Dawn Phenomenon



The dawn effect, or dawn phenomenon is an early-morning increase in blood sugar, that befalls both Type-1 and Type-2 diabetics. In so much that the fasting blood glucose is the highest of the day, even though careful attention is paid to keeping post-meal readings normal.

  

Why Does This Occur?

At about an hour before waking, the body gets ready for the energy needed to get up and moving, by releasing different hormones, like norepinephrine, cortisol and epinephrine. They stimulate the increase of blood sugar, resulting in the increase of insulin production. In a non-diabetic, this is the necessary energy boost to get going. A diabetic, however, do not have this normal relationship with insulin and the result is an abnormally high fasting blood glucose, instead of an injection of morning energy.

According to some researchers, the released hormones could cause insulin resistance in diabetics, this would explain the rise of blood sugar, resulting in the dawn phenomenon. 

Overnight the liver mops up unused/excess insulin, so there is limited available insulin by the time the hormones stimulate the increase of blood sugar. The hormones also trigger the secreting of insulin to cater for the expected raised blood sugar. This works great for a normal person, but a diabetic ends up with high blood glucose in the morning.

Restricting carbohydrates produce a natural decline in insulin needs and levels, which in turn activates hormone sensitive lipase. Fat tissue is then broken down, and free fatty acids are released into the bloodstream, which are taken up by the muscles, to use as fuel. And since the muscle’s needs for fuel were met, it decreases sensitivity to insulin.

Taking insulin stimulating drugs or insulin injections could result in an abnormally low blood sugar while sleeping. When this happens, the body releases stress hormones to get the blood sugar back to a safe level. By the time the liver starts its morning ritual, there is already an adequate supply of sugar in the blood, with the liver just adding more.

Abnormally low blood pressure also secretes stress hormones that raise the blood pressure and the blood glucose along with it. Low blood pressure could be caused by taking too much blood-pressure medication.

Poor food choices; regardless of the time of day, inferior food choices will impact your glucose levels negatively.

Any of these situations or a combination of them is what instigate the dawn phenomenon.


Know your Fasting Blood Glucose

Always use the readings from a minimum of three consecutive days to come to  more correct conclusions.


You cannot cheer from the side-lines on your own life, you have to be an active participant

Take blood sugar readings at bedtime and before eating in the morning. Another reading during the night, at about 3 a.m. would also be helpful, but it is rather inconvenient. However, overcoming this untimely activity will give greater insight into your dawn phenomenon.      

These tests will show if you do have dawn syndrome. Without these figures, it would be impossible to control a problem, if the existence of the problem is not even known.


Possible Solutions for dawn phenomenon

The timing and the amount of increasing of the blood sugar levels vary from one person to another. It is therefore imperative that any truly workable treatment plan be specifically tailored to each individual.


Trying any method

A bedtime snack works for some. The theory is that while there is still food in the system, the liver will hold back on glucose production. Try it for at least three consecutive days. Take note of the fat/carbohydrate/fibre composition of the snack, to know what nutrition group works the best for you, if at all.

Exercise does improve insulin resistance, letting the insulin you make or take work better. This improvement can last up to 36 hours. Just increasing your daily physical activity will not only be healthier,  but could help to improve fasting blood glucose. There are many ways to be more active, walking at least ten thousand steps must be the minimum daily physical activity. Remember that before starting a rigorous exercise program clear it with your doctor, as some conditions/medications could limit what you are allowed to do.

Medication can also improve on the dawn phenomenon. Take your blood sugar readings to your doctor and together decide on the medication type, dose and schedule changes needed.


Concerns

Many studies have found that raised fasting blood glucose that is NOT accompanied by high post-meal blood sugars, do not relate strongly with the progression of diabetic complications. Even if the fasting blood glucose is elevated, but the rest of the day is tightly controlled, then there is no reason to be concerned.

Furthermore, if you eat a low-carb diet and get borderline high fasting blood glucose  (95 mg/dL - 110 mg/dL), it may not be a cause for concern. Your post-meal blood sugars and HgbA1c levels are more important.

On the other hand, if your post-meal blood glucose levels are not within the acceptable range, take the dawn phenomenon very seriously and do something about it.


For a diabetic, the goal is to get and keep the fasting blood glucose below 110 mg/dL, to prevent complications and have a normal, wonderful, terrific,  active life.

For Contemplation

For a diabetic, the goal is to get and keep the fasting blood glucose below 110 mg/dL, to prevent complications and have a normal, wonderful, terrific,  active life.

You can learn much more about the dawn phenomenon in Blood Sugar 101.



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