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Sunday, November, 08, 2009
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Diabetes Awareness Month: Kicking off with type 1 innovations From Petri Dish To Human Trial

Taming the Dawn Phenomenon

David Mendosa
David Mendosa
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Medical Journalist Living with Diabetes and Author of Fitness and Photography for Fun, www.mendosa.com/fitnessblog

After earning a B.A. with honors from the University of California,...

David Mendosa

Tuesday, December 06, 2005
View All of David Mendosa's Posts
Just like diabetes itself, we don’t have a cure yet for the dawn phenomenon. But unlike diabetes, you can’t completely control it. The best you can do is tame the dawn phenomenon. There are a lot of definitions for what the dawn phenomenon is, but the simplest is the government’s ...
  1. Untitled Comment
    Nicky
    Wednesday, December 21, 2005 at 11:20 AM
    A glass of wine and a handful of nuts at bedtime work for me. I think the theory is that the wine keeps the liver busy, so not doing a dump; and the slow-digesting nuts provide a few carbs when the liver checks to see if it needs to put glucose out as part of the dawn phenomenon.
    Reply
    re: Untitled Comment
    Rosemary
    Friday, November 09, 2007 at 02:28 PM

    Hi

          I have the Dawn Effect very high bood level in the am only I'm not a wine person what would you recommend

          What kind of wine? Many thanks

    Reply
    re: re: Untitled Comment
    David Mendosa
    Friday, November 09, 2007 at 03:36 PM

    Dear Rosemary,

     

    I have written quite a bit about the dawn phenomenon, including some promising-sounding suggestions. But I tried them all and the only thing that worked for me was reducing my weight to a normal level. 

    Reply
    re: re: re: Untitled Comment
    montanamuse
    Saturday, September 26, 2009 at 01:33 AM

    I usually have a snack in the evening, nuts or something low carb. ButI have about a 6 - 8 oz glass of skim milk just before bed. And if I wake up in the middle of the night, usually around 2:30 or 3 to use the bathroom, I will have a drink or two of milk then as well, not more than an ounce or two at most. I have been able to keep my morning numbers around 104-110 since starting this. Before that, and when I am unable to do that, they are usually around 150.

    Reply
    re: re: Untitled Comment
    Anonymous
    Wednesday, April 22, 2009 at 03:24 AM

    Hi Rosemary

    How about trying Apple Cider Vinegar or just ginger tea?  If the former, I would suggest using a straw as the vinegar can weaken or erode tooth enamel.  One lady tried ginger tea and found that it worked for her.  Beware of commercial apple cider pills as these have been found to be faked or worse mouldy.

    Cjuan

    Reply
    Sharp Conflict
    Susan Taylor
    Wednesday, May 13, 2009 at 10:24 AM

    What I don't understand is this: a lot of people's advice falls in the circle of "eat less, eat lighter" while a whole other group is loosely suggesting "eat a snack late, eat slow burning food at n ight to fool the liver" - aren't these two camps really contradictory? Which one is correct?

     

    Signed,

     

    Dawn Phenomer

    Reply
    re: Sharp Conflict
    David Mendosa
    Wednesday, May 13, 2009 at 11:18 AM

    Dear Susan,

     

    You are so right! They are indeed in conflict. But since some things work for some people and other things for others, I don't have a general answer. You need to try first what you think will work for you.

     

    Best regards,

     

    David

    Reply
    re: re: Sharp Conflict
    Susan T
    Wednesday, May 13, 2009 at 02:38 PM

    Thank you!

     

    I've admired your work greatly for many years.

     

    Your reply here makes a lot of sense.

     

    My biggest problem these days is finding a doctor that will let me do things my way, e.g. refuse flu shots, refuse cholesterol pills, but work with me on exercise, nutrition, and Metformin when I need to go back on it. I know, I know.

     

    I also recently figured out (for me) that in short term my weight lifting makes my blood sugar go up. But I'll keep it as part of my overall plan.

    Reply
  2. Untitled Comment
    Peter Polk
    Sunday, January 01, 2006 at 03:25 PM
    I have a real problem with the "dawn" phenomena. Some mornings my sugar is 170 or 180 even after taking my pills. If I eat a small protein snack at bedtime, it seems to help get my am sugar into the 120 range.
    Reply
  3. Untitled Comment
    Mary
    Sunday, January 01, 2006 at 06:20 PM
    i'm type 2 and had the dawn phenom. a guy on a diabetes board said to try eating something before i went to bed. i did and it has totally gone away...doesn't matter what i eat either. sometimes i have a small piece of candy, or fruit or even toast. i never wake up high when i have a snack before bed. i often use that snack for some little treat i normally wouldn't have during the day.
    Reply
    re: Untitled Comment
    Anonymous
    Saturday, June 20, 2009 at 12:52 PM

    tell me what did you eat during the day and what time did you stopp eating a regular meal. I am struggling with trying to get my fsting blood sugar below 100.  I have attempted to watch what i eat and how much i eat but my fasting blood sugar level have been between 115 and 120 almost consistently in the am. o

    Reply
    re: re: Untitled Comment
    Anonymous
    Thursday, July 30, 2009 at 07:36 AM

    Gosh,  this is me all over again.  No matter what I do, I have 110-120 in the morning even when every night it is under 100 when I go to bed.  I have not been eating after six but help from contributers on another site have suggested either a teaspoon of peanut butter first thing in the am and/or a lite snack before bed.  I have felt deprived at night so  I may try the snack.  The idea of an apple does not really work for me as fruit shoots me way up.

