dawn phenomenon??

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Rhoda
Regular Member


Date Joined Feb 2007
Total Posts : 55
   Posted 3/13/2007 6:23 PM (GMT -7)   
What is this dawn phenomenon?  My husband is diabetic along with basilar migraines.  His blood sugar in the morning ranges from 140s to 200!!! after toast for breakfast then at noon his sugars are around 120s....and then the 120s around 4:30 pm...what is going on?

Phishbowl
Veteran Member


Date Joined May 2006
Total Posts : 547
   Posted 3/14/2007 12:55 PM (GMT -7)   
Hi Rhoda,
Even when I'm in control, I'm often surprized if I'm below 8/(145) in the morning (fasting). I've been Type1 for just over 2 years and I still struggle with that one. The DP is a wrench in the gears for many Diabetics trying to manage control.

The DP is a naturally occuring event for everyone: sometime in the pre-dawn hours, our bodies get ready to wake us up and get us going by the liver dumping glucogon (think: sugar) into our system in preparation for our bodies to get going. For Diabetics, who basically have metobolic issues, we can't sufficiently deal with the amount pumped out and see that result in the high morning glucose level.

Sounds like he's doing great throughout the rest of the day. Is he type1 or 2? What are the bedtime numbers like? Any snacks at bedtime? How's his A1C?
Cheers,
- Phishbowl (Type 1 since Jan'05 - Levemir, NovoRapid)
"What's Not Measured Is Not Managed"

"It is impossible for a man to learn what he thinks he already knows"-Epictetus


Rhoda
Regular Member


Date Joined Feb 2007
Total Posts : 55
   Posted 3/14/2007 5:16 PM (GMT -7)   

Thanks for your encouragement.  His A1c ranges from 5.6 to the highest of 6.8.  We quite having nighttime snacks thinking that made it worse but then I read that an apple, cheese or something like that may help so we are trying that this week.  He is type 2 going on 7 years now on oral meds morning and evening.  I just changed my work hours and we get up a couple of hours earlier than we used to so maybe we are just now seeing this DP when it really was happening all along....there is always something new to learn and deal with.

Thanks again for sharing your expertise.  I appreciate it.


Phishbowl
Veteran Member


Date Joined May 2006
Total Posts : 547
   Posted 3/14/2007 6:10 PM (GMT -7)   
Wowzers, Rhoda! Those are awesome A1C numbers! I wish I had those - my last one was over 9 (hey, better than the 14 I started with :-) Just went this morning for my bloodwork; I'm anxious to find out the results next week.

Getting up a couple hours earlier will make a difference in that morning number, too. Not sure where you are but we just moved our clocks back an hour this past weekend so, if you did also, then your looking at a 3 hour difference or so. That definitely is enough to see some different numbers than you're used to. Has he done a 3:00am test lately? It sometimes gives you an idea of how you're affected by the DP when you know what your blood sugar was before the liver dump versus what you're fasting number is.

It's been my experience (as a Type1, though), that a bedtime snack helps me with DP. Having to 12-hour fast this morning, for example, I woke up to an 8.9/(160), was 10.2/(185ish) when blood was drawn, and 11.3/(208ish) by the time I got home to eat something, 2.5 hours later than usual. I do think timing (of food, exercise, insulin, etc.) has a lot to do with keeping things in control. Maybe some detailed logging might help point out some patterns?

You're right...there is always something new to be learned :-)
Cheers,
- Phishbowl (Type 1 since Jan'05 - Levemir, NovoRapid)
"What's Not Measured Is Not Managed"

"It is impossible for a man to learn what he thinks he already knows"-Epictetus


Rhoda
Regular Member


Date Joined Feb 2007
Total Posts : 55
   Posted 3/15/2007 1:10 AM (GMT -7)   

We live in North Dakota, USA and yes our time just changed too.  Funny you ask about what his blood sugar is around 3 am because he woke up just now and took it and it was 137 so that made us feel better - we were getting worried about the high ones but now we are understanding it better.

Thanks!


A.F.MomDiane
Regular Member


Date Joined Aug 2004
Total Posts : 151
   Posted 1/31/2008 3:43 PM (GMT -7)   
Hello! I've been fishing thru the old posts on this subject. It just ain't fair!! I'm just getting back on the wagon, eating like a carnivorous rabbit, drinking "water" in various forms and DOING REALLY GOOD! (IMHO)

But then my B.S. started shooting up in the middle of the night! I would wake up at 2 or 3am, have to pee and then have a reading of 180-200. By morning it would be 140 or so and then it would go down to normal acceptable readings thru the day. I'd get so frustrated, and even after a PERFECT day my B.S. would again shoot up.

Is this Dawn Syndrome too??? I've only been Diabetic for 2 years and this is a scarey first for me. (makes me mad too)

I've read the old posts but still...I'm a scard lil' rabbit and I need reassurance from you old pros whom I greatly respect. I'm nervous by nature. Is this something that I NEED to be upset about? Thank you for your response. All the above should suffice as an answer to me but I'm a worry wort and need that personal reassurance and encouragement

THANK YOU!!!!!!!

