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Think I may have Dawn phenomenon?

Discussion in 'Newly Diagnosed' started by jostoate, May 31, 2018.

  1. jostoate

    jostoate Type 2 · Newbie

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    I was diagnosed Type 2 (HbA1C 50) at the beginning of March (told by GP receptionist!!!) I had never been told I was even pre-diabetic so it was a bit of a shock. I have been trying to get control of my blood sugars and lose weight eating LCHF. I've managed to lose a stone so far and also been going to gym 2-3 times a week but weight loss now seems to be tailing off. I had my first appointment with Diabetic Nurse mid April who just told me to lose weight and cut down on fruit (which I used to eat a lot of). Since then I have been testing my blood sugars although she says I dont need to test so cant get strips on prescription and have to buy myself. I kept detailed record of my levels for the next 5 weeks, along with a food and exercise diary. Blood sugars are mostly within normal ranges of 4-7 before lunch and dinner and <8.5 after meals. However, despite normal levels before bedtime, I've been testing during the night if I wake up to go to the loo and its always >8.5 (highest was 14!) and morning average is 8. I just dont know what else I can do to bring these levels down. When I saw the DN a second time, she was not interested to look at any of my details, says I dont need to test as it will just confuse me (?) and just to lose weight. How?? I'm due to go on an education programme but not until beginning of July. So currently feeling like I'm dealing with this on my own without very much help or guidance from my DN or GP and I'm scared cos my mum died of pancreatic cancer after she developed T2. Please can anyone suggest what I can do/eat to try to bring my blood sugars down at night? Thanks for any suggestions.
     
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  2. dbr10

    dbr10 Type 2 · Well-Known Member

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    That's another distressingly familiar story about diabetes care.

    Testing is obviously the right thing to do. I'm just wondering if you eat supper at all; and, if so, what do you eat?

    I follow a low carb diet and have my last meal at around 7pm; the idea being that the overnight trickle of insulin will hopefully bring BG down by breakfast.

    You will get lots of people giving you their thoughts on here.
     
  3. Prem51

    Prem51 Type 2 · Expert

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    Hi @jostoate and welcome to the forum. It is a shock when you get that diagnosis, but you have done well in taking action to control this condition with lchf and exercise. It's good that you have a meter and are testing. Your test results are pretty good, and I expect your 3 month HbA1c test result will reflect that.

    I wouldn't worry too much about Dawn Phenomenon. Morning readings are often the highest of the day. Non-diabetics get dp too.
    Some people on here find that a small protein snack before you go to bed, like a bit of cheese or a handful of nuts block the dp.
     
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  4. jostoate

    jostoate Type 2 · Newbie

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    Thanks for this - no generally dont have supper and have evening meal around 6.30pm. Sometimes have some almonds, an apple or tomato or slice of cheese if peckish later. Have my next HbA1C in a couple more weeks so hope to see an improvement then.
     
  5. jostoate

    jostoate Type 2 · Newbie

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    Thanks for this. If I need a snack in the evening, then it does tend to be cheese or nuts as you say, but so far this hasnt stopped the high readings at night. Now longer evenings and better weather are here, maybe I will try a walk after evening meal.
     
  6. Rachox

    Rachox Other · Type 2 - well controlled. Moderator.
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    Hi @jostoate and welcome to the Forum, as this is your first post let me tag @daisy1 for her useful info post. Dawn phenomenon bothered me for quite sometime after diagnosis, even on low carb eating while all my other numbers got back to normal. I started having a small handful of almonds every night before bed after asking here, and I continue with that. My fasting levels gradually came down. I’d skip the apples and tomatoes as evening snacks as they don’t have the fat content required to help, apples are a relatively high carb fruit, I no longer eat them I just stick to berries and always with cream.
     
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  7. dbr10

    dbr10 Type 2 · Well-Known Member

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    Good luck.
     
  8. Mal37

    Mal37 Type 2 · Well-Known Member

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    I agree with Rachox regarding the apples.
    I only eat berries now (with double cream)

    I think you will see a gradual improvement.. just as I have.
    Carry on doing what you are doing as it's doing good, but just keep checking carb content,
    and that you are eating enough fat (sounds crazy doesn't it)

    You are doing wonderfully in so short a time!
     
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  9. Crocodile

    Crocodile Type 2 · Well-Known Member

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    A small snack just before I turn into a pumpkin fixed up the morning highs for me. Every night before bed is a few slices of cheese, salami and a pickled onion. May not work for everybody but I did get the hint from this site.
    Glenn
     
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  10. kitedoc

    kitedoc Type 1 · Well-Known Member

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    Good on you for being inquisitive !
    As I understand it our body prepares for waking and the start of day by the adrenal glands releasing some cortisol, our stress or coping hormone, at about 4 am each day. Cortisol increases insulin resistance and hence blood sugars can rise a bit then. With diabetes I know my blood sugar rises at around 4 am because I have checked it at that time and to compensate my insulin pump puts in a higher dose of insulin around the 3 am to 6 am mark. Why protein etc taken at suppertime might ease the 4 am rise in BSL I have no idea.
    As has been said as your diabetes improves with treatment like losing weight one would expect the blood sugars throughout the 24 hours to improve.
     
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  11. Crocodile

    Crocodile Type 2 · Well-Known Member

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    I don't really understand why a snack at pumpkin time works either. I can only reckon that it is a long time between the evening meal and breakfast so the ol' body might need a little kick up the whats-it to get moving. A late night snack makes the time to breakfast a bit smaller. It is only my guess.
     
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  12. daisy1

    daisy1 Type 2 · Legend
    Retired Moderator

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    @jostoate

    Hello Jostoate and welcome to the Forum :) Here is the Basic Information we give to new members and I hope you will find it useful and interesting. Ask as many questions as you need to and someone will help.


    BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS

    Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

    A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you'll find well over 235,000 people who are demonstrating this.

    On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

    The role of carbohydrate

    Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

    If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

    The bad news

    Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

    The good news

    People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

    Controlling your carbs

    The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.

    There are two approaches to controlling your carbs:
    • Reduce your carbohydrate intake
    • Choose ‘better’ carbohydrates
    Reduce your carbohydrates

    A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

    The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

    Choosing better carbohydrates

    The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

    Read more on carbohydrates and diabetes.

    Over 145,000 people have taken part in the Low Carb Program - a 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

    Eating what works for you

    Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

    To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

    The blood sugar ranges recommended by NICE are as follows:

    Blood glucose ranges for type 2 diabetes
    • Before meals: 4 to 7 mmol/l
    • 2 hours after meals: under 8.5 mmol/l
    Blood glucose ranges for type 1 diabetes (adults)
    • Before meals: 4 to 7 mmol/l
    • 2 hours after meals: under 9 mmol/l
    Blood glucose ranges for type 1 diabetes (children)
    • Before meals: 4 to 8 mmol/l
    • 2 hours after meals: under 10 mmol/l
    However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

    Access to blood glucose test strips

    The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:
    • structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
    • self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

    Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

    You may also be interested to read questions to ask at a diabetic clinic.

    Note: This post has been edited from Sue/Ken's post to include up to date information.
    Take part in Diabetes.co.uk digital education programs and improve your understanding. Most of these are free.

    • Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why

    • Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.
     
  13. Mr_Pot

    Mr_Pot Type 2 · Well-Known Member

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    I take it you sleep alone ☺
     
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  14. Crocodile

    Crocodile Type 2 · Well-Known Member

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    No. I have a toothbrush and don't snore.
     
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