    Reply
  4. Untitled Comment
    lisa Johnston
    Tuesday, January 03, 2006 at 01:49 AM
    I have started to drink 4 oz of wine every night with a small snack an I've notice a drop in my before breakfast Bs by 15 points....
    Reply
  5. Untitled Comment
    Joe
    Thursday, January 19, 2006 at 04:37 PM
    I have found that having a glucerna drink at night before bed does the trick.
    Reply
  6. Untitled Comment
    Allen
    Wednesday, February 01, 2006 at 03:57 PM
    A better way to do keep your morning sugar down without using alcohol is by using milk thistle before bed. It works directly on the liver in a healthy way and prevents the glucagon output that raises blood sugars. Works great. Allen David's Response David's reply: I am so glad to hear from you, Allen, that milk thistle helps keep down blood glucose! I am taking it for fatty liver, as I wrote at "Fatty Liver" at http://blogs.healthcentral.com/diabetes/david-mendosa/fatty-liver-2005-11-09. Someone else wrote me a comment to the same effect earlier and now I am a believer -- particularly after I got my most recent A1C result yesterday -- 6.1.
    Reply
    re: Untitled Comment
    Anonymous
    Sunday, July 05, 2009 at 01:38 PM

    my blood sugars can be 105 at night but in the morning it is 135.  I do not snack at night after supper.  I am trying to get this down.  What is milk thistle?  My last A1C was 5.3 so that isn't the problem.

    Reply
    re: re: Untitled Comment
    David Mendosa
    Sunday, July 05, 2009 at 05:10 PM

    The active ingredient in milk thistle is silymarin. The best guide this milk thistle -- and all other herbs -- is The Natural Pharmacist. You can find it online at http://www.memorialhospitaljax.com/healthcontent.asp?page=/choice/demonstration/TheNaturalPharmacist-Consumer

     

    Best regards,

     

    David

    Reply
  7. Untitled Comment
    Gail
    Thursday, February 23, 2006 at 10:23 PM
    How much milk thistle? David's Response The standard dosage of milk thistle is 200 mg two to three times a day of an extract standardized containing 70 percent silymarin. There is some evidence that silymarin bound to phosphatidylcholine may be better absorbed. Consequently, this form should be taken at a dosage of 100 to 200 mg twice a day.
    Reply
  8. Untitled Comment
    Richard Petersen
    Tuesday, March 28, 2006 at 01:15 PM
    After reading about the dawn phenomenon I tried an experiment last night. I ate some dry-roasted unsalted peanuts right before bed. My reading before doing this was always 125-135. This morning it was 110! I'm going to talk to my doctor but if this is all that I need to do to fix this DP, wah-hoo!! David's Response Let us know, Richard, if the peanuts at bedtime continue to work for you. Different approaches seem to work better for some people and at different times. Personally, I have recently tamed the dawn phenomenon consistently. When I went on Byetta, as I wrote at http://blogs.healthcentral.com/diabetes/david-mendosa/going-to-byetta-2006-02-17, I found among its many benefits that it also brings down my morning fasting levels to normal.
    Reply
    re: Untitled Comment
    Anonymous
    Wednesday, February 25, 2009 at 12:46 PM

    I curious as to exactly what you and others refer to as your morning blood sugar reading. When I first get out of bed and test mine it's not usually too bad  (130"s).  After being up for an hour (still fasting) my blood sugar has gone up to 170 -  180.  Doesn't seem to matter what I eat the night before, it still goes up after being up for an hour.  Very frustrating and doesn't give me a lot of incentive to stop the junk food at night.

    jmk

    Reply
    re: re: Untitled Comment
    Writer2B
    Friday, June 12, 2009 at 01:53 AM

    It was explained to me that your liver can dump sugar into your system any time you are up, active, and haven't eaten recently. So your BS rising is probably because you need to eat something soon after you get up. Even if you are no ready for a full breakfast, eat a piece of whole wheat toast, fruit, or yogurt. That way your body knows you are handling your body's fuel needs and the liver doesn't have to do it. Then you can finish your breakfast at your normal time.

