Reply
lizzylou
Total Posts: 13,930
Topics: 565
High Fives: 1,994
Solutions: 142
Registered on: ‎10-31-2009

DAWN PHENOMENON

DP Information - or Why Are My Morning Numbers So High


Dawn phenomenon is a normal early-morning rise in glucose (blood sugar) that occurs before or shortly after
waking. Everybody experiences this physiological phenomenon,but it can be troublesome for people with diabetes.
Such people may need to adjust their treatment regimen to account for dawn phenomenon.

Between 4 a.m. and 8 a.m., the body increases the production of certain hormones. These
natural body chemicals suppress the activity of insulin, a hormone that transports glucose
into cells to use for energy and reduces blood sugar levels.

The hormones include:

Growth hormone
Cortisol
Catecholamines
Glucagon
Epinephrine (adrenaline)

These hormones trigger the liver to release enough glucose to give the body the energy
to wake up. In non-diabetic people, the body responds to the excess glucose that
accumulates as a result of this process by producing insulin. The insulin then moves the
excess glucose into the cells. However, people with diabetes either fail to produce insulin
or cannot properly use the insulin that is available. As a result, glucose continues to rise
to abnormally high levels (hyperglycemia).

The effect of dawn phenomenon on diabetics varies. Some people are strongly affected
and have very high glucose on wakening, but others are weakly affected. In addition,
some people with dawn phenomenon find that their glucose continues to rise until
they eat in the morning
. For others, levels will settle down a few hours after waking,
regardless of whether or not they eat.

In some cases, high glucose in the morning may be the result of factors other than dawn
phenomenon. For example, during sleep people experience falling glucose levels because
of the lack of food overnight. To compensate, the body may produce a �rebound effect
� response that increases the liver's production of glucose to levels that are abnormally
high. This is known as rebound hyperglycemia, or Somogyi effect.

People who experience symptoms may need to perform glucose monitoring in the middle
of the night to distinguish between dawn phenomenon and rebound hyperglycemia. They
may be advised by their physicians to test their glucose around 4 a.m. and compare it
to their waking glucose level. If glucose is low in the first reading and high in the second,
Somogyi effect is likely at work.

Symptoms and diagnosis

People who experience dawn phenomenon are unlikely to detect any symptoms associated
with the condition. The condition may reveal itself only after they test their glucose
(blood sugar) in the morning and find levels to be high.

If dawn phenomenon or the Somogyi effect is suspected, the person may be asked to
perform glucose monitoring between 2 a.m. and 3 a.m. for several consecutive nights. If
glucose in these blood samples is consistently normal or high, dawn phenomenon is the
likely culprit. If glucose readings indicate nocturnal hypoglycemia, which is followed by
morning hyperglycemia, the Somogyi effect is indicated.


Treatment and prevention

Diabetics who need treatment for dawn phenomenon should consult their physician
about the best treatment for them. Depending on the case, options may involve
adjusting the pre-bedtime diet, exercise plan, oral medication or insulin therapy. The
variation in the effect of dawn phenomenon from one individual to another may require
differences in how people control glucose (blood sugar). Possible changes may include:

Adjusting medication dosage. Physicians may recommend that patients take
more medication in the evening or schedule their dosages of long-acting insulin later
in the evening so peak action occurs when glucose starts rising.

Eating a snack before bedtime. Some patients may be advised not to eat late
at night. However, some cases of dawn phenomenon are a response to lower glucose
that occurred earlier. Their physicians may advise such patients to smooth these glucose
roller coasters by eating a snack before bedtime. They may recommend a small snack
that contains protein or fat and is low in carbohydrates, such as nuts or cheese.

Exercising earlier in the day. Strenuous physical activity at night can cause lows
at night, which may trigger rebound highs.

Taking metformin. This oral medication curbs glucose production by the liver,
and has been used effectively to treat people with dawn phenomenon.


Source Information: click here


Lizzy
Knowledge is Power!





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 All About Carbs

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Long Lost Member
omahamom
Total Posts: 33
Registered on: ‎11-02-2009

DAWN PHENOMENON

Lizzy thanks for responding so quickly. One of my problems is I get up in the middle of the night and eat. I thinks its also in my meds. I take 1 mediformin twice daily. My numbers have been running between 140 and 190, I've been so down about it I haven't been keeping track. Darling dr thinks I'm doing okay or he just doesn't care. But I have to admit I've been into the candy and cakes a lot. And I love bread. And no excerise, or very little of it. So the whole thing is what I'm eating and I'm having to start over from stratch. So I'll be checking in a lot and I'm going to start checking my numbers around 3:00am I'll be up anyway. Thanks

Sandy
Long Lost Member
jwsnell4
Total Posts: 2
Registered on: ‎08-08-2010

DAWN PHENOMENON

thank you foir informative ecellent article. a year ago after a stroke, being at home, i chose to tear the but out of these issues and rectify what i was doing wrong.

i fixed diet, i exercised like hell and after checking a year ago, i found my blood sugar at 110 at 1:00 am, 150 at 3:00 am and 245 by 6 am.

it was taking 2 to 3 miles walking and a load of 30 un its of humolog to walk that god-dammed glucose out so by noon down to 100 every god dammed day.

by a fluke recently i discovered by metformin pills late at nigh modified this. after some testing, i fond that 500mg at 10:00 and 500 mg at 12:00 am cut this horrendous
sugar dump off so that numbers late at night were similar in am plus or minus some nits,.

