some sugar!!' and it makes your numbers go up; you can have sweats as someone mentioned, shivers, headache or just wake (wide awake)! I am doing this at 3.00 - 4.00 am and not able to go back to sleep!
 
My experience, fairly recent, is that mine kicks in when I get out of bed - if I test then and there low. Within two hours I have gone up 2-3mmol and it is the devil to get down. Interestingly this is relatively recent and seems to be linked to being very low carb for a period of time (below 10 for the day).

I have not found a way of stopping it - I have tried coffee with milk, breakfast, no breakfast - fat only breakfast. Nothing stops it.
 

Same for me - I have found that radically changing my diet stops it for a day or two but my body quickly adjusts to the new diet regime and the DP kicks back in again. I am on the Newcastle Diet at the moment and I'm finding that on two or three days recently I've been getting a liver dump just before dinner.
 
I suffer from dawn phenomenon every day, unless I've been out drinking the night before! I will wake with normal sugar levels but if I don't take 2-3 units of insulin as soon as I wake, my sugar levels can shoot up into the teens. I don't eat breakfast as I do intermittent fasting from 8pm to midday. I've got used to DP now but it used to drive me mad when I first started the keto diet!
 
Interesting about some of you waking up early - I wake up at 3am every morning ( probably habit/body clock now)...but I'm not tired through the day, quite the opposite actually. Doing Fasting/Keto I find I go to sleep at night way more quickly too.
 
After reading this thread, I went online to look for the info on 'physiological insulin resistance' (which apparently increases the DP in keto eaters, all of them - not just diabetics), but I got waylaid in Dr Fung's blog entries (very enjoyable but not useful for this thread. Many apologies!). I don't really understand it myself, but there is some body mechanism when in fat-burning mode. There are a heap of scientific papers and research on mice on this, but I won't include it (but you can find them easily online if you plug in physiological insulin resistance in the search.

But if I want an easy to understand explanation I often go to Mark Sisson in his 'Mark's Daily Apple' blog. Here is his explanation:

"...going very low carb – to around or below 10% of calories, or full-blown ketogenic – can induce “physiological” insulin resistance. Physiological insulin resistance is an adaptation, a normal biological reaction to a lack of dietary glucose. As I’ve said in the past, the brain must have glucose. It can use ketones and lactate quite effectively, thus reducing the glucose requirement, but at the end of the day it still requires a portion of glucose. Now, in a low-glucose state, where the body senses that dietary glucose might not be coming anytime soon, peripheral insulin resistance is triggered. This prevents the muscles from taking up “precious” glucose that the brain requires. The brain’s sensitivity to insulin is preserved, allowing it to grab what glucose it needs from the paltry – but sufficient – levels available to it.

It appears that weight loss is the deciding factor, and since low carb diets tend to be more effective at inducing weight loss in subjects, they also tend to be better at reducing insulin resistance in insulin-resistant, overweight people. Once you’re lean and weight stable, though, very low carb diets (less than 10% of calories from carbs) can reduce insulin sensitivity. This is normal and totally necessary in the context of a very low carb diet. If we didn’t become insulin resistant while eating very low carb, our brain wouldn’t be able to get the glucose it needed to keep us alive."

Dr Fung says not to worry about it. I find it hard not to worry about higher FBGs too. As diabetics how can we not? So I don't have an answer to this one.
 
ps there are some good suggestions in 'Insulin Resistance and ways around it' thread in this section of the forum.
 

You could be adapting to keto. Also, are you sure that it's high BG that's waking you up rather than low BG? Did you test?
 
I find that my blood sugars are slightly up on waking and go down after breakfast, which rather puts me off missing breakfast. I am on no medication but about 20g carbs per day or less.
 

Sweats, shivers, headache sounds like Somogyi Effect from low sugars. I experienced Dawn Phenomenon too when I first started Keto (just about 3 weeks ago). I started taking my meds right before sleeping to counter and found that I went hypo around 2-3am. I experienced sweat, shivers, headache, etc. and I couldn't get back to sleep until I had something to eat. It was the Somogyi Effect.