    Reply
    re: re: re: Untitled Comment
    David Mendosa
    Friday, June 12, 2009 at 08:22 AM

    That makes sense and is a good strategy. In fact, I have been doing that lately and am doing that right now as I write you at 6:21 am. I'm drinking GreensFirst with sparkling mineral water. I wrote about GreensFirst at http://www.healthcentral.com/diabetes/c/17/67280/drink-veggies

     

    Best regards,

     

    David

    Reply
  9. Untitled Comment
    Sam
    Wednesday, May 03, 2006 at 04:10 AM
    1.In addition to the ordinary diatary selection, try making main meal at lunch when you will be active later.2.Try lowering caloric and carb intake at evening meal. I've found that a light meal of veggies and a small portion of protein and fruit at night consistently gives me lower a.m. readings. David's Response: Eating the biggest meal of the day at lunch time makes a whole lot of sense, Sam. Not just to help control the dawn phenomenon but more generally to give your body more time to digest the meal before you go to bed.
    Reply
  10. Untitled Comment
    JJ Jones
    Wednesday, May 17, 2006 at 02:23 PM
    I agree with Peter. I've found that my FBG goes up when I eat a big meal before bed, and particularly with a lot of protein.
    Reply
  11. Untitled Comment
    Alice
    Monday, June 05, 2006 at 03:55 PM
    Has any testing been done on'the dawn phenomenon' on people who prefer evening hours? My 'internal clock runs 1030 to 4AM, when given the option; and my husbands runs noon to 5AM. (Lucky for him, his job gives him that freedom) I'd love to know if it IS dawn or if it's 'wake up time'. This affects my fasting BG at the Dr, because the lab opens at 830, so I sleep in. Before finding your blog, I never knew that this was the worst time to get it done. How many people have been misdiagnosed with 'pending T2 because of this? My Dr diagnoses pending T2 at >120 two years running. Now that I'm testing, I find that 130 is normal for first thing in the morning, but it's 90-110 right before lunch. If they'd told me, I would not have slept in, and would have come in a little later for the test. David's Response: You're right, Alice, that it is really wake up time, not the dawn of the day that governs the dawn phenomenon. It is the body's getting ready for the work of the day, pumping more glucose into your system, that is what's happening.
    Reply
  12. Untitled Comment
    Nancy Meister
    Saturday, July 08, 2006 at 06:53 AM
    Please help!!! I have been on Byetta 3 months and I still am having 200 and above morning readings. If I continue this in 3 more months, I have to go on Lantus. Can you take Lantus and Byetta together? I really like the byetta and it does the job, except for the dawn phenomema. Anyone have a suggestion? David's Response: If your doctor chooses (and many do), yes, you can use Byetta together with Lantus. Byetta doesn't do much to counteract the dawn phenomena, because it works for only 2 to 4 hours after a shot.
    Reply
  13. Untitled Comment
    Anne
    Friday, September 01, 2006 at 05:16 PM
    Hi, I am a borderline diabetic in my fifties. At this time I do not take any medication. However my A1C was 6.1 and my endocrinologist says I must get it below 5.7 soon or else I should begin taking Byetta and Metformin. So I am striving very hard to bring it down. My father was a diabetic and died from diabetes. At this point in time, I have been diagnosed with "metabolic disorder." I am in the process of assembling my health care team. My internist has helped me bring down my cholesterol readings to the excellent range. I am exercising an hour almost every day and my daytime BG readings are completely normal EXCEPT for the early morning one. My endocrinologist told me about the Dawn Phenomenon and suggested that I eat a snack before bedtime. Both my In & Endo docs suggested a little protein and low fat cheese. I am experimenting with different foods and am having great success. Prior to including a nitime snack in my schedule my early morning BG would be somewhere between 115 and 130. Now they are under 110, sometimes even in the 90s. I usually have half a can of Glucerna (for Weight Loss) and a tablespoon of peanut butter. I highly suggest anyone who has this condition to eat something before bedtime and wake up around 5am and take your BG. Even when my fasting BG is normal I will still drink a small glass of milk at this time and when I take my BG at 7am it has fallen to a completely normal range. So eat before bedtime and get up early to see what your BG is and then get another small snack and return to bed and hopefully by breakfast your BG will have fallen. Sorry to be so wordy, this is my first time here...and I must compliment David on all his hard work in providing such vaulable information at one website. David's Response: You are doing great to prevent your pre-diabetes to develop into diabetes, Anne. Keep it up and you won't have the chance of complications that all of us with diabetes have to face.
    Reply
  14. Untitled Comment
    Jessica M.
    Saturday, October 07, 2006 at 11:40 PM
    Jessica M. I'm sorry for little off-topic, but I want to ask you about design of this site. Did you make this template yourself or got from any templates website? Looks pretty cool for me :) Hi Jessica: Thank you for your feedback on this site. The site was created by a professional web designer and it is updated by a content management system. Please continue to give us your feedback on the site. Your comments are very valuable to us. Michele Site Producer
    Reply
  15. Untitled Comment
    Josephine
