Really big dawn effect

I know i suffer from dawn phenomenon. I usually go up about 0.5mmol (9 mg/dl) per night, but lasst night, I was 4.7(85) when i went to bed and woke up 6.1(115) !!! I was not happy. I’ve been working on getting into the 4s for weeks. I’m more often about 5.2 -5.6 (94 - 101)
If anyone has the answer. I’d love to hear it

I am sorry but a dawn effect is something more dramatic. With 85 mg/dL you are below the normal range due to your activity. At night the value will rise to normal levels around 110 mg/dL and this means that 115 mg/dL is fine when it stops there. Please consider that your glucose meter has an accuracy of roughly +/- 10%. Furthermore the human body is not a machine and therefore you should accept small deviations. In other words the likelyhood to measure 115 mg/dL should be lower than the likelyhood of 110 mg/dL if all runs well.

People with dawn effect will release massive amounts of glucose from their liver at dawn. This means they have perfect levels until 4 to 5 o’clock in the morning and then all the mobilized glucose kicks in. These patiens will likely come out with 150 mg/dL and more. In most cases this can only be handled by changing the wake-up time or the use of a pump.

I deliberately keep my BG in the 4.5- 6 mmol/l( 81- 110mg/dl) range. According to Bernstein, this is where it should be. 110 is NOT normal to me,it’s my target top limit . Bernstein writes that 85( 4.7 is normal non-diabetic), but that 90 is OK. For me that morning rise to my limit is annoying and definitely part of the Dawn Phenomenon. I find it frustrating. For example, I went to bed at midnight last night on 5.3 (95.4) and woke at 6.0(108) at about 7:00am So having kept my level right throughout Sunday dinner, with dessert, I wake up at my limit. I’m trying to minimise my weight and my use of medication too. As well as avoid any further complications ( I have mild background retinopathy)
The levels that many doctors recommend are Too high for the avoidance of complications and lead to the belief that T2 diabettes is always progressive. After 5 years of living with this, I only have the damage that happened before diagnosis and I suspect I’m healing it . ( waiting on next retina appointment to be sure, but it seems so from dispensing optometrists eyecheck for glasses) Also I’m fighting my weight down and using less medication. HbA1cs are usually in the high 5 range.

Bernstein is right but these are figures for healthy people. I guess he says that a normal working regulatory systems of a healthy body will regulate in a way that the morning values are 85 mg/dL. But does he really say that values around 115 are harmfull? Maybe I got it wrong and it is possible to conclude from 115 in the morning that the values where much higher at night. In this view it would make sense to bother.

A 115 mg/dl blood sugar is almost at normal level; it’s slightly high for fasting but pretty darn good for a type 1 diabetic. You don’t have anything to worry about. A person without diabetes can have blood sugars in the 160’s after eating. I think your worrying about nothing… really. From what your saying it doesn’t seem like you ever have high blood sugar levels.

If I had a 115 blood sugar every morning you would never hear any complaint out of me. Prior to having an insulin pump I had a hard time getting my sugar to be below 200 in the morning. My opinion is that you’re being obsessive compulsive with your diabetes management. If you had a 115 blood sugar all of the time you would never have any complications.

I don’t allow myself to have high BG levels EVER!! The highest I can remember in the last year or so is 9(162) and that was down to stupidity. I’m careful with diet and judicious with my medication. Oh and I’m a T2. Bernstein makes it clear that tight control is the only way to be safe. In other words normal Non-diabetic BGs at all times. that’s what I aim for.
It wouldn’t be common for a non-diabetic to have a BG of 9 or 10 (160 -180). they’d have to be thoroughly carb loaded and it wouldn’t stay up for long. It woul drop back within an hour or two.
The only time I’ve had BGs above 10 (180) were whilst I was in hospital following a stroke and the medics were in charge. they thought 20 (360) was acceptable. I’ll never let them take charge again. AND their idea of diabetic diet was poison. Huge portions of rice, pasta or mashed potato at every meal and toast for breakfast.
also I AM HEALTHY. I don’t have an illness, just a portion of my metabolism, which doesn’t function well. I can control that by diet, exercise and medication. I’m never ill. I have had maybe one cold a year for the last five and nothing more. I weigh less than I did at 40, even though it’s still too much. My blood chemistry is excellent and blood pressure is under control with the help of medication. I can walk 5 miles with ease even if there are hills. My skin doesn’t look over 60. Yes I do miss bread and rice and pasta, but I know I must not have them. there’s so much I can have. I pay very little heed to fats, so I eat butter and cream regularly. I have my coffee with whipped cream.I have the occasional square of 75% - 80% cocoa solids chocolate and every now and again a miniature eclair, with cream. I eat bacon and eggs for breakfast.

Hana-

I understand what you are saying! I hate being over 100 fasting! Since I have been a member of Tudiabetes, pumping and once a very friends on the site told me about the Dawn P, I have managed to keep my fasting under 100. I have a high one when Aunt Dottie visit’s but it goes back after a day or so. Here is a link to an article "Taming the Dawn P."
I noticed once I cut out my snack before bedtime, changed my basal setting and take a evening walk my fasting numbers looked better and better.

