Dawn phenomenon

[BarbaraB]

Hello
I am new to the forum and new to Type 2 Diabetes, having been diagnosed only six weeks ago.
Since that time, I have been on Dr. Bernstein's 30-gram carb program and have been prescribed Metformin HCL 2 X 500 mg./day. I had been walking 60 minutes, five times a week but found my BG level rose when I walked. I have now started working out at a gym with hydraulic weights and aerobic exercise (Curves).

I am testing between two and five times a day, depending on my schedule. I find my blood sugar is relatively high in the morning at 6 a.m. when I arise. It is almost always higher than when I went to sleep. My fasting BG ranges from 7.1 (127) to 8.9 (160). During the day, I can usually keep it in the mid-to-high range of normal. (5.5 to 7.0).

Does anyone have some tips for reining in the predawn phenom?
Thanks
bb

[Jamilah]

I'd suggest talking to your health care provider. You may need to cut the pm dose of metformin, (even though metformin isn't supposed to cause hypoglycemia), you may still be dropping, and your liver kicks in with gluconeogenesis, which would increase your blood sugars.
Good luck,
J

[rainne]

I wrote the following, and someone who knew something posted at the same time............




I don't have any tips, but I can spare some warm wishes until someone comes along who knows something. ;)

I got my copy of Dr. Bernstien's book a couple of days ago. I noticed he said he often perscripes metformin at bedtime to help with morning numbers. Maybe your doc can help...

[nopie]

I takes about 6 weeks for the metformin to really kick in.
With all the exercise you are doing, and if you are eating low carb, plus the metformin, you should start to see the morning numbers go down. If not, you may need to increase your metformin. Talk to your doctor, of course. It is supposed to work on the liver to cause it to slow down its sugar production.
How do you like Curves?

[kjturner]

You may also want to ask your doctor to switch you to Glucophage XR (extended release). You take it only once a day and it lasts all day/night. (Plus it does not have the intestinal side effects the non-extended release form does) I've found that if I alter Dr. B's recommendations of 6/12/12 carbs per meal to more like 5/15/10 I don't have that much of a problem in the morning. The liver kicks in with gluconeogenesis plus the body tends to mop up insulin during the night in a sort of 'housekeeping' thing and that makes the BG rise. There is also a link to hormone release too (which also occurs at night) Basically, I've found the less carbs I've had before I go to bed the better the BG looks in the A.M. There are some folks on another discussion board who swear that eating pure fat just before bedtime helps a lot. (Favorites seem to be an ounce of real cream or a pat of butter--sprinkled with cinnamon)

[BarbaraB]

Thanks for the advice. It's good to have some suggestions ready for my general practitioner, who has a more laissez-faire approach to controlling blood-sugar levels. He told me I didn't need to try as hard as I was in restricting carbohydrates as the glucophage would do most of the work for me. Well that's not what I am seeing in my glucose monitor.
I am grateful that I did most of the hard work in giving up carbs five years ago when I first started trying to lose weight. The transition was difficult and I fell off the wagon many times. But since late March, when I was diagnosed with Type 2, I have been vigilant . I am also grateful to have heard about Dr. Bernstein and his book before I was diagnosed.
Barb

[BarbaraB]

Nopie,
So far I'm enjoying Curves. It's just around the corner from my place and the women are really friendly. No spandex in sight. I'm hoping it will be more effective than walking for losing weight. Although, I must say fast walking is an excellent exercise for my cardiovascular health and I will continue to do that on the days in between going to the gym.
bb

[richard2]

Hi BarbaraB,
I too was recently diagnosed Type II and until this weekend felt like I was swimming against the tide. My BG counts were up around high 300's to 518. It put me in the hospital 4 days after my GP told me I was Type II. The hospital dietician truly believed in the pyramid food plan. I'd low-carbed in the past and had just started back when I found out about my Type II. Low-carb felt "right" to my body and I really wanted to stay on it.

I thank everyone on the "diabetes forum" who referred to Dr. Bernstein's book as a must have. I've just really gotten started this weekend and can't wait to finish so I can really understand how to help myself.

I feel like I have a good doctor who has so far encouraged me to try low carbing. I still am fluctuating between HIGH highs (high 200's now) and between LOW lows (sometimes as low as 49). But thankfully he wants to here from me ASAP so he can adjust my meds and insulin.

I'll keep checking in to see how you progress. My sign-on is Richard2 but my name's Lindy. Nice talking to you.

[BarbaraB]

Hi Lindy,
I hope you gain as much from Dr. Bernstein's book as I did. It made me feel a lot more empowered and ready to take my blood-glucose levels into my own hands.
Another book that has been enormously helpful is The First Year, Type 2 Diabetes/ A Patient-Expert Walks you Through Everything You Need to Learn and Do. by Gretchen Becker, Marlowe & Co., publishers, 2001.
b

[Sherrielee]

This is very confusing for me. I am getting readings in the 105 range before bed. When I awake, BG is around 140-150. I never eat for atleast 5-6 hours before bed. I do eat a pat of butter or cream cheese before going to sleep. WELL...I found this article. It starts out about Starlix, but midway through addresses the Dawn Phenomenon. It is extremely interesting. Seems weight loss is the key....isn't it always?

http://www.healthtalk.com/dtalk/edition18/06.html

[Lisa N]

Interesting dialogue. It also seems that another one of the keys would be decreasing insulin resistance which low carb will do.
I was experiencing higher fasting blood sugars when I first started low carbing as well, but those leveled out after a few months on low carb and now my fastings are pretty consistently lower than my bedtime readings.

[Ruthxxx]

I had high morning readings too. However, they are now consistently below 6 (108) since the carbs are cut. I imagine my Doc will allow me to drop my Metformin from 1500 mg to 1000 mg if my HA1C is still good next test.

Hang in there. It does work eventually.

[c6h6o3]

It took about 1 year for me to get my fasting reading where I wanted it - 90 mg/dl. This morning it was 89. Yesterday morning it was 91. Perfect.

If I let the evening reading get down to around 70, I can depend on it's being between 88-92 in the morning when I get up. If it's in the 80's when I go to bed, it'll be somewhere between 90 and 100. I think leaving it a little higher when I retire keeps gluconeogenesis from kicking in. No matter. Either way the average is really good.

As recently as six months ago, the readings were swinging from 68 in the evening to up to 115 in the morning. The key to this for me is persistence. Just keep low carbin' and it'll work eventually.

[BarbaraB]

Thanks to all for the good advice and the reassurances. It's good to know that others who have struggled with high fasting levels have been able to get them down over time with low-carbing, exercise and medication, if necessary.

I find I am very motivated for the first time in my life to stay as healthy as I can, in all the circumstances. I am keeping a journal and record the date, time, etc. of what I ate, whether it was at home or in a restaurant, my readings, medications, supplements, exercise and any other factors that my have affected my blood sugar, such as stress, for example.

Barb