    Thursday, October 19, 2006 at 01:34 PM
    I am finding the dawn phenomenon a bit challenging in my case. I take Byetta twice a day along with 8mg Avandia, and 30 units of Levemir at bedtime. I go to bed with blood sugars at 115 and wake up at 150. What other insulins do people take to help their morning sugars. David's Response: The dawn phenomenon is a difficult problem for most of those of us with diabetes, and it seems to respond to different strategies at different times among different people. One thing that you might try is to avoid carbs in the evening -- or at least avoid high glycemic carbs. That's because the dawn phenomenon does seem to have a correlation with what you have to eat the evening before. As to your insulin question in relation to the dawn phenomenon, I have never heard that different insulins will make much if any difference in morning fasting levels.
    Reply
  16. Untitled Comment
    Greg
    Saturday, November 04, 2006 at 12:24 PM
    I'd had a hard time getting my infusion pump's dawn basal set correctly to counter my dawn phenomenon, but adding in a CGMS about 3 weeks ago has allowed me to titrate it up from 1.4 U/hr to the 4.2 U/hr that keeps me at 100 mg/dL through the night. I was suprised to see that it too 300% more insulin than I used to require (just turned 40 yr old, type 1 for 34 yrs, A1c 5.8%). Now the only problem is that if the dawn phenomenon doesn't kick in with its usual visciousness, I have a severe hypoglycemic episode in the morning. Fun fun fun. At least the pump now has a hypo alarm on it if I have the CGMS sensor in. Will be hitting up friends and family for CGMS gift cards for Christmas.
    Reply
  17. Untitled Comment
    Rick C.
    Wednesday, November 22, 2006 at 05:21 PM
    I have a question about the sentence in the 3rd paragraph: "It is a rebound from a high blood glucose level in the middle of the night." Do you mean "low" blood glucose level??? Thanks
    Reply
  18. Untitled Comment
    Karen Gonski
    Thursday, November 30, 2006 at 10:59 AM
    Between Somogyi,the Dawn effect or my blood pressure meds I don't know what I have. I do know Other than small bowl of cherrios in a.m. salad no protein gives me a reading of 85 when I come home from work (before dinner) mornings I awake to 120-135. I had to stop one BP med sugar was getting higher but never over 180 not fasting. Can't seem to get straight answers fromPrimary, or Dietician or Diabetes Assn. David's Response: It is hard to figure out what causes high morning numbers. Here is what I wrote in the book The New Glucose Revolution: What Makes My Blood Glucose Go Up...And Down? (New York: Marlowe & Co., July 2006, and other publishers in the U.K., Australia, Taiwan, Vietnam, and Italy): 60. Can you tell me why my morning blood glucose reading is often higher than it was when I went to bed? If you take insulin injections, it could be that the effect of insulin you took is waning. Your blood glucose will rise if you didn’t take enough to keep your insulin level up through the night. Otherwise it is probably the “dawn phenomenon.” The dawn phenomenon is a normal physiological process whereby certain hormones in your body work to raise blood glucose levels before you wake up. These so-called counter regulatory hormones, including glucagon, epinephrine, growth hormone, and cortisol, work against the action of insulin. They stimulate glucose release from the liver and inhibit glucose utilization throughout the body. The result is an increase in blood glucose levels, ensuring a supply of fuel in anticipation of the wakening body’s needs. It’s not true that only people with type 1 diabetes experience the dawn phenomenon. People with type 2 diabetes, can also experience it. Their livers continue to make new glucose even when it’s not needed. In fact, even people who do not have diabetes can experience it, but for them increased insulin secretion by the pancreas keeps blood glucose levels relatively stable. The dawn phenomenon varies from person to person and can even vary from time to time in each of us. A third—much less likely—possibility is called the Somogyi effect or Somogyi’s phenomenon, named for an Austrian-American biochemist who first described the effect in 1938. The Somogyi effect can follow untreated high blood glucose in the middle of the night by going too low as a sort of rebound. You can check if this is happening by measuring if your blood glucose is high at 2 or 3 a.m. But the Somogyi effect is actually much less common that we previously thought.
    Reply
  19. Untitled Comment
    Aundrea
    Tuesday, December 19, 2006 at 09:52 AM
    Hello! And I want to thank you for having answers that have dumbfounded me for several weeks now. I am currently 23 weeks pregnant with my 2nd child. I have had a total of 3 3° glucose tolerance tests with both of my pregnancies and with each test my original fasting level was, what they consider, too high. Each level was still within very normal boundaries under 110, but they wanted it under 94! I am not diabetic nor do I have gestational diabetes, however my Perinatologist wants my fasting level lowered. They have me on a low carb diet and I have been monitoring my levels which seem to be working. Thank you for giving a name to what I have been working with AND for giving me insight on how to lower it!
    Reply
  20. dawn readings
    Anonymous
    Monday, March 05, 2007 at 01:11 PM
    I find that if I don't eat anything after 9 p.m., i will have low blood sugar readings in the morning, but if I eat after 9 p.m, they will be in the 130-150 range.  Any thoughts on why that would be?

