I’ve improved my Dawn phenomenon by a simple change in timing. I use 2 x 500mg Metformin per day. Itake the first as I get up and then have breakfast. the second I was taking at bedtime to help slow down DP. I’ve been taking it with my dinner instead and my fasting BG has stayed firmly around 4.7mmol/l [85mg/dl] this is my personal preferred zone. I end the day at abut 5.5 [100] I don’t know why this is. I did it for the first time, because I was going to have a curry of unknown ingredients for dinner one night and it WORKED. You’d have thought I’d know this kind of stuff already after about 9 years of T2
Hana
That is so true about Docs (and I didn’t like the suggestion of eating that many carbs). Thanks for the info, I will do some more reading.
My first problem is to wake up and test. (LOL) Once I wake up, I have a hard time going back to sleep.
I tend not to snack at night, but that could be because that we eat late (8-9), since we are are on the run all of the time.
When I start getting to the 100’s and lower, I start feeling low (or at least a weird feeling, can’t really describe it, it’s not the normal “really low symptoms”). Does anybody else? I normally stay within 111 to 130. (I take Januvia in the a.m. & 500mg Metformin p.m.)
This is what I did: Had a burger (8p.m.), I know I shouldn’t but that is my downfall.
2 hr BG - 193, 2 a.m. - 114, 3 a.m. - 110, 5:30 a.m - 138
I will have to try this again with my “normal” type meal. I don’t think tonight though. I didn’t sleep from 2 to 3 and had just dozed off when it was time to get up.
I think your numbers would rule out Somogyi effect. Thus snacks and different types of snacks would probably not help. I would say its Dawn Phenomenon coupled with increased insulin resistance in the AM which is very common in T2s and very difficult it deal with. Do you take metformin? This helps with DP. Hanna’s idea of taking it at bedtime would have the best chance of helping, but some have GI issues with metformin and can’t do this.
Like you, I often wake up in the middle of the night and then doze off for an hour before time to get up. I often wonder if that hurts my morning numbers as my body starts gearing up for the day and then there is no meal to tell my liver to shut off the glucose pump.
In my case, and perhaps in yours, I think high fasting numbers are mostly an insulin resistance/liver dump problem. I have found that when I am being good about exercise, my insulin resistance falls, and thus my morning fasting falls.
That is what I am kinda thinking.
Yes, I do take metformin in the p.m. I was taking 2 - 500mg (p.m.), but he back off a little and so now it is 1 - 500 mg p.m.
Metformin does make my stomach kinda hurt, but I just deal with it.
Hi Jean,
I'm coming to your discussion really late, so I hope that you've been able to work out your DP issues.
I'm reading the new edition of Dr. Bernstein's "Diabetes Solution" that came out November 1.
On page 274, he's talking about what to look out for if you inject several different insulins at the same time. I'm new to all this, so I can't comment usefully on what he's saying. But he also says he does not recommend Lantus for most patients.
I hope that your issues are all worked out so that this information is not needed!
Best wishes,
marty1492
Hi Jean,
I hope you've worked out your difficulties with DP. Since I emailed on Wednesday, I've read more of Dr. Bernstein's new edition.
He has a lot to say about DP and insulin dosage. Also a lot to say about Lantus, especially on page 186 and 293.
Hope this helps if it's still relevant for you.
Best wishes,
marty
II can't remember how long I've been "doing Berrnstein". Somewhere around 7 yeas. I'm a T2 and still using 2 x 500mg metformin as my only medication. I take one in the morning and one with dinner. because I fund my own test strips, I usually test only once per day;unless I feel something's off. [I'm on a fixed pension] Currently my fasting ranges from 4.7mmol/l [84.6mg/dl ] to 5mmol/l [90mg/dl ] On occasions when I've tested at other times of the day, I have reached as high as 6mmol/l [108mg/dl ]. I have had an A1c in the 5.x% range for several years. I not only eat very low carb, I do LOADS of exercise. every day!. I don't think 30 minutees a couple of times per week is enough. I WALK everywhere, which is one of the best ways of integrating exercise into daily life. I used to have a DP problem, but I'm not seeming to at the moment. I have lost a LOT of weight over the years ;about 45 pounds, and I'm trying to lose more. However It has got difficult to shift it.
I eat all kinds of things I don't think Bernstein would approve of. However I keep the portions TINY.
For example, I just made a batch of Grape Jelly from my own vine. What do ytou do with about 100 bunches of grapes, which all ripen at the same time? Most of the jelly will go to my grandchildren, but I had a bit on a slice of home-made flax bread this morning. Delicious and containing sugar, but i only had a LITTLE BIT. It fits the Bernstein principles.
Keeping portions of food DOWN is an answer to many diabetic problems I'm sure
Hell yes. Wake up in am and BG was 238 - 240. at midnight was 120.
Bernstein's program does not deal with the liver being a pain.
I use metformin - standard met. You need to identify dose needed to do job but for me I take 500 mg
at 10:00 pm amd 500 mg at 12:00am and that shuts down liver dawn effect from midnight to 5:30 am on my numbers on met and my body. That is 2.5 hours uptake time; 2hours with liver dawn effect shutdown and 1/2 hour leaving body.
Dose size may matter and need to identify. Do not combine doses into one large dose - does not work.
When I awake, at 5:30 am I take 3 to 4 units of humalog lispro ( lasts 4 to 5 hours followed by met dose 500 mg at 6:00 pm.
The dawn effect can cancel all the good work on your carb/diet program and execise by constantly leaking glucose to the rest of the storage sites - fat cells, skeletal muscle cells and put insulin resistance back on when these local stores filled up.
It is NOT food that causes dawn effect but your body clock and liver. This nonsense usually starts at 3:00 am and peaks around 8:00 am. Some suggest that insulin level in your body causes this as liver cannot see and sits in make glucose mode always instead of fasting mode when gut outputting glucose. Not in my case, any time my BG went sub 70 and liver/brain hopped into action; I would get the french foreign legion starvation march into the sahara with the full pail - full liver dump of liver and sening BG to 511 and sliding back to 278 as heart pumped crap around my large body and averaged out.
For more data see - Salk Institue ans John Hopkins research on this. John hopkins says they know how to establish dose size.
I am not Doctor and not authorized to prescribe for you - I am only sharing what I am doing to stop the mess.
Once liver under control, the low carb-restrained carb and sufficient diet and hearty exercise are critical to keep the local storage of glucose in fat and skeletal muscle cells from topping off on glucose. As long as there is room to store more glucose, insulin resistance is turned off and BG performance is much better.
Also see cell physiology on body skeletal cells and how they process glucose and turn on insulin resistance when cell cannot take any more glucose.
Oh yes, I have cgms running all time especialy when I sleep to watch BG to ensure it doies not go too low.