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The “Dawn Phenomenon”

Posted by in Carb Counting, Eats, Insulin, Lifestyle |

type one diabetes dawn phemonemen

Lately, I have been going to bed with a blood sugar around 90-100, and waking up with a blood sugar much higher – between 130 – 170. At first, I thought it was a fluke, but it’s happened several times over the last week. How can my blood sugar increase if I’m not eating any carbohydrates at night?

During my last visit with my Endocrinologist Doctor, he noticed it too after reading my glucose monitor. I asked him if it was because I was eating less carbs and more high protein at night, which was making my liver release more insulin than I needed into my blood stream. He said most likely not because this blood sugar spike would happen a couple of hours after I ate, and not while I slept.

My Endocrinologist Doctor mentioned that our bodies typically release hormones around 4 am, and this was most likely the culprit. And after a bit of online research, I came across the “Dawn Phenomenon” (2), which coincides with his theory, along this my initial speculation about my liver – called gluconeogenesis (1).
 

Why Some Type One Diabetics Wake Up With Higher Blood Sugar

 
Livers that produce too much glucose are one of the main ways diabetes causes high blood glucose levels. Other organs also produce small amounts of glucose. Again, this is called “gluconeogenesis”.

Organs do this to keep blood glucose from going too low at night or other times of not eating. From about 2 AM to 8 AM, most people’s bodies produce hormones, including cortisol, glucagon, and epinephrine. All these hormones increase insulin resistance and tell the liver to make more glucose. The idea is to get you enough glucose to get out of bed and start the day. The whole process is apparently started by growth hormones.

Whether we have Diabetes or not, everyone has a Dawn Phenomenon. Otherwise we’d be too weak to get out of bed for breakfast. But us with Diabetes, we can’t increase our insulin levels naturally, so our early morning blood glucose levels can rise dramatically.

Experts estimate that 25% – 50% of Type 1 Diabetics experience the Dawn Phenomenon. (2)

 

So, How Can Type Ones Prevent the “Dawn Phenomenon”

 
While different methods work for different people, here’s what experts recommend:

  • A protein snack like nuts or cheese at bedtime
  • An insulin pump can help a lot
  • A little alcohol at bedtime
  • Vinegar tablets or a liquid. Research says that most people need 4–6 vinegar tablets at bedtime to avoid a morning spike. There’s not much research, though vinegar has been shown to reduce insulin resistance

Personally, I want to try the vinegar method, as it seems to be the easiest and most natural. I’ll keep you posted on the outcome!

Until then – all my best,

Ashley

 

Information Sources:
(1) http://www.idf.org/sites/default/files/attachments/DV58-2_Debate.pdf
(2) http://www.diabetesselfmanagement.com/blog/controlling-the-dawn-phenomenon/