Using alcohol intentionally to manage dawn phenomenon?


#21

cardamom…thanks! Great info.


#22

I’ve always had DP, and never considered drinking booze before bed as a viable alternative. In fact the pump and adjusted dawn basal solves high BS in the morning.

Reducing TDD is an important way to reverse the effects of insulin resistance. Upping my total daily basals has ultimately reduced my TDD by 30%, and resulted in A1C’s in the mid-5 levels. Currently TDD is 65-75% basal, 25-35% bolus.
Jim


#23

Me too Kelly. And it was November! Are you better ? I gained weight.


#24

@cardamom, what was the result on your DP-lowering experiment?


#25

I haven’t actually done it yet in any sort of systematic way—ended up increasing my metformin to 2000mg (ER, split into two doses a day) and switched to Tresiba, and I’m still tinkering with getting my Tresiba dose right, but I think it’s helped some with the DP, although it’s been inconsistent–some days it’s gone, some days it’s there but usually more mild. I have found on that combo that my reactivity to alcohol is even more pronounced (I’m guessing mostly due to the metformin), so I think it would take very little to have an effect at this point. Still might try it once I feel like everything else is set; will update if I do. Did anyone else try it?


#26

I use alcohol regularly to actually prevent a high onset. Now granted it’s just a tiny amount but I use straight, high quality vodka to prevent a high spike after meals often. Please be careful and drink responsibly, never EVER even think about doing this unless you are at home for the evening. A shot before every meal isn’t possible so I need to stress here how moderately and pre planned it should be.


#27

The problem that you raise is one of the number 1 reasons for getting on a pump. Thats what pushed me back onto a pump - a split basal MDI wasn’t cutting it anymore. I may have split it multiple times and it just wasn’t working adequatley.

I believe your strategy could definitely work. But, it might not work consistently because your metabolic response to alcohol may change over time.

If your DP is not consistent, then you might consider that it may be something other than DP.


#28

Since the initial post, I’ve since actually nearly eliminated my dawn phenomenon by using metformin (now at 2000mg, 2x a day), which I know has worked similarly for other T1 diabetics. I think more endos should consider it for T1 patients. Alcohol still furthers that effect, but now that I’m on Tresiba (which is great, but makes making temporary adjustments harder), it typically means I risk drifting low during the night if I have more than one drink.

I think for many people, DP and foot on the floor phenomenon is not necessarily consistent day to day, especially for naturally cycling women. It’s all driven by cortisol waking responses, which can be variable both within and between people (so some people have it more than others, and some people have more variability in how much they have it than others).


#29

DP is highly variable in me, as well, over time. But, day to day, it tends to be fairly predictable. If I don’t see a pattern of behavior then I don’t call it DP. Further complicating definitions, my Doc prefers that I not call it DP unless it starts rising around 3 am in the morning while I’m sleeping. Although, I agree that’s a pretty strong adherence to the strictest definition of the word.


#30

I do have a personal and family history of alcohol abuse, so I don’t drink for this purpose, but I do pursue a parallel strategy. The effect al alchol suppressing DP a bit (or BG more seriously) you are describing is real, and is attributable to the mechanism you mention:

thanks to alcohol’s effect of suppressing liver glucose output

I also suffer from annoyingly regular DP, and have found that doing my intense workouts in the afternoons/evenings does a fantastic job of keeping my DP in control (I find that after a heavy weights session, my next FBG is ~15-20 mg/dL lower than when I don’t). Three days a week of weights, walking to work, eating low-carb, and biking when the weather is nice does a really efficient job at keeping liver glycogen depleted, which means that there is very little fuel available for my liver to dump into the bloodstream as its trying to be helpful every morning…

So yes, I’m following a similar, parallel strategy: I use Metformin and try to keep my liver glycogen as depleted as possible to blunt dawn phenomenon. I’ve also found that even though I don’t consume a lot of carbs, if I consume the majority after I workout (when my muscles are feeling starved), it appears that most carbs I eat go to restoring muscle glycogen (which is never released to the rest of the body) rather than the liver (which is, among other things, a rechargeable glucose battery).


#31

I used to have terrible DP symptoms until I started giving just a small amount of insulin for breakfast with basically NO to very few carbs. This has been a great counter.