dawn phenomina

[carbavoidr]

we have run up against something referred to as dawn phenomina (spelling). which basically is DH's sugar is way high in the early am when he gets up. then a couple of hours later it is lower and a few hours after that is is "normal". all that we can find out is the body thinks its being starved so does not metabolize as it should while he is sleeping, which cause the high numbers. has anyone else run into this? is there a solution? we thought we might try protein every 4 hours as an experiment to see if the problem really is caused by fasting during sleep. this sugar spiking has made him grumpy to say the least, any help is appreciated.
Jane

[Oldsalty]

Bernstein reports on the dawn phenomenon in his book Diabetes Solution. Throughout the book he talks about strategies to deal with this aspect of diabetes care, it is difficult to rapidly put a finger on specifics, but I really recommend that you read his book cover to cover and see if he has a solution for you. He claims that it is caused by the liver taking insulin out of the blood stream during the early hours of the day.

[doreen T]

Very early each morning, the body releases hormones (from the pituitary) that wake you up and tell the liver to release stored glucose to give you energy to start the day. These hormones also inhibit insulin. The result is that glucose level rises between 4 a.m. and 8 a.m., in a process called the dawn phenomenon. Also, it doesn't matter whether the insulin is injected or is the person's own ... the cells are less sensitive to insulin's effect during this time.

There's another mechanism, called the rebound effect ... The diabetic experiences overnight hypoglycemia, and in response, the liver is stimulated to release stored glucose (glycogen) .. thus, the blood sugar rises.

You can read more about these symptoms here (http://www.faqs.org/faqs/diabetes/faq/part2/section-13.html).

I couldn't find in any of your posts if your husband is insulin-dependent, or on any kind of medication?? There are different treatments, depending on whether it's simply DP, or if there's an overnight hypoglycemia problem. If he's on medication or insulin, these may need adjusting. If he's not on medication ... and the problem is related to hypoglycemia, then a protein-containing bedtime snack is in order, however a snack in the middle of the night would just compound the problem, since the rebound release of glycogen from the liver would already be underway. A bedtime dose of Glucophage (metformin) may be helpful, as this increases the sensitivity of the cells to insulin.

The link I gave you has some suggestions for checking blood sugars during the night, and how to tell which problem is the culprit. Then you can show the results to the dr. who will recommend the best course of action.

Doreen

[Debi Warne]

Thank Doreen!

I've been trying to figure this out for myself.

But my question is it seems if I have a low carb snack (such as low carb toast 7 and butter) my sugars drop a little by morning. I haven't checked mine during the night in a while, but I will do that (if I wake up -- I'm sleeping really well lately).

I have also noticed that if I take the glucophage too late (if I forget at dinner) and too close to bedtime my sugars are higher in the a.m. also.

Sometimes it does get very overwhelming.

[carbavoidr]

I have that book, I will do some more research and see what I missed. It makes sense the way you guys explain it, I am going to try to print this info for DH. he takes just 3 mg of Glynase a day and has for 8 years now. we thought he might need a dosage, but by mid morning, or after any exercise, his BS is actually low, these spikes and lows are hard on his system and I would love to get him back to even levels. I will let you know what we come up with, thanks again all
Jane

[Lisa N]

Hi Carbavoidr!

I was having a problem with DP when I first started this WOE. Of course, when I first started, my average blood sugars were 250. It may be because I was taking my Glucophage too late at night (I'm bad about remembering to take my pills at the right time), but my morning blood sugars were consistently running higher than my bedtime blood sugars. My doc said not to worry about it since my morning blood sugars were still in the acceptable range for diabetics (between 110 and 120). After 9 (almost 10) months on this WOE, the Dawn Phenomenon has completely cleared up and I'm actually having a problem with my morning blood sugars being a bit on the low side...sometimes around 80 (Time to drop that last dosage of Glucophage, I think). It may take some time, but I think if your DH sticks with this WOE, his blood sugars will even out. My doc also told me that I shouldn't be eating dinner and taking my Glucophage any later than 6 PM.