    Thanks,
    Mark
    Reply
  21. Dawn Syndrome
    wildflr8
    Sunday, March 11, 2007 at 02:46 PM
    I discovered that I was experiencing the Dawn Syndrome when I was awoke with extreme all over body  sweating, shaking, tremors and confusion.  Checking my blood sugar revealed a level of 60.
    Within 1 hour, my levels had risen to 130.  Metaformin 1000mg at bedtime was creating this problem.  I don't consider it dramatic, my levels remain within norms all day.  I've cut back on the Metaformin, eating something slow burning, the level remains at 130, no matter what I do.  I'm not going to worry about it. 

    Reply
  22. Walking works for me...
    Ken
    Wednesday, May 23, 2007 at 02:43 PM
    Just having a very light meal at night time puts my bedtime sugar between 110-120 (sometimes, even lower). But my morning level goes up to 130-140 in this case. If I have a decent (not too heavy but sufficient) meal at night time and then go for a 30 minute walk, my bedtime is between 140-150 (acceptable, I guess) but my morning sugar comes down to between 110 and 120.
    Reply
  23. Correcting Morning High Glucose Levele
    David C. Murray
    Friday, June 08, 2007 at 05:08 PM

    I've been trying things that have worked for others -- sour apples, protein snacks, vinegar tablets, all at night. So far, I've not had any noticeable success in reducing my dawn phenomenon glucose levels.


    What has corrected the problem, once it is discovered, however, is the vigorous exercise David recommended to me in a private e-mail. Ten (or even five) minutes of vigorous pedaling on my dual-action (Schwinn Airdyne) exercycle does the trick every time. This morning's 139 turned into 112 after just ten minutes on the exercycle. David suggested that the exercise needn't be for too long, but it must be vigorous. Walking for forty minutes in the morning does reduce my levels but not like five or ten minutes on the bike.

    Reply
  24. dawn phenomena and Somogyi effect
    ASHA KHANNA
    Thursday, July 05, 2007 at 11:32 AM
    Iam experiencing dawn phenomena. At 4am my blood sugar starts rising from whatever number it is and continues to rise beyond 9am, but going on becomes very difficult as I get severe headache with quivering in my lips and if I get up and do not eat anything I feel like vomitting. If I eat something and then take medicine, then the BS starts reducing. My problem is how to get fasting BS and fasting cholesterol at 8am. Please advise.
    Reply
    re: dawn phenomena and Somogyi effect
    David Mendosa
    Thursday, July 05, 2007 at 12:49 PM
    Dear Asha,

    My first suggestion would be for you to eat a small, low-carb dinner early in the evening and then not to snack afterwards. That should help you control the dawn phenomenon somewhat better, since your dinner has a direct influence on how high your level goes in the morning.
    Reply
  25. The dawn phenomenon - chocolate and peanut butter
    David C. Murray
    Sunday, July 29, 2007 at 01:45 PM

    As I said in Comment #23, has been the persistent dawn phenomenon. Lately, I've begun eating about one ounce of very dark chocolate which I've read has some antioxidants that are good for cardiac health and, at the same time, I've begun snacking after dinner on about three tablespoons of peanut butter.

     

    What a difference! My morning blood glucose numbers are down a consistent 20 points, and in three weeks I've had no reading higher than 111! For me, this is great news. I don't know if my success derives from the chocolate, the peanut butter or the combination and for now I'm loathe to experiment by cutting out either one. Maybe I'll get brave later and let you know.

    Reply
  26. Dawn Phenomenon
    Al1944
    Wednesday, August 01, 2007 at 04:08 PM

    My blood glucose reading before breakfast is ALWAYS higher than at bedtime, and as someone wrote, it's a bad start to the day.

     

    But a year ago I had sciatica; very painful, couldn't sleep, well I must have slept some, but I was up & down all night in agony for almost a month.

     

    Guess what?  Pre-prandial blood glucose readings better than bedtime, all below 7mmol/L (I think below 126 in US money.) 

    Then, as I recovered from sciatica and got a good night's sleep, all readings were above that figure, too often 8 or slightly above.

     

    I've considered setting my alarm to sleep for, say, 3 to 4 hours, then get up for a little exercise, then back to bed for another 3 to 4 hours sleep.

     

    Reply
    re: Dawn Phenomenon
    David Mendosa
    Thursday, August 02, 2007 at 09:20 AM
    That would be a solution -- albeit a drastic one! I hope that you are able to control your dawn phenomenon some other way. And remember that everyone has it to some degree, whether we have diabetes or not. It's the body's natural way to give us energy to get going in the morning, since our bodies can't produce a cup of coffee for us automatically.
    Reply
    re: re: Dawn Phenomenon
    Al1944
    Thursday, August 02, 2007 at 09:42 AM

    David,  your comment everyone has it (dawn phenomenon) to some degree  makes me wonder if I have it because I'm "a morning person." 

    Reply
    re: re: re: Dawn Phenomenon
    David Mendosa
    Thursday, August 02, 2007 at 10:21 AM
    Easy to know! Just check your blood glucose when you get up and compare it with your level when you went to bed. It's good to know in any case.
    Reply
    re: re: Dawn Phenomenon
    kfleming55
    Tuesday, February 10, 2009 at 05:31 PM

    what is the big deal about morning BS of about 150-160?

