The Dawn Phenom Blues

So. I’ve read all about it. I experience it almost everyday. But gosh dern it all, the Dawn Phenomenon still makes me crazycrazycrazy. I believe I read in another discussion (maybe one about meters and testing) that one gets used to it and learns to trust that it will indeed come down. But at the moment it sets me off with a nasty feeling for the whole morning. And yes, by lunchtime, I am consistently back in the low 80s. I don’t seem to be able to find the emotional equilibrium to take that first higher # in stride. It always leaves me feeling like I’ve done something wrong, though I can’t figure out what. And perhaps it is that fact that makes it so hard. Does anyone else still struggle emotionally with the impact of seeing the highest # of the day very first thing in the morning? I’ve always believed that getting a positive feeling to the start of a day can carry you a long ways through whatever Life may fling at you later in the day. And I used to look forward to my mornings of caring for kitties and planning the day. Now I lie in bed for an hour dreading getting up to face another d*#*%# ickey poopoo fasting number. Do you ever get calm about this circumstance?..Judith in Portland

No I don’t. Not ever.

High sugars, I am told with confidence, are Not a Good Thing. So how can I possibly “get used to it”? I have tried everything possible to combat the Dawn Phenomenon (I think of a large woman with brown hair. It’s a Brit thing), underinjecting overinjecting with midnight snacks multiple snacking through the night with sensible injections but nothing works.

Am I fed up? Yes. What can I do about it? Nothing. Maybe I should just try to get used to it.
Judith in Portland, believe me you are not alone! Ross x

Sigh… I can relate, but in a totally opposite way. I experience the reverse of the dawn phenomenon i.e. i hit nasty lows early in the morning. Waking up at 5:00am with a BG of 35 every day just plain sucks. And this happens in spite of hitting the sack at midnight with a BG of 112! No doctor seems to have an answer. So, yeah. I can relate to crappy mornings, for all the wrong reasons.

Hi Judith,
Its Beth, I am just cruising thru the forums while waiting for some calls. We have been talking to each other and thought I’d add a (belated) comment about the dawn phenomenon - I am on MDI (multiple daily injections) and have constant problems with the Dawn Phenomenon too. I can obviously keep fiddling with my insulin and compensate with that - its related to a fine balance between basal (long acting insulin - the ‘base’ dose) and bolus ( short acting insulin taken to compensate for any meals) But, the adjustments, after a ‘honeymoon’ period seem to only last so long.
My newest theory (and believe me, I am NOT a doctor) is that, as dawn phenomenon and its relative the symogi effect are related to hormonal issues - insulin is a hormone, that perhaps age and being female have something to do with it.
Think the M word. I am looking into this.
Some ideas:
have you checked your BS at about 2 or 3 am? With dawn phenomenon, BS will rise consistently thru the nighttime (sleeping) period. But, the symogi effect is where the BS dips significantly at about those times and then rebounds (think of an out of control rubber ball bounding from wall to wall and insulin (or, the next meal) as the hand that grabs it and stops the out of control bounding) and results in high fasting BS.
If you have, then just keep on keeping on. Ironically, if you lay in bed, your BS is just ticking quietly higher and higher so you are going to be even more disappointed when you get up. I find that I have to set my alarm and get up at 7 or 8 am to get my best readings (and yes, they are often higher than I would like) I then do my morning injections, and eat - yes eat, funnily enough, a meal sends signals that stop the steady rise of dawn phenomenon BS. I also found that some exercise (and believe me, my morning body with its high BS HATES! exercise) will help.

i am just wondering…how high do you go? i dont know much about type 2 diabetes—been T1 since 4 years old…i am 37 yrs old now. what are your A1C’s? has your endocronologist considered a small amount of lantus or NPH at night to combat this? or even a small about of Novolog?

Judith,
I have to say that the high fasting blood sugars were very bad for me. I would do well up until about 2 am., wake up and be miserable for the rest of the night. I didn’t mention this to my doctor for quite awhile. I had not been checking my blood sugars during the night. I am a type 2 after all. I didn’t know we went through this kind of thing. Well when the doctor started me on insulin after checking my daily log he said we had to start some fast acting insulin and then get my basal under control too. Now I am using Humalog for fast acting during the day and Lantus at bedtime to control the night and early morning times. I no longer wake up to a high blood sugar. We had some unexplained highs that kept coming up during the days also so started a small bolus of Lantus in the mornings as well as using the Humalog after breakfast. I use the Humalog after each meal and with the Lantus on board as kind of a cruise control I am running steadily under 100 each day. I sure hope you get your early mornings worked out. The difference in the way you feel with a normal reading is incredible. The best of luck to you. Please keep us posted and let us know what finally works out for you.

Hi, Saundra,
Do you really take the Humalog after meals? In my experience, it is much more effective if you take it 20-30 minutes before you eat.

That is the most frustrating part of diabetes for me- that you can’t count on anything staying the same from one day to the next. I sometimes wake up with a BG reading of 80-85 and then the next day it’s 103. I woke up in the night and tested recently and I was 97. A couple of hours later, in the morning, I was 82. Sometimes I am in the low 80s and by the time I’ve dressed and gone downstairs I’m up to 100. I have decided to hold off on a basal right now as it doesn’t seem like a good idea if I sometimes have a fasting level of 80. I figure I’m still in the honeymoon phase (Type 1.5) and my pancreas has good days and bad days.

