05-17-2011 05:36 PM
I have noticed that my morning BG levels before breakfast range from the 118-120's to 130's. These are my HIGHEST numbers before eating throughout the day. My levels before eating lunch and dinner are much lower.
So, I decided to look it up and figure out what is going on. I found it is something called "Dawn Phenomenon" or "Somogyi Effect". It says it happens between 3:00AM and 8:00AM.
When it comes to the "Dawn Phenomenon", it says that IF you test BEFORE 3:00AM and if your BG level is still HIGH, it is the Dawn Phenomenon.
When it comes to the Somogyi Effect, it says IF you test BEFORE 3:00AM and your levels are LOW at that time, it is the Smonogyi Effect.
I have tested my BG levels at 12AM, 1AM and 2AM and during that time period, it is much lower. Tyipically between 100 and 115. So I assume I have the Somogyi Effect.
Does anyone else experienced these 2?
05-17-2011 07:00 PM
I definitely experience the dawn phenomenon. I can easily see my blood glucose rise even 60-80 points from my fasting number if I don't eat breakfast. I never had any luck with either eating a bedtime snack or avoiding eating in the evening. Taking 2500mg of metformin a day didn't stop it from happening. Even with a careful breakfast, I could still watch my numbers rise.
Now that I take insulin, I've finally hit on a strategy that works for me. I just let my liver go ahead and send out that extra glucose it thinks I need, and don't fret about it, but I take an extra amount of rapid acting insulin to keep the glucose moving on into my muscles as soon as possible. It's the same amount every day, whether I eat a big or small breakfast, and it is in addition to the insulin I take to cover breakfast. I don't think I've heard of anybody else doing that, but it seems to work just fine for me.
I'm afraid I may have to throw a monkey wrench into your thoughts about the Somogyi effect. When we talk about checking blood sugar at 3AM, to see if it is low or not, we're not just talking about a nice low number in the 70-80 range. We are talking about real, serious hypoglycemia, with low numbers, probably below 60, that summon your liver to supply emergency glucose. Is that what you are seeing in the middle of the night?
Another thing to consider is that there is nothing magical about 3AM. That's just a nice middle of the night time for an average person who goes to bed at 11PM and gets up at 7AM. If you are an early bird who goes to bed at 9PM and gets up at 5AM, or a night owl who is up until 1AM and then sleeps in until 9AM, your body has its own circadian rhythm, and you may need to check earlier or later in the night to find a low spot.
That may make you want to rethink your conclusions.
05-17-2011 07:11 PM
No, I don't experience lower than 60's in the middle of the night. When I have tested at 12AM, 1AM and 2AM, it is around 100. Maybe 114 or 115 at the very max.
My Morning BG levels always tend to be my HIGHEST before meal numbers. Usually when I test right before I eat lunch or dinner, my levels can be anywhere between 83 to 115 or 118.
Now, for the past few days, I have been experiences higher number no matter what, but that is because I have been really sick for the past few days. I am finally starting to get better and my numbers are starting to come down.
Like I said, my morning numbers before eating seem to be my highest before meal numbers.
I was just curious if anyone else experiences this as well. It seems like it is a common thing.
05-17-2011 08:06 PM
Since we're both "night owls" it makes sense that our body clocks would differ from a "normal schedule" person, so a specific time for everyone doesn't make sense to me.
I have also heard of people taking the extra rapid-acting for their DP on the type-1 board. I just can't remember who.
But here's something to consider, maybe not for this case but others.
The liver is also involved in this process and often with newly diagnosed people and people controlling with only diet and exercise the liver doesn't always wait for a "real" low before releasing glucose. That's why we often hear of ND folks saying they feel low when the numbers are really pretty normal like 100-120. That's also a reason why Metformin is such a popular drug because it helps "calm" the liver down.
So perhaps in instances such as the above the distinction between DP and Somogyi isn't as clear.
Just something I'm thinking about.
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05-17-2011 09:45 PM
You know, I am slowly learning that no matter how much I read up on Diabetes and learn, I will always be one step behind...lol
Thanks again for the insight. It actually was very helpful.
05-17-2011 10:13 PM
Oh, and yes, I do experience the feeling of my BG being really low and then when I test, it is between 83 and 115. Diabetes is such a crazy disease. Well, maybe not crazy, but surely very annoying.
05-17-2011 10:28 PM
Most of us 'betes old timers on the T1 board, do take rapid acting for DP. There are also, some of us, that our DP hits at various times of the day. If my fasting number is around 30 points over the top of my target area, I take a very small dose, usually just 0.5 units Novolog. That does, of course, change, if a larger dose is needed. Also, some have to dose for their coffee, where others of us do not - I'm in the do not have to arena.
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05-18-2011 12:46 AM
It's pretty common to feel low with normal numbers like that when your first getting things under control. After ones body gets acclimated to high numbers, the drop to normal type numbers "feels" low. At least until you get used to the new normal type numbers