    I was told to keep titrating my Lantus until my BS came down...it actually went up along with my weight which is a cyclical problem. I used to walk intensly on the treadmil for 5-6 mins prior to bed and was fine in the morning but my Register, EDucator wasn't impressed. They wanted to keep increasing lantus and maybe start some other injection.

    If this is a normal body effect to rising for the day, and eating and taking insulin at breakfast yields a fine 

    BS by noon, what is the big deal?

    Reply
    re: re: Dawn Phenomenon
    kfleming55
    Tuesday, February 10, 2009 at 05:31 PM

    what is the big deal about morning BS of about 150-160?

    I was told to keep titrating my Lantus until my BS came down...it actually went up along with my weight which is a cyclical problem. I used to walk intensly on the treadmil for 5-6 mins prior to bed and was fine in the morning but my Register, EDucator wasn't impressed. They wanted to keep increasing lantus and maybe start some other injection.

    If this is a normal body effect to rising for the day, and eating and taking insulin at breakfast yields a fine 

    BS by noon, what is the big deal?

    Reply
    re: re: re: Dawn Phenomenon
    David Mendosa
    Tuesday, February 10, 2009 at 05:36 PM

    Unfortunately, it IS a big deal. Any blood glucose levels above the normal range -- that is above 90 mg/dl or so -- are a step toward later complications. That's why those of us who have had diabetes for a long time do our best to control our blood glucose levels.

     

    David

    Reply
    re: re: re: re: Dawn Phenomenon
    Anonymous
    Saturday, July 25, 2009 at 08:24 AM

    David, just found this site.  My husband had been "pre-diabetic" for a long time..now he is waking up with blood sugar at 240 for several days. He has a doctor's appt. on Tuesday, but I am terribly worried.  I read about the dawn phenomenon, but noone's blood sugar seems to be as high as his. He seems afraid to eat anything..should he try snacking before bed?

    Reply
    re: re: re: re: re: Dawn Phenomenon
    David Mendosa
    Saturday, July 25, 2009 at 09:59 AM

    I don't think that a snack before bed will help your husband much. In fact, he needs to eat less, not more. Specifically, he needs to cut WAY BACK on his carbohydrates, particularly starchy carbs (grains, including of course bread, rice, potatoes) and sugar/high fructose corn syrup (particulary soft drinks). It is only the carbs (not fats or protein) that drive us to diabetes. I hope that he can get his diet on track before he joins us.

     

    Best regards,

     

    David

    Reply
  27. Dawn Phenomena and Travel
    Larry
    Friday, October 12, 2007 at 04:17 PM

    I have DP and I also travel globally for my job. When I experience significant time zone changes my DP goes away altogether. In fact my whole sugar issue disappears. I can eat absolutly anything I want (I enjoy those times). As I get over my jet lag the issue starts to creep back and in a week or so it's back to normal. Then I'll fly home and get another week of good times.

    While I'm home I'll take a dose of GLY/Met at bed time and I'm OK.

     

     

    Reply
    re: Dawn Phenomena and Travel
    David Mendosa
    Friday, October 12, 2007 at 04:31 PM
    Larry,

    That's a cure for DP that I have never heard of before! Thanks for writing. And keep on travelling!
     
    Reply
  28. Chia for DP
    Love my Chia
    Tuesday, October 30, 2007 at 04:17 PM

    Try 1-2 TBSP chia in any fluid at bedtime - to combat dawn phenomenon.

    David perhaps you'll write about them?

    Reply
    re: Chia for DP
    David Mendosa
    Tuesday, October 30, 2007 at 06:00 PM
    I do intend to write about chia seeds! I would also like to correspond with you. Could you please email me at mendosa@mendosa.com
    Reply
  29. Dawn Phenomenon
    Dave
    Sunday, March 16, 2008 at 10:02 AM
    It's ironic that blood sugar testing is routinely done after a required all-night fast when, for those of us with dawn phenonmenon, that may be the only time when blood sugar levels rise above normal.  My blood sugar levels without any medication or control are between 75-100 every afternoon before supper.  Yet my levels in the morning before breakfast ran between 120 to 165 and occasionally as much as 200.
    Several years ago (I am a 65-year-old male) I was astounded to learn that I was determined to be an otherwise symptomless diabetic because I had accumulated two (2) morning fasting blood sugar readings of 126 (i.e., over 125) in my lifetime.  I was further astonished to find that I was barred for life from being able to buy health insurance at any cost or even with exclusion because I was non classified me as a diabetic solely based upon these two readings.
    There appears to be little knowledge of or attention paid to the dawn phenomenon in the medical profession.  I knew that what was happening to me was contrary to what was expected by the medical profession.  My blood sugar was supposed to be lowest after fasting, but mine was just the opposite.  I had to research online and diagnose myself.
    I had tried every other natural remedy I could find to control the dawn phenomenon and even the medication glubride in the evening and none had every worked with any consistency.
    I had noticed that I when I went out and ate an evening restaurant meal at [a national Australian-themed chain] consisting of chardonay wine, griller shimp, green beans, grilled pineapple, brown rice, and brown bread with butter, that I would unexpectedly have a reading the next morning of under 100. This would not happen every time I went back but it did more often than not.
    After reading some of these posts I determined to try three things together I had found there and they have worked like gangbusters.  Now my morning readings match my afternoon without any medication.
    In short, I am not a diabetic but a sufferer from dawn phenomenon, though it is too late to convince health or life insurers of that.
    The three additional things I have now added to my bedtime routine after reading the posts here are two 100 mg capsule of milk thistle, one tablespoon of organic peanut butter, and one tablespoon of chia seeds.  I don't know if any one would work by itself, but the 3 definitely do for me.
    Reply
  30. Thank you all for the input -- dawn phenomenon
    Janet
    Saturday, June 14, 2008 at 08:57 PM