LanieG
Forum Moderator


Date Joined Nov 2006
Total Posts : 5404
   Posted 1/31/2008 4:04 PM (GMT -7)   
Dear Scared Lil Rabbit, you have all the encouragement we all can give you here!  Hey, Diane, refresh my memory.  Are you on meds?  What are they?  What are you eating for meals?  What kind of exercise are you getting? 

Lanie
forum moderator - diabetes
diabetes controlled so far by low/no carb diet and exercise; no meds


A.F.MomDiane
Regular Member


Date Joined Aug 2004
Total Posts : 151
   Posted 2/1/2008 1:04 AM (GMT -7)   
Hi...I'm on 850mgs of Metformin and 5mg of Glyburide a day.
I also take the Diabetes packet from NatureMade, Cinnamon, Fish oil, Calcium and Evening Primrose.

For breakfast I eat 2 pieces of whole wheat toast with Smart Balance spread with a little P.B. or I have sugar free oatmeal. A grapefruit, avacado or orange and 1 or 2 cups of green tea with artifical sweetner.

For lunch I make soup or salad and eat that...For dinner I finish the soup or salad and then have meat. I do put crackers in my soup and put Teriyaki sauce in it. Sometimes I make eggdrop soup, lental or 7 bean soup.

I've been snacking peanuts and apples and I drink Green ice tea and sugar free drink mix and then water. Sometimes I have bacon with a little bit of sugar free syrup on top (my new comfort food)

In Emergencies I have a piece or 2 of sugar free candy...

I don't eat any sugary things, rice, potatoes, or pasta. No soda or juice. I don't drink either. I do have a small sweet potato occasionaly.
My problem is excercise. LONG STORY...But I do misc excercises in my room. When it comes to excercise I'm pathetic and harbor a lot of "hang-ups". But I do excercise each day pretty much.
In my job I'm always ALWAYS sitting. No way to get around that, a lot of TV watching too. I'm still VERY (plus size) overweight. (Please don't tell me what I already know) Ughhh...I'm a mess, but I'm trying to stay positive and get back on the band wagon.

This discouragement really wrecks havic on me!

Thank you for caring!!

gelchick
Regular Member


Date Joined Aug 2006
Total Posts : 477
   Posted 2/1/2008 8:50 AM (GMT -7)   

AFMom

You might want to talk to your doctor about taking your metformin at night. One of the actions of metformin is to prevent the liver from making too much glucose from its glycogen stores.

I have a very strong DP- but it improved considerably when I changed my medication times. I take most of it (1000mg) when I go to bed with a glass of low carb (Calorie Countdown) milk and a spoonful of nut butter.

sandy

 


I just want to live happily ever after-every now and then. Jimmy Buffett


A.F.MomDiane
Regular Member


Date Joined Aug 2004
Total Posts : 151
   Posted 2/1/2008 10:05 AM (GMT -7)   
So take my "G" in the morning (I usually take all my pills in the morning with breakfast) and then take the "M" before bed?? I can do that!

about the "just talk to your doctor" bit. Are you able to literally "just talk to your doctor"? Or do you have to make an appointment,(1 to 2 wks) rearrange your schedule, drive around for 10 minutes trying to find a parking spot, wait in a waiting room 45 mins, jump thru all the hoops (BP, dumb questions, etc...) and then wait in a cold exam room for 15 to 20 mins, to see a hurried doctor for 5 minutes tops.

I come from a long line of long-living people (98, 100, 102, 101) Who avoided and mistrusted doctors like the plague! My mom, 72, hasn't been to the doctor in 43 years! And she just recently built a 6 ft. fence around my parent's 1 acre yard from scratch! (none of these premade sections for her!) She's the most healthy person I know.

But she's afraid of doctors and I think a little bit of that rubbed off on me. Not the fear part but the dislike of it all! Unfortunitly I'm not my mom health wise. I have the disgusting Diabetes...(sneer)

I'll try the bedtime snack thing and take my "M" at night and see if that helps.

Sorry to ramble on. I do that...THANK YOU FOR LISTENING. (reading)

A.F.MomDiane
Regular Member


Date Joined Aug 2004
Total Posts : 151
   Posted 2/1/2008 10:47 AM (GMT -7)   
I don't want you to get the impression that I DON"T or WON"T go to the doctor. I just go kicking and screaming. Am I the ONLY Diabetic like this??????? It's a big stumbling block to get over.

My last AC1 thingy was 6.2...a bad score from what I gather here.

gelchick
Regular Member


Date Joined Aug 2006
Total Posts : 477
   Posted 2/1/2008 2:23 PM (GMT -7)   

Diane

Yes, I can literally call my doctor and talk to her. She has a call-in hour every morning from 6:30-7:30- I call and speak with her nurse- then either the nurse or the doctor calls back with the response. She has open appointments from 7:30-8:30 every morning also- you go in and sign the list to get seen. Her office is in the doctor's wing of the hospital, so I don't even have to go very far to the lab if necessary. She's very accessible.

