Dawn Phenomenon Saga

Type 2
1

Okay - so a few years ago, I did a lot of experimentation with trying to get my morning blood sugar to lower. I often wake up in the 125-135 mg/dl range (6.9-7.5 mmol/L). Not horrid, but not ideal. Let me mention - I’m T2 and take no medication - last A1c was 5.7%. I eat low carb - aprox 30-40 g daily.


I tried many different things. Wine before bed, protein before bed, exercise...etc..etc. Sometimes, I could get my last test/numbers of the day low but, by morning, I was back up. Then I would linger there till noon-ish. Annoying as all heck as many of you know. :)

The only thing that would help is exercising first thing in the morning on an empty stomach. It would bring my numbers back down quicker most of the time.

I followed Jenny Ruhl's advice (Diabetes 101) I ate to my meter and was able to get my A1c down despite this annoying DF. Jenny if you read this, thank you and please weigh in on my question????

Recently, I've noticed that if I eat carbs before bed - in the form of grains, my morning numbers are improved. I start off the day in the 90-105 mg/dl range (5.0-5.8 mmol/L) rather than the range mentioned above.Yesterday, I was reading Alan's blog (you may recognize him from the ADA website - I did) Very interesting and informative. He also had a similar experience to me. So, I started experimenting again. This is what I have noticed so far:

If I eat no/low carb before bed: I end up with higher numbers in the morning that linger until noon. Breakfast doesn't seem to change that for me whether it's low carb or moderate carb. Exercise, as mentioned above, seems to help the numbers return quicker but, they still linger a bit. Not ideal but, an improvement.

If I eat white carbs before bed, my numbers are low in the morning but, they spike high before getting there. My understanding is that, that isn't good. We don't want to sacrifice post prandial numbers for good fasting blood glucose.

If I eat a small amount of high fiber carbs, similar to what Alan was doing, I don't spike high and I wake up with good morning numbers. I use low carb the rest of the day to maintain those numbers. FYI: I ate 1/2 cup of Fiber One cereal with a little half/half. I'm under the impression this would be a good thing because I'm eating to my meter? No?

So - I'm wondering if I I'm doing the right thing, by eating the high fiber carb before bed, or if I'm confused about the whole dawn phenomenon thing. I know the bottom line is our A1c and I've improved that already but, if tweaking my meals may lower it more - why not - no?

I'm continuing to test this out because it may end up a fluke but, so far, it's working.

Any insight would be much appreciated!

~Danielle



2

Hello, this is really interesting, I have also been wondering how to get my fasting blood sugar down and your post has given me some good ideas. I think you are absolutely on the right track, judging from Jenny’s explanations on the dawn phenomenon page of Bloodsugar101. Jenny writes:

“I noticed that a raising my dose of dinner insulin too high always resulted in a higher, rather than lower blood sugar the next morning. The rise would be about 20 mg/dl (1.1 mmol/L). Eating 10 grams of carbs before bed eliminated the problem, and I would see a lower blood sugar the net morning. So did lowering the dinner dose of insulin.”

“Some people find that they can reduce their fasting blood sugar by eating a small snack before bed. Some people use a protein snack, which can be thought of as “slow release carbohydrate” since about 60% of protein turns into carbohydrate over a seven hour period.”

This is the website with all the information.

3

It would be really great to find out how to bring those morning numbers down. I started to take meds for the morning problem and it has become worse. Before I took the meds, I found that wine was the best thing to bring them down, a little popcorn or cheese was good too. Problem is… who feels like eating or drinking before bed. Keep on trying… sounds like you are doing really well.

4

Wow, my blood sugar is about 165 in the mornings. Am going to get a “Sleep Study” as Doctor says it may help lower my blood sugar once study is done with certain devices and meds. Hope he is right.

5

I think you are doing all right things. Did you try wine and walnuts before bad?

Once I had 8.9 in the evening and instead of injecting myself with insulin I took a glass of wine and 2 oz of walnuts.

Morning was 5.5 and I did not inject since the previous morning (I am type 1 ).

good luck

6

I struggled with DP for 3 years. This past year I finally got it under control. I had to up my metformin dose and take the last dose right before bed. I take the next dose as soon as I wake up to stop any DP spike in the early morning. I take my last dose around 10:30 am to prevent the spike before lunch. DP is a natural phenomenom and happens to everyone. The difference with diabetics is when these hormones are naturally produced and then signal liver to convert stored glycogen into available glucose we get a big bg spike because our insulin is usually low at that time of day. If we had a strong insulin response we would not spike. The metformin works in the liver to control these spikes. Even with the metformin and low carb diet I will occasionly be over 100. I have heard people say the best thing is long acting insulin. But I am not quite there yet.