I am thankful for the authors well written and excellent article. Years ago I was concerned about numbers surging in morning but could never get decent answer about this. Today, I am very angry and upset off,. I asked all sorts of medical professionals
about my latest readings and could not get a decent answer. Forget the endoctrinologists. thats like the star trek movies on the whales where Dr. Mcoy and his boss are wandering around a current time frame hospital looking for a member of their crew and Mccoy bumps into this lady and when asked - she was in for Kidney dialysis.
Mccoy says - what is this the dark ages - here take this pill and call me in the morning.
Later in movie you see womazn being run around and her kidneys are now working perfectly anbd current staff cannot explain. She said doctor gave me a pill and I am all working.

Dawn effect, liver leaks all fit into this catagorie. Go exercise some more, figure it out
yourself. Re-arrange my current meds with all the resultant mess. (endoctrinologists)

As a big person, with big organs, liver and kiidneys , my body strips pill;s out of my body routinely at drug mfg worst cae to live numbers. Metformin - 3 hours in, 2 hours up strength and out with 1 hour or less like niagra falls.

I am 6ft 2 - overweight at 310 and am working weight down an dhav elost 18 lbs in last cycle.

Today, I hav emy diet down but am getting fed up watching my glucose nmbers on a 15 minte intervalso that my insulin does not snake bite me. Take 3 numbers a day - are you serious.

After extensive tetsing I now have a good picture when the lows occur. my stomack and intestines take longer. i am big person, not some sparrow fart 80lb 4ft race jockey.

Right now , i can get numbers down t0 100 but any exercise at all can senr bw sub100 and do emergency dump. if i need to go out and do something, i need to preload extra treats to prevent emergency dump and send sugar to 245.

suffice to say i am fed up with horse and bggy whip sites out there stuffed with dick and jane reader info.

lizzylou
Total Posts: 13,930
Topics: 565
High Fives: 1,994
Solutions: 142
Registered on: ‎10-31-2009

DAWN PHENOMENON

DP Information - or Why Are My Morning Numbers So High

Dawn phenomenon is a normal early-morning rise in glucose (blood sugar) that
occurs before or shortly after waking. Everybody experiences this physiological
phenomenon, but it can be troublesome for people with diabetes. Such people may
need to adjust their treatment regimen to account for dawn phenomenon.

Between 4 a.m. and 8 a.m., the body increases the production of certain hormones.
These natural body chemicals suppress the activity of insulin, a hormone that
transports glucose into cells to use for energy and reduces blood sugar levels.

The hormones include:

Growth hormone
Cortisol
Catecholamines
Glucagon
Epinephrine (adrenaline)

These hormones trigger the liver to release enough glucose to give the body the energy
to wake up. In non-diabetic people, the body responds to the excess glucose that
accumulates as a result of this process by producing insulin. The insulin then moves the
excess glucose into the cells. However, people with diabetes either fail to produce insulin
or cannot properly use the insulin that is available. As a result, glucose continues to rise
to abnormally high levels (hyperglycemia).

The effect of dawn phenomenon on diabetics varies. Some people are strongly affected
and have very high glucose on wakening, but others are weakly affected. In addition,
some people with dawn phenomenon find that their glucose continues to rise until
they eat in the morning
. For others, levels will settle down a few hours after waking,
regardless of whether or not they eat.

In some cases, high glucose in the morning may be the result of factors other than dawn
phenomenon. For example, during sleep people experience falling glucose levels because
of the lack of food overnight. To compensate, the body may produce a �rebound
effect
� response that increases the liver's production of glucose to levels that are
abnormally high. This is known as rebound hyperglycemia, or Somogyi effect.


People who experience symptoms may need to perform glucose monitoring in the middle
of the night to distinguish between dawn phenomenon and rebound hyperglycemia. They
may be advised by their physicians to test their glucose around 4 a.m. and compare it
to their waking glucose level. If glucose is low in the first reading and high in the second,
Somogyi effect is likely at work.

Symptoms and diagnosis

People who experience dawn phenomenon are unlikely to detect any symptoms
associated with the condition. The condition may reveal itself only after they test
their glucose (blood sugar) in the morning and find levels to be high.

If dawn phenomenon or the Somogyi effect is suspected, the person may be asked to
perform glucose monitoring between 2 a.m. and 3 a.m. for several consecutive nights.
If glucose in these blood samples is consistently normal or high, dawn phenomenon is the
likely culprit. If glucose readings indicate nocturnal hypoglycemia, which is followed by
morning hyperglycemia, the Somogyi effect is indicated.


Treatment and prevention

Diabetics who need treatment for dawn phenomenon should consult their physician
about the best treatment for them. Depending on the case, options may involve
adjusting the pre-bedtime diet, exercise plan, oral medication or insulin therapy. The
variation in the effect of dawn phenomenon from one individual to another may require
differences in how people control glucose (blood sugar). Possible changes may include:


Adjusting medication dosage. Physicians may recommend that patients take
more medication in the evening or schedule their dosages of long-acting insulin later
in the evening so peak action occurs when glucose starts rising.