    Dear Contributors,

     

    I only recently heard the term "dawn phenomenon" when ordered to a diabetes rehab program by my physician.  My levels were indeed high in the evening, so adding more glyburide at dinnertime did bring them down.  Before doing this, my waking BG would be 200 and even 300.

     

    However, now at bedtime I would read (for example) 92 but on waking I would read 175.  I asked about this at the diabetes rehab program and the nurse mentioned "dawn phenomenon".  I immediately googled this term and found your site.  This explains so much!

     

    I will try some of the suggestions to see if I can bring down my waking BG levels.

     

    Also, one of the most VALUABLE tips I've found is ..... Don't do your blood test labs first thing in the morning!!!

     

    Again, thank you all and I will continue monitoring this site.

     

    Janet (Type II)

    Reply
  31. Frustration with Dawn Phenomenon
    villani95
    Saturday, August 30, 2008 at 07:36 PM

    I could use anyone's help here.  It will be 6 years in Dec when I was diagnosed with type 2 diabetes and all went well with diet, exercise, vitamins and other supplments until 3 years ago when dawn phenomenon began.  I read all of David Mendosa's writings and did additional research and discovered that 1/4 cup of almonds and half a bagel worked for me.  That was until 11 days ago when out of the blue I woke up at 142 and have been in constant hell with morning readings  between 133 and 140!  I can't figure this out.  I began testing before my snack and discovered I was around and average of 120, when I used to be 100 so I am in some vicious cycle.  Any suggestions from anyone would be apprecitated.

     

    Chris

    Reply
    re: Frustration with Dawn Phenomenon
    mamanamwana
    Monday, January 19, 2009 at 05:44 PM

    I can totally relate, dawn syndrome can be very frastruating, but first things first...how are your blood sugars round the clock? You need to work at keeping your blood sugars between normal levels...that is betwee 75 (fasting) to 120 (i.e. if you have eaten lots of carb). This way you gonna keep a healthy life and avoid all diabetic complications. This is by no means easy, but the benefits are enourmous. It takes a lot of discipline and eliminating lots of foods, especially carb and all sorts of sweets.

     

    The thing is the body has a way of regenerating cells, and if you provide your body with the right nutrition and environment, you will start producing new healthy cells, including pancreatic cells. Which means over time, you will see that DAWN PHENOMENON will reduce or go away completely. For example, my current fasting sugars are between 75-83, after eating they may go up to 115, but most of the time they hover around 100. I usually wake up with 92-98. But this is not where I started, the situation was worse than this.When my morning sugars used to go over 100 (this would happen between 6-6:30am), I would wake at around 6am and give myself a shot (2units used to cover me for the dawn phenomenon). You will have to investigate how much insulin will bring you dawn. So that way I would keep my blood sugar levels within normal ranges throughout the day. These days since it doesnt rise that much, sometimes I skip giving myself a short early in the morning to cover morning rises.

     

    But one main point, to take control of your health as a diabetic you gonna have to eliminate certain foods from your diet, and slowly you will see your health improving. If you need help on how to manage diabetes, buy DIABETES SOLUTION by Dr. Richard Bernstein, very good book with every details on how to keep your blood sugars within normal non-diabetic ranges.Most people think it is not possible, but I can assure you it is. I tried it and it worked for me...

     

    Other two books which are very helpful in reversing your situation are The pH Miracle for Diabetes (Dr. Robert O. Yound) and Dr. D. D'Adamo (Eat Right for Your Type). Dr. Young argues that Diabetes is reversible. And I can testify that it is possible. I went on his diet and I reached a point where I did not need insulin at all. This was sometimes in Aug-Sept 2008. I would wake in the morning with no dawn phenomenon and I would have my meals as normal without taking any insulin. Dr. Young emphasises eating Alkaline diet, acidic diet makes your body very acidic which is a perfect environment for all kinds of bacteria and diseases to thrive. Dr. Young argues that, once we provide our body the right envrionment, then our body cells will start to slowly regenerate including Pancreatic beta cells.Well it did happen to me, so at least I can testify that it is it can happen..