Hi Judith, I am somewhat confused. You say your highest BG’s are your fasting BG’s but your most recent post mentions very good numbers when you get up in the morning. Am I not reading this correctly?

I no longer have trouble because I am pumping but I did have problems before pumping. I would eat a high protein snack at bedtime. That protein actually digests slowly and prevents the liver from dumping glucose into your system at about 3am. There was also a period of time when I would test at 1am and take a small dose of insulin . The 3am and fasting numbers greatly improved. there is a product called Extend Bars that is produced for this purpose. Some people control their DP with these bars.

http://www.extendbars.com

Here is another site dealing with DP:

http://www.diabetic-talk.org/dp.htm

Good luck!..Richard

I can relate. I’m a T2, but having two parents both T2 meant that I caught it early enough to still be on the diet/exercise treatment. Regardless, I can go to bed with a 102-104, and wake up with a 13X. Finally started checking it a few times during the night. One night, low carbs the day before, I went to bed at 104, at 2:30 am it was 111, and I was 133 at 7 am.

I am convinced that I must go somewhat hypog. during the night, and my liver dumps glycogen. Actually, I have a theory that says since I can pretty much wake up fully alert 2 mins prior to any time I set on the alarm, that my body dumps the BG to help me wake up alert.

(I have to have my wife set the alarm to wake up so that I didn’t automatically wake up for the tests…)

I’ve tried the snacks, the exercise, the Peanut butter.

The worse I behave during my eating day prior, the better the next morning is for me to have a lower BG. And vice versa.

The study continues…

Aha! So that helps explain (I thought it might but hadn’t really thought it through) why during my trip (from Wisconsin) to France last winter I had such wonderful low blood sugar readings in the AM. I thought–wow, my body really loves France! But in reality, it was that I was actually defeating the dawn phenomenon by getting up many hours earlier than in Wisconsin. I can’t seem to figure it out exactly and couldn’t then, but this may explain those wonderful readings. It doesn’t explain why, after a few days, my body didn’t get used to this and start the same-old same-old, sending out glucose to oh-so-helpfully (NOT!) get me ready to get up, which is what I understand the dawn phenom to be. But I think I remember the readings did get a bit higher as the week went on, so eventually I would probably have gone back to the same-old high AM readings.

Yes, that seems to be true for me also. The better my BG at night, the worse it is in the AM. And here’s a new one. My doc just put me on extended release Metformin (somehow she neglected to discuss that with me so I’m not sure why, maybe it was to overcome the dawn phenom), but…ever since I’ve been on it, my AM readings are even higher!!

I may have figured out something that works, for me at least! I figured that since the dawn phenomenon is the body’s attempt to say–whoa, better get some glucose in there to help her get up!–if I do that myself rather than wait for my body to do it, because my body always overshoots and sends me way high, it might be more reasonable in the morning. I allow myself one small piece of chocolate (about 3 g. carb) a day, and decided to save it for when I wake up between 3 and 5 am, when my BG is usually fairly low before my liver takes over and starts squirting unneeded glucose around. (I ALWAYS wake up around this time for the bathroom, so that’s no problem.) This morning I ate my chocolate then, and my AM BG was about 20 points lower than it usually is!! Of course that is one night’s test, but it made me feel good. This dawn phenom thing seems like the biggest puzzle about diabetes, and no one seems to have really good answers, at least that work for everyone. But had to share my one-night triumph, anyway!

I am almost always betwween 200-250 in the morning, no matter what I do, I can check it at 3:00 at night and be 110, then wake up at 7 w/ 250, it drives me crazy, so then I exercise and then have breakfast and fall low right before lunch, still cant figure out how to fix it, at least I am not alone

It worked this morning too! I may have finally discovered the answer! For me, anyway. It is possible because I do wake up at that time (3-5AM), invariably, for the bathroom. I don’t like “enjoying” my one piece of chocolate when I’m groggy and just want to go back to bed, and even when I brushed my teeth afterward last night I woke up with that yucky “went-to-sleep-with-candy-breath” feeling, but my BG was MUCH better in the AM, so it’s worth it! (And yes, it’s nice dark chocolate.) :slight_smile:

No, you are definitely not alone.

Forgive the stoopid q from a newbie - I am only just educating myself about this stuff - but why would you worry about an occassional high of 100-105, given that this is not even within the medically accepted diabetic range? Just a question :slight_smile:

I had that…didn’t know what it was, until I got on the Metformin. I thought it was all in my head, and I tried to ignore it for decades. Now I know it has a name.

Dawn phenomenons sucks i have it every day from 380-550 every morning.just went on the deltec cozmo and its like magic It is just going away slowley

jt

Well, I tried some things last month that I posted about here, but none of them worked more than once or twice, which means the fact that they worked once or twice was a fluke. This is the hardest thing because it is so uncontrollable. And it makes me mad when, say, a doctor other than my own (or even my own) or someone else asks me what my “fasting” numbers are, assuming that is sort of my baseline number, when my “fasting” numbers are often the highest my blood sugar gets all day!

The only solution I really have for myself is to remind myself it’s only high for a couple hours before wake-up time and then I eat breakfast (low-carb) as soon as I can, which, oddly and illogically, stops the climbing sugars.