question about Dawn Phenomenon

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Carina1962

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Type 2
My morning readings have so far been 7.1 maybe 7.4 but on a few occasions they have hit the 8 mark. Last night i tested before i went to bed which was about midnight and my reading was 6.2 but then this morning it was 8.2, I don't understand, i didn't eat anything before bedtime as i wasn't particularly hungry. I know that there is very little i can do about the fasting glucose level but what i want to know is will these occasional 'high' readings cause problems for me? i will be seeing my diabetic nurse next Monday and will speak to her but it is just concerning me.
 
I think this could be a mild case of the dawn phenomenon. Personally I think your levels are excellent. The odd reading up in the 8s should not cause problems for you. However as this is worrying you speak to you DSN about it.
Keep up the good work
 
I have the dawn phenomina....I wake up between 12-18 EVERY MORNING and its sooo rubbish...am going on a pump next month to hopefully sort it out..

And yes I agree 6-8 is awesome...well done!! Speak to your nurse if you are concerned tho xxxx
 
I'd be very interested to know if any of us have developed a strategy that works for combating this effect. Having started testing only recently, I have no more than a couple of weeks data to go on, but I'm developing a definite upward trend in my fasting level which, at 8.3 this morning, is my highest reading to date (my levels immediately before and 2 hours after meals are pretty good and not giving me any cause for concern).
 
Shelley - I am like you my blood sugar can often be 6 at about 5am and then up to 14 by 7:30. I am getting a pump too, though due to waiting lists it is a distant dream at the moment.
 
rachelha said:
Thanks northerner, that is a good explanation. My problem is a have both of these effects, night time hypos followed by live dump or if I dont have a hypo the dawn effect. Can't win. :confused:
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Hey rachella....it's rubbish isn't it!! I've tried everything at least twice and have battled it for 3 years now, pump is like last resort for me now...getting it in 23 days so will let you know if it does the trick! How long are ure waiting lists?? x
 
Shelb1uk said:
Hey rachella....it's rubbish isn't it!! I've tried everything at least twice and have battled it for 3 years now, pump is like last resort for me now...getting it in 23 days so will let you know if it does the trick! How long are ure waiting lists?? x
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Shelley - I have been on the waiting list about 7 months and probably have about another 8 months to go. The waiting list here was about 15 months when I got on it, apparently it is now up to 2 years!!! How long is it since you got the approval for getting the pump?

Rachel
 
Cliff said:
I'd be very interested to know if any of us have developed a strategy that works for combating this effect. Having started testing only recently, I have no more than a couple of weeks data to go on, but I'm developing a definite upward trend in my fasting level which, at 8.3 this morning, is my highest reading to date (my levels immediately before and 2 hours after meals are pretty good and not giving me any cause for concern).
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how do we get these fasting glucose levels down? mine vary between the 7's and 8's and whatever i have tried (eating a small snack before bedtime) nothing helps, are these damaging?
 
Shelb1uk said:
I have the dawn phenomina....I wake up between 12-18 EVERY MORNING and its sooo rubbish...am going on a pump next month to hopefully sort it out..

And yes I agree 6-8 is awesome...well done!! Speak to your nurse if you are concerned tho xxxx
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That used to happen to me until I reduced my lantus by two units and things got better. But sometime I wake up at 7am at a normal level and by the time I get to work i'm 16 :(
 
Katie - do you eat breakfast before going to work? I find if I dont eat in the mornings by BS just keeps going up. If I eat and have my insulin about 20mins beforehand and eat a low GI breakfast then it is not too bad, but I need to get breakfast in me early.
 
Hmmm....going right back to the start of the thread, I think expectations should be different for T1 and T2 as far as FBG is concerned. T1s have the whole night-hypo avoidance issue where T2s do not. While 6-8 might appear to be acceptable for a T1, its too high for a T2.

And the OP (original poster) is T2.

I am personally disappointed at any FBG over 5.5 mmol/l. 4.5 is much more like it.

Part of the difference for T2s is the morning IR issue. Most people, diabetic or not have some degree of IR in the morning. This seems to hit the majority of T2s. So having IR in the first place, the mornings can mean much higher IR for a T2 than any other time of day.

So its the worst possible time to have high BG because whatever you eat is going to raise your BG further. The recommended weetabix breakfast will raise my BG by 6 points. An omelette by only 1. But starting at a BG of 8, I will be overrange (I never like to go over 8). Starting the day at around 4.5 gives me some more flexibility (and 3.5 is not comfortable).

Its just one of those cases where there are different factors for T1 and T2 so its important to bear that in mind when making comparisons between results and targets.
 
Hi again Carina,

I'm a Type 2 like yourself and I've found that my on rising fasting level seems to reflect my overall control - i.e. if my results throughout the day/week are good then my on rising fasting level is more predictable and lower. Also, as I have improved my overall control then my morning level has dropped and is now consistently less than 6.

However, I still do occasionally see a slightly higher than expected morning reading of say 5.8 or 5.9 and can't always seem to tie it exactly to something that happened the night before.

I don't worry about it!

Best wishes - John
 
Cliff said:
I'd be very interested to know if any of us have developed a strategy that works for combating this effect. Having started testing only recently, I have no more than a couple of weeks data to go on, but I'm developing a definite upward trend in my fasting level which, at 8.3 this morning, is my highest reading to date (my levels immediately before and 2 hours after meals are pretty good and not giving me any cause for concern).
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Hi Cliff,

In my opinion, the on rising fasting level seems to reflect my overall control - i.e if that is good then my morning reading is more consistent and lower.

If you have achieved good control of your before eating and 2 hours after eating readings, why not now start looking at your one hour after finishing eating levels and try to lower some of the spikes by adjusting what you eat in some small way? That technique seems to have brought down my morning fasting levels.

Best wishes - John
 
At the moment I am reading a book 'Type 2 diabetes, the first year' by Gretchen Becker (which is highly recommended). Throughout the book she mentions keeping to BS levels between 4 - 7 mmol. She doesn't say whether these numbers should be throughout (ie before meals and after meals). Apart from fasting levels, i tend to manage these figures before meals but not always after 2 hours eating but because it states on the NICE guidelines for Type 2's that 2 hours after eating should be 8.5 or below I have taken note of this but then when i read something else about levels somewhere else it is totally different, in some articles a lot lower levels should be expected. It is no wonder that all this is confusing :-(
 
rachelha said:
Katie - do you eat breakfast before going to work? I find if I dont eat in the mornings by BS just keeps going up. If I eat and have my insulin about 20mins beforehand and eat a low GI breakfast then it is not too bad, but I need to get breakfast in me early.
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sorry, only just seen this. sometimes I leave it till I get to work and I do rise. But I try to eat early and take my insulin early like you said. I still usually go too high but that's probably because I eat weetabix and I haven't got round to buying something different yet 🙂
 
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