I've since cut back on my medication (under Dr. supervision) and I started doing some simple anaerobic exercise (planks, pushups, sit ups, etc.) before sleep. The idea is that anaerobic exercise burns glucose more slowly and gradually than aerobic exercise. This lowers BG to counter DP before you wake. It's been working for me but I'm not sure if it's the exercise or simply being more adapted to keto over time.

Also, DP really bothered me when I first started Keto. It was discouraging to see my BG spike after all the hard work I'd been doing. But I found that it also dropped pretty quickly throughout the day. In reality I was probably experiencing just a few hours of higher BG and overall my BG was a lot healthier than it looked.
 


I get woken at any time between 4 and 7 am with a jolt. Scan my Libre and see that my levels are just beginning to rise. Depending on what they are, I inject a unit or two of Novorapid , and go back to sleep - crucially not getting out of bed. The trace on my scanner evens out, and I sleep until my usual 8am alarm. I can’t set an alarm to wake me to do this jab, as the time is so variable, but it happens every day with only rare exceptions. The arrow in the photo shows the point of the rise that I usually wake, it’s just on the upturn. If I don’t inject at this point it’ll probably hit double figures and be difficult to get down. Felt a bit strange injecting Novorapid when I was in range to start with, but I kept a lot of glucose handy while I was experimenting with it.

I only started getting this when I started keto... but it’s definitely not caused by going hypo in the night in my case. I’ve not had a night hypo since starting keto in January.
 

Ah I have been experiencing the same. Been monitoring myself in the night so know for sure I’ve not gone hypo but wake up nicely in range and then within 20-30min of waking my blood sugars have risen by 1 to 2 mmol (without any food). I always fear giving my bolus incase it throws me into hypo.

I have noticed this only happens on work mornings! On the weekends I stay steady even after waking. Could this be work anxiety related? (Not anxious as such but that Monday morning feeling- I tend to get every morning
).

I’ve recently started Keto- does this rise eventually disappear? Or is it the effect of a keto diet?
 
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If you are wide awake, would you be happy to read? I am type 11, with insulin, I wake up every night 2 or 3 times, not because I'm hungry, I pick up my e.reader& within a couple of minutes I'm asleep.
I started Keto in January this year, and insulin levels are a 1/4 of what they were and I've lost 14lbs in weight. My Diabetic Nurse has told me to take small amounts of carbs with each meal. She's not happy when I refuse. I'm very elderly and after 25 years of Diabetes, I'm hoping to come off insulin at the end of the month. My last HBA1C was 5.7. Best wishes to all.
 
I suffer from DP too. I wake (5.30-6.30) with BG in range and take 2 units to cover the rise (I can feel the effect of cortisol rushing through my body)! - an extra unit if I go for a run, which I always do fasted as I find it limits chances of a hypo. I also have to take a higher ratio of insulin at breakfast 7-8am) and then another unit mid-morning. My BG is still a couple of mmol higher than I'd like come my next meal (3-4pm) and after that everything is great - I sometimes don't have to take insulin with my 2nd meal. This has been on keto and now a carnivore diet (5 days in). So I'm often injecting 3 times as much insulin over the 1st half of the day compared to the 2nd. I'm hoping that DP will subside over time as I've heard this has happened for some.
 
It’s not just me that wakes with the cortisol rush, then? I can’t tell you how glad I am to hear it, was beginning to think I was some sort of weirdo... well, I am, but that’s another story! But same as you, I take most of mine in the morning, rarely after 11am. Just hoping the DP will subside because I’m getting quite bored with it now.
 

Haha! Diabetic weirdos unite! The rush feels similar to a hypo for me so it freaked me out at first - it became more noticeable when I went low carb and now even more so since going carnivore. It's frustrating because I'd want to be taking as little insulin as possible. What are your ratios like in the morning compared with later in the day?
 
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