Cherise

Geez. my mornings are usually in the 130mg/dl to 140mg/dl.

Mine is progressively getting worse :frowning:

6 months ago it was in the 100-120s.

Hi Hanna,

You have admirable discipline. Wonderful the control you have! I’ve been following Dr. B’s recommendations also.

I’d be dancing to have morning readings this good. I have serious dawn phenonmenonon. I go to sleep with readings between 85-110 & often wake up over 150, Sometimes over 200:( I take Lantus at bedtime, don’t eat for 6 hours before going to bed. I’ve tried vinegar (straight–ugh & capsules), walks before bed, you name it. I haven’t tried Granny Smith apples mentioned in the link Cherise sent. I was told to eat a snack before bed to “feed the Lantus.” I usually eat something high protein like a small piece of cheese or some peanut butter. Supposedly this will prevent the lows that send BG too high. I’ve increased my Lantus by .5 units over several days, but haven’t seen much improvement. If it wasn’t for dawn phenonmenon, my other readings are pretty good. Really bums me out starting out the day high.

That’s the objective. I don’t think I’m obsessive. Just safe. I do have background retinopathy and aim for that to get better. I live with( married 37 years) a lifelong T! who has serious complications. I am NOT going down that road.
I have actually got him being much more careful and some of his problems are improving. Especially the nephropathy. That’s the life-threatening one. The price of poor control is just too high!!

I haven’t managed to get that link to work. It just tells me that there’s no service. I am just starting to have a bedtime snack.( none low carb cheesy cracker) It’s working so far. I’m only on Metformin 500s.( I can have up to 4 per day) and Starlix 60s, which I only use occasionally and cut in half anyway. I’m not really all that disciplined, but I’ve decided what I WILL NOT do and I aim for Bernstein’s doctrine of low numbers. Minimal carbs and minimal meds. It seems to be working.

Hloger,

85 mg/dl is ROCK SOLID NORMAL. In fact normal extends down to 70 mg/dl in people without diabetes.

110 is not normal for a fasting blood sugar, even according to the most conservative ADA. 100 is the top of normal.

Hana,

Since you are not using insulin then it is very tough to control that kind of dawn phenomenon. I am using both basal and bolus, and it is STILL hard for me to get my fasting blood sugar where I would like it.

A suggestion that works for some people are a glass of wine before bed (to stop the liver from dumping glucose). That worked for me for a few days and then stopped working.

The other thing is to look at what you are eating at night. If you are eating a lot of protein that is converting while you sleep, perhaps eating your large meal of the day earlier and eating a light dinner will help. That is the strategy that seems to work the best for me.

Jenny is right on with the protein idea. I ate beef skirt steak at 6:30 last night and when I got up today my BG was 123 and typically I am around 89-95. This has happened to me before, but more so with red meat than say chicken or seafood. Next time I will do a temp basal to cover this.

Since you don’t use insulin I would try having larger lunches and smaller dinners this may help you out.

It is all one big learning game and sometimes it takes a while to figure out the patterns and connections with the foods we eat and what it does to our BG. Good luck

I eat my main meal in the evening, because my husband is still working and likes me to be sociable. It’s 3:30 pm here now and I just put some chicke thighs, with onion, peppers and tomatoes into the slow cooker (crockpot), with a splash of wine. I shall add about 4 baby potatoes,( in their skins) for the last hour. That’s the kind of thing we eat in the evening. I test my BG bedtime and morning. I’m not allowed more strips and I’ve noticed that the biggest DP jump is when I go to bed between 5.6 and 6.1 (approximately between 100 and 110, that’s a rough conversion) I wouldn’t allow Bg to go over 6.2. I can use Starlix to stop that. I had a small piece of miccrowaved cod fillet and a cup of tea for lunch. A Scotch egg for breakfast with a couple of cups of coffee in between times. I’ve been out walking with my walking group today. 3 miles over gentle hills in the rain. I certainly tried out my new water repellent trousers.

To be honest if you want to keep you BG in line I would ditch the potatoes unless your husband eats all 4 of them. You will be amazed at how much easier it is to manage you BG when you don’t eat the starchy foods.

One pretty much has to be clinically obsessive-compulsive in order to manage diabetes correctly. According to my doctor’s corrections to the Joslin numbers (she made them tighter, not looser), fasting BG for non-diabetic is ‘below 100’, and acceptable fasting for someone with diabetes is ‘100-110’. The best way to avoid complications is to keep one’s numbers in non-diabetic range to the greatest degree possible (this isn’t just A1C, but also fasting, postprandial, and random-check glucose levels).

Last year I found that when I am chilled overnight, I will wake up with my bg much higher than I like it (i.e., over 100). If I wake up under 90 I will generally have a massive headache along with it. I believe that the higher reading may be a stress response to the chill, but don’t have enough data points to be certain.

baby new potatoes are only about 20% carbs and I eat 2 the size of walnuts. that’s not much carb. I’m not a no-carber, but I do keep low. there’s quite a big difference in carb content between old and new potatoes. the baby ones haven’t “starched Up”

If I had a blood sugar every morning at 115 I’d be pretty happy too Kev.