My mother was like yours. She was as healthy as anyone I knew, did not believe in doctors or dentists. Hadn't been to one since my youngest brother was born - he's 42. about a year and a half ago, she 'came down' with a bad case of diarrhea and used it as a weight loss tool for over a  month until it caused a massive GI bleed to occur. It was a simple infection that could have been cleared up easily if it was caught early. She was in and out of the hospital and rehab centers for the next 17 months with recurrent infections, colitis and other issues that developed as a result of the extended confinement to bed. We lost her last month.

My dad is the same- both of them would snipe about my cousins who regularly visit doctors for multiple medical problems. Their attitude was that the 'doctors' keep finding things wrong so they can stay in business.  As a result of that attitude, I walked around with sky high blood sugar levels ( over 400 at dx) for a very long time. By the time of my dx, I already had retinopathy in  my eyes. It's a miracle that I'm not worse off than I am. One of my very healthy friends recently died from breast cancer- she never went to the doctor for routine visits- it probably would have been caught in time if she did.

I used to avoid doctors because I had adopted the same attitude that my parents had, and because I tutored plenty of sub-par medical students, who were pushed through to meet quotas. I can bury my head in the sand with the best of them.

I rely on my doctor, my eye doctor, my dentist, and my podiatrist to help me do the best I can to preserve my health despite having diabetes. If you catch an impending problem early- you can avoid a lot of really terrible complications. It feels really good to hear that nothing has changed, or I have improved during an office visit- it sure beats wondering.

sandy


I just want to live happily ever after-every now and then. Jimmy Buffett


A.F.MomDiane
Regular Member


Date Joined Aug 2004
Total Posts : 151
   Posted 2/1/2008 3:34 PM (GMT -7)   
Wow..you are so lucky doctor wise. But I am sorry to hear about your mother. It must be hard seeing it was preventable. Gosh, that would be haunting...

There's gotta be some middle ground where common sense would step in to balance out both extremes. Somewhere between Hypochondria and Paranoia. I don't want to be SO dependant but you don't want to be totally on your own either!

That's why I come here so I don't have run crying to my doctor everytime I'm concerned about something...so I come crying here instead, LOL. And if I have to run the "gauntlet" for those magical 5 minutes I'll do it. I'll grumble and complain but I'll do it...

Life is complicated enough without having this stupid disease!

It's funny, the way you described your dad's attitude, that's how I feel about VETS! But they really are that way because they have an excuse. They go so often unpaid that they have to make up ground to keep above water. I avoid vets too, LOL. But for $ reasons.

Right now I'm kinda between insurance plans so I couldn't call even if it were an option. Starts today but I have to wait for my new paperwork and card. what a wonderful system your doctor has!!

ScooterFL
New Member


Date Joined Mar 2008
Total Posts : 9
   Posted 3/28/2008 7:03 PM (GMT -7)   
I learn something new every day. I was wondering about this same thing I have noticed that my numbers were higher in the morning after not eating since dinner time. I also noticed that the numbers were more in line if I ate a bowl of oatmeal before bed time.
I have a question that comes to mind... Would eating smaller portions throughout the day (while maintaining your current caloric intake) help prevent dp? I take Janumet with my evening meal usually around 5 to 6 pm and I am usually up around 8 am.
Live to ride ride to live


Jeannie143
Veteran Member


Date Joined Apr 2004
Total Posts : 6056
   Posted 3/29/2008 7:55 AM (GMT -7)   
Scooter,
Oatmeal is pure carb with some fiber. It's not totally evil but there are better bedtime snacks. How about a banana with a tablespoon of peanut butter? Or apple with about 30 peanuts? One inch block of cheese and an apple? 9 or 10 olives and a tomato? The secret is to mix monosaturated fat with plant sugars for me. By consuming fat with the fruit you slow down the tummy emptying time and sort of make a 'timed release' snack that feeds you for most of the night.

Grain based carbs are already mechanically broken down and just dump their glycemic load into the intestines, often resulting in a blood sugar spike followed by a drop followed by an even bigger dawn phenomenon trying to compensate. All of this is because the brain runs on pure glucose and will do whatever it takes to have a steady supply of glucose to operate. The brain doesn't care about the rest of the body. If it doesn't get glucose it sends signals to the liver to do a glucogon dump. By having some fruit/fat food in the intestines the body goes there for glucose as it is absorbed. The fat slows the whole process down a bit and you should do better.

Our bodies are all different, and this may not work for you, but you wont' know until you try it and chart your results.
~ Jeannie, Forum Moderator/Diabetes & Fibromyalgia
I know God will not give me anything I can't handle. I just wish that He didn't trust me so much. ~Mother Teresa

"People are like stained glass windows: They sparkle and shine when the sun's out, but when the darkness sets in, their true beauty is revealed only if there is light within."- Elizabeth Kubler-Ross

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