So who REALLY knows about the "dawn phenomenon"....?

… more than, “well, I have it”… or “I have some crappy blood sugars in the morning”… I want to really KNOW what is going on, biochemicals, hormones, liver excretions, etc. I haven’t sat and talked it out with my endo yet, and literature is tough to really narrow down, so was hoping you all could shed some light. Man, does it effect me, the “Darn Phenomenon”… :slight_smile:

think the in simplest terms your body notices you haven’t taken on any calories in a while so it thinks you are starving so the liver dumps a bunch of sugar (hope that not too technical :wink: ) into the bloodstream. so you wake up w/ high sugar reading even though you haven’t eaten or done anything for 8 hours. my endo recommended having a snack before bed to let my body know i’m not starving. hope that helps

Interesting… I have always been taking extra amounts of basal in the morning and having to extra-compensate for any food, so I wonder if food before bed would help. I am also really watching my weight, and isn’t there some rule about not eating before bed ? :slight_smile: Thanks for the response!

You can eat something like cheese. It takes a while for it to digest, doesnt raise BG hardly at all, and stays in ur system for a few hours so ur body knows that it’s not starving.
One piece of cheese is like 100 calories (or something like that)

You can have sugar free jell-o too, but i dont think it lasts long in the body. Might not cure ur dawn phenomenon completely.

Joe_h. Thanks! That totally makes sense why when I eat cheese before bed, my BG morning numbers are great! haha. I knew it had SOMETHING to do w that, but wasn’t sure. Just experimented until something worked and then stuck to it (or try to)

The cortex of the suprarenal gland produces cortison (and similar products) to react to different stress situations. This cortison will fuel our own glucose production and we will see the BG rising. If you get up from a lying position the cortex will release tiny amounts of cortisol to help raising our blood pressure to a level that is necessary for the upright position. That is the reason why some people see their levels rising in sports activities (stress). Despite from these quick responses to physical demands the cortex is always producing a certain level of cortisol. At dawn the cortisol level is at its maximum. This increased production releases glucose and that helps to get started for the day. The problem is that we are normally sleeping when the process begins. This will result in a higher BG when we are finally waking up.

The cortisol reaction is highly individual. If you are a late starter it may not even be noticable. But the early starters will have a problem. It seems possible that the cortex can be tricked with a higher BG so it does not have to release cortisol. But in my opinion this is not easy to achieve and can be unreliable. Therefore I would recommend a pump to everyone with a severe dawn reaction. With a pump the basal profile can be adapted to match the cortisol production at dawn.

interesting. I have problems w/ my mid-morning number that I blamed on mymorning coffee(s) which I skipped today and still got a higher spike than I would have liked. hmmm

and oddly a glass of red wine at bedtime usually ehlps me too. my liver is too busy working onthe alcohol to worry about the sugar dump (and the red wine helps w/ insomnia for me)

Cool explanation, thanks. I like getting a better sense of these things at a molecular level. I am one to suffer most when I “put my feet on the floor”… my sugar just starts to cruise upward! I can even wake a little low and still reach high 100s by the time I’m at work. My basal and carb:insulin ratio is higher here to compensate, but I still suffer because I’m not on quite the same exact schedule every day. Thanks so much for the info!

While part of the DP is certainly a hormonal cascade causing your liver to dump blood sugar. Another element of DP is that during the night, your liver gets seriously active clearing insulin. This means that for many diabetics, their insulin requirements go up during the night. If you are on a pump, you can easily respond to this by increasing your basal during key morning hours. If you are on an MDI, you may be more challenged. Some people use a split dosage with more basal during the night, and some even use NPH for its profile to get that little extra during the evening.

My secret weapon is red wine. Drink two hefty glasses of red wine right before bed, and your liver will stay busy metabolizing the alcohol all night and never get around to dumping that blood sugar in the morning. Of course, downing two medicinal glasses of red wine right before you brush your teeth soon disrupts any pleasure you may think you get out of the treatment.

If someone hasn’t already suggested it to you, “Think Like a Pancreas” provides good information about the dawn phenomenon and how it works differently for different people.

I have to tell you, the explanation(1) that you provide is for the “Somogyi” effect, a counterregulatory effect ( While it certainly can be true for some people, it is actually not very common. Some type 1s may have this problem and it can usually be addressed by having a complex carb or protein snack before bed that takes a while to digest overnight. The Somogyi effect occurs when you essentially go “hypo” and have the counteregulatory response but don’t wake up. When you wake up in the 300s and wonder why the sheets are all wet, that is when you should be on the lookout.

You (2) is simply added stressors dumping blood sugar. Most chronic DP comes from simply not have enough insulin overnight. As a T1, particularly one on a pump, you should be able to adjust your basal rates and avoid any serious DP.