Eating a snack before bedtime. Some patients may be advised not to eat late
at night. However, some cases of dawn phenomenon are a response to lower glucose
that occurred earlier. Their physicians may advise such patients to smooth these glucose
roller coasters by eating a snack before bedtime. They may recommend a small snack
that contains protein or fat and is low in carbohydrates, such as nuts or cheese.

Exercising earlier in the day. Strenuous physical activity at night can cause lows
at night, which may trigger rebound highs.

Taking metformin. This oral medication curbs glucose production by the liver,
and has been used effectively to treat people with dawn phenomenon.


Source Information: click here

This is a read-only document. Please address any questions or comments in a separate post either here or on the Type-2 General Discussion Boards.


Lizzy
Knowledge is Power!





Here's some useful links, click on the titles


Testing 101
 
 All About Carbs

Resources For The Un-insured and Discount Medicine and Equipment

LizzyLou Videos



Lizzy's Blog
for lots more  


Occasional Responder
skreitman
Total Posts: 9
Registered on: ‎12-19-2013

Re: DAWN PHENOMENON

I understand, I eat choc. chips at 10:30, trying to stop and limit the amount at 8:30, when I do that my BS drops to 120 if at 7:30 and I go on the treadmill for at least  half hour or more, then it is 90.  I think you have to get the temptations out of the house, and do not get up at night, the Dr. only cares in a limited way.

Watch biggest loser, they help me what to eat better.

Valued Contributor
marty1955
Total Posts: 8,718
Registered on: ‎05-12-2013

Re: DAWN PHENOMENON


skreitman wrote:

I understand, I eat choc. chips at 10:30, trying to stop and limit the amount at 8:30, when I do that my BS drops to 120 if at 7:30 and I go on the treadmill for at least  half hour or more, then it is 90.  I think you have to get the temptations out of the house, and do not get up at night, the Dr. only cares in a limited way.

Watch biggest loser, they help me what to eat better.


Eating chocolate chips before bed is probably causing your problems.  Snacks at night should be about 15 carb g or less and include protein and fat as well as the carbs.  I just answered you in another post regarding DP.  Taking the two glyburide at night disregarding what your doctor told you about 1 in the evenings could cause you to go low during the night....you really don't need for that to happen. 

"The road to success is always under construction."
- Lily Tomlin

01/2013 - diagnosed with T2 and hypothyroidism
A1c - 7.2
04/16/2013 - A1c 6.1
07/24/2013 - A1c 5.8 (bayernow)
09/21/2013 - A1c 5.6 (bayernow)
10/10/2013 - A1c 5.7
04/30/2014 - A1c 5.5
500 mg Metformin/1 per day
Low Carb
Beginning weight - 183
08/27/2013 - 143
10/03/2013 - 141
12/05/2013 - 138
Blood Pressure 12/05/2013 - 118/60
Blood Pressure 02/2014 - 106/54 (too low, medication cut to maintenance dose)
Blood Pressure 04/29/2014 - 110/65
T2 paternal grandmother, father, two sisters, my current and my ex husband

lizzylou
Total Posts: 13,930
Topics: 565
High Fives: 1,994
Solutions: 142
Registered on: ‎10-31-2009

Re: DAWN PHENOMENON

This post is from 2009 and has been updated several time since then.

 

If you want to read the current post click below:

 

D.P. or Why Are My Morning Numbers So High | Lizzy's Diabetes Lounge

 

Lizzy

Knowledge is Power!





Here's some useful links, click on the titles


Testing 101
 
 All About Carbs

Resources For The Un-insured and Discount Medicine and Equipment

LizzyLou Videos



Lizzy's Blog
for lots more  


Super Advisor
dw8888
Total Posts: 1,410
Registered on: ‎06-23-2012

Re: DAWN PHENOMENON

@Lizzy,  Those old posts being resurrected: they got me and morris again!! Your update is much more informative.

 

Dennis
T2 25yrs and DIABETIC STRONG!
Metformin 2000, Levemir, Humalog mdi
A1c 7.1 @ 11/11, 6.6 @ 3/12 , 5.6@ 6/12
5.2 @9/12, 5.3@1/13,5.3@4/13,5.5@7/13,5.7@10/13,5.6@12/13, 5.6@2/14,5.5@4/14, 5.3@7/14
Most Current 5.5 @ 11/14
Occasional Responder
skreitman
Total Posts: 9
Registered on: ‎12-19-2013

Re: DAWN PHENOMENON

I wanted to let you know that I told my physician that I switched my medicine to two glybyride at night instead of one and now have normal blood sugars, and she thinks I might be right and have the Dawn effect, funny, I thought the physican should have thought about it when I told her the issue.

Occasional Responder
skreitman
Total Posts: 9
Registered on: ‎12-19-2013

Re: DAWN PHENOMENON

If I do not respond it is because I am having trouble understanding who responds to my posts.