     

    Now my situation got worse, in October 2008 when I received news that I was gonna lose my job. Stress started to build up and all of a sudden my blood sugars started to go sky high...I guess you may be away that stress + diabetes doesnt go very well - and Dr. D'Adamo explains why and how you can sort out the situation. For one he emphasises Blood Type Diet, which I agree with as well to a great extent, and explains exercises which are right for different people in order to eliminate the effects of stress. For example, he argues that Blood Type As (which is what I am) have a very sensitive immune system and are susceptible to many cronic diseases including diabetes and stomach cancer. They strive better in a vegeterian diet than other diets. Well vegeterean foods (i.e. vegetables, with the exception of grains) are alkaline. Remember I was already on an alkaline Diet (which is suggested by Dr. Young), when I didnt know about Blood Type Diet. And my condition had improved so much. One more thing, Type As when stressed, they produce a lot of stress hormone Cortisol, which doesnt go away completely even after the  stress is gone, so it keeps lingering on in your system which works very well in breaking down your body cells. Aparently, the best kind of excersise for Blood Type As to eliminate cortisol is Yoga.

     

    Now that my stressing moment is over, and I am still on the diet, my situation has once again improved. Blood sugars are between 75-115 round clock, my morning sugars go up only to a maximum of 98. I have started to do Yoga and I enjoy it, it energises me so much. I think I will get back to levels I was at in Aug/Sept last year if I continue on the diet and lead a healthy lifestyle. The reason I wanna do it is because, it is so refreshing when you do not have to worry about insulin anymore...if thats possible...for sure I would trade anything for it!!

     

    So I encourage you to buy these books, try out some solutions...and see how it works for you! Be patient, you will see outstanding results (if you are serious with the diet) after at least 4months.

     

     

     

     

    Reply
  32. Dawn Phenomenon or Not?!
    Steve
    Tuesday, March 24, 2009 at 12:03 PM

    I found your site very interesting and very informative, but there still seems to be some confusion, certainly on my part!  I have been diagnosed as Type 2, though told probably treatable with diet change.  I have done so and reduced my weight by 25lbs with about 7 more pounds to go.  My readings are within range during the day, before and after meals, but in the morning I regularly hit 140 and as a consequence feel very tired etc.   However, I note some indicate this is might just be normal?  So my main question is - Is 140 in the moring an acceptable reading and if so why does it make me feel so lethargic?  I was thinking of taking a protein shake to combat this - any thoughts please?

    Reply
    re: Dawn Phenomenon or Not?!
    David Mendosa
    Tuesday, March 24, 2009 at 12:28 PM

    Levels of 140 can make you feel fatigued. While I have written about various strategies to combat the dawn phenomenon, my guess is that the best way is to deal first with what you eat the evening before. Generally it helps to eat your dinner early and then to have little or nothing after dinner. Also, if your dinner is very low in carbs, you will be able to prevent high blood glucose levels in the morning. And as you continue to lose weight you will notice that your morning blood glucose levels will also improve.

     

    Best regards,

     

    David

    Reply
    re: re: Dawn Phenomenon or Not?!
    Steve
    Tuesday, March 24, 2009 at 12:44 PM

    David, thank you for your prompt response.

    I take it then that this reading is indeed high and what would be phrased as Dawn Phenomenon.

    If that is the case, my eveing meal is usually finished by 7 pm and is very low in carbs.  (This has been the factor in reducing my weight).

    Is this something that can be controlled by medication or within the bracket that could be dealt with by diet?

    Thank you for your time.

    Reply
    re: re: re: Dawn Phenomenon or Not?!
    David Mendosa
    Thursday, April 23, 2009 at 09:40 AM

    The dawn phenomenon is when your morning fasting numbers are lower than when you went to bed. It is a concern, but high levels an hour or two after eating are a bigger concern. No medication seems to do anything specifically for the dawn phenomenon.

     

    David

    Reply
  33. Weight correlation
    Nick
    Thursday, April 23, 2009 at 05:03 AM

    Does anyone know if there's a correlation between weight and DP? I'm type 2 but don't have the typical overweight couch potato profile. I'm 6ft 2 in and weigh 175 lb (190 cm, 80 kg) and exercise regularly. Between say 10 am and midnight my readings are usually acceptable (but very sensitive to diet), but I have not yet successfully been able to manage my sometimes horrendous waking readings. Although it sounds counter-intuitive, I'll try snacking before going to bed and see what it does. Any comments welcome.

    Reply
  34. diabetes
    Anonymous
    Wednesday, October 28, 2009 at 10:12 PM

    can anyone answer this question for me? if someone has diabetes as a result of being overweight, if he loses the weight, can the diabetes disappear?

    Reply
    re: diabetes
    David Mendosa
    Wednesday, October 28, 2009 at 11:02 PM

    When we have type 2 diabetes (but not type 1) and we get our weight down to the normal range and we eat a very low carbohydrate diet (which doesn't spike our blood glucose) some of us (myself included) have been able to control our diabetes totally without drugs. We don't have any cure for diabetes, but as long as we control our weight and keep our blood glucose in a normal range (probably below an A1C level of about 5) our diabetes will be in remission.

     

    David

    Reply
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