Type 2 Dawn Phenomenon

[xyzzy]

I am Type 2 diagnosed beginning December. I am low carbing < 60g / day to control my BG's and now have all my fasting and +2 hour readings between 4.5 and 6.5 ish. I am getting a significant Dawn Phenomenon effect such that vary rarely do I get a sub 6 reading first thing. I am on 2 x 500g Metformin / day. I take one with breakfast and one with my main meal at around 6.30pm. I very rarely eat anything after that.

I work from home and don't have to get up most days prior to around 8.45am (I work late though!). I would like to keep it that way as I would rather work late than get up earlier.

For breakfast I eat a small amount of fresh fruit and yoghurt which will normally kick start things and drops my BG into the low 5's by 11.00am

Any advice to help alleviate the dawn phenomenon? Are there specific drugs I can ask for, would SR metformin help etc.

 

[viviennem]

Don't worry about it. I was like you are for quite a while, but as your control continues, you'll lose the dreaded DP.

Some people find that having a small carby snack at bedtime can help - maybe an oatcake with cheese, to give your system something to work on overnight. But I think it will stop of its own accord.

I don't get up usually unti 08:00 or later. As long as you don't lie there wide awake for an hour, your fasting test should be "accurate". I've been known to get up, test, open the curtains so they know I'm not dead, then go back to bed for that lovely warm half-hour. Until the coffee cravings get the better of me!

Love your dog!

Viv 8)

 

[Grazer]

In my experience, not much you can do about. It's the body's way of getting us ready for the day by injecting a bit of go juice into the system. Good news is - why worry about it? Your numbers are a bit like mine, so what it means is the DP is giving us a 1 or 2 mmol rise for a few hours. Won't do much to our overall average and thus our HbA1c. For that reason, I hardly ever bother taking a fasting BG any more. I concentrate on the 2 hour post meals to check what different foods do to me - something I CAN do things about. You're doing great by the way, so keep it up.

 

[Ardbeg]

Doesn't the DP also have something to do with your body ridding itself of toxins, etc whilst you are asleep?

I'm sure I recall Culiga posting about this previously

 

[Sid Bonkers]

Like Viv says, I wouldn't worry about it, and to be honest a fasting reading in the 6's is fine, many people would love to see those numbers.

Even when I was on insulin and using a long acting insulin at night I rarely got sub 6 fasting readings, in fact only now 3 years in am I stating to see regular fasting readings in the 5's.

Your doing great xyzzy :thumbup:

 

[MaryJ]

Hi xyzzy,

The morning reads have been bothering me a little but not overly as many on here say there is nothing you can do.

I've been diagnosed since type 2 14th dec, have discovered can't tollerate carbs at all in the morning, my before meals and post meal reads are now always within the nice guidelines. My morning reads are rarely below 7.

Ths morning as a trial i took a read in bed before starting the day. 6.6. Had my usual shower, made a brew. took a readingi again at the normal sort of time 7.2.

I knw this doesn't change the average HBA1c but it does make me feel better and I will be taking my monitor up each night now til i stop taking quite so many reads lol

 

[Grazer]

Just one small observation, and not disagreeing with anything said. We're all different, and some people do indeed have a small carby snack at night before bed, but that's really for those on insulin or similar meds, not diet only or metformin. They have a snack to avoid night hypos, or to avoid low blood sugars at night that can result in a liver dump. That "nocturnal liver dump" is not the same as the dawn phenomenon. For us on diet only/Met, a late night carby snack will raise our BG at night but probably won't stop the DP; so we just get 2 increases in BG rather than one. Even if it did stop the DP (doesn't in my case, checked a number of times) all we would be doing is swapping a small short term rise in the morning for a potentially bigger one, that can last longer, at night. So my view is don't; nice excuse for a treat though it may sound!

 

[viviennem]

I'm not in the least disagreeing with you, Grazer, because I'm very fond of sheep, but 1 oatcake at 5g carb, plus butter and a slice of cheese, won't spike me overnight.

What it does do (but this is all theory!) is stop me going too low overnight , by the slow conversion of the protein to glucose, and the slowing-down effect of the fat. So my liver doesn't feel compelled to give me a heavy dump of glucose for the morning.

Not that I have these snacks any more - haven't for a while, in fact! But I recommend always having a little something if you've had more than a small amount of alcohol. I often used to have alcohol-induced hypos before I was diagnosed diabetic, but now I've learned what they are (scary when you don't know) and curbed my drinking, I haven't had one for 18 months.

But IMO there's not a lot you can do about DP, and as Sid said, readings in the 6s are quite aceptable. NICE fasting guidelines are between 4 and 7 before meals. As you gt better control, so you'll get lower readings. It takes time.

Viv 8)

 

[hanadr]

xyzzy
If you work from home, how much exercise do you get?
i find[as a retired person] that my exercise classes give my week shape and I definitely notice my bgs are better if I walk or work-out.
I'm currently getting fasting bgs of about 4.5 and bedtime readings of 4.9. I also take 2 x 500mg Metformin per day and have done for most of the last 10 years.[I started on 3plus Gliclazide, but got rid of what IDON'T need]
A diabetes consultant[ in a conversation NOT a consultation] said Iprobably have a rarer form of T2 [Glucokinase deficiency], which means Iwon't probably experience progression.
i wanted to ask him if it's a co-incidence that diabetics I know who keep tight control on low carbs all have the same rare form of T2, but it wasn't the right venue.
Hana

 

[xyzzy]

I knw this doesn't change the average HBA1c but it does make me feel better and I will be taking my monitor up each night now til i stop taking quite so many reads lol

Great idea!

small carby snack at night before bed

Tried that for a few days but made it worse but thanks!

how much exercise do you get?

I walk the dogs for around an hour a day so around 2 miles I would guess. If the DP causes a reading greater than 6 I do a warp factor 9 10 minute walk after brekkie that includes a steep hill. Found that is a guaranteed way of reducing BG by around 1 pt within 2 hours. Unfortunately I hate organised exercise and would rather suffer DP I think!

As you gt better control, so you'll get lower readings. It takes time.

Yep you're right but I'm the impatient type!

Your doing great xyzzy :thumbup:

Thanks Sid much appreciated


Thanks everyone.