when things go bump in the night
One of the interesting things that I deal with is a rise in blood glucose overnight. I go to bed with a BG of 84 mg/dL (last night), and wake up with a BG of 104 (this morning)! My last meal was about 12 hours ago so what happened?!
This can be the results of two different processes: Dawn Phenomenon and Somogyi Effect.
The dawn phenomenon is a natural part of our bodies circadian rhythm. The evolutionary process developed this so that our ancestors could get up in the morning after a night of fasting and have enough energy to find food. This is great ability to have when your food can run away ( think woolly mammoth ) but not so great when you just need enough energy to open the refrigerator.
The Somogyi Effect is caused by the bodies response to night time hypoglycemia. When BG drops overnight the body reacts by secreting a hormone, glucagon, which signals the liver to start converting stored glucose (glycogen) into glucose. This of course raises your BG.
I notice that my before breakfast morning BG is always higher (about 20 points higher) than my bedtime BG. I believe it's the dawn phenomenon at work. Have you experienced either the dawn phenomenon or the Somogyi Effect and how have you controlled it?
This can be the results of two different processes: Dawn Phenomenon and Somogyi Effect.
The dawn phenomenon is a natural part of our bodies circadian rhythm. The evolutionary process developed this so that our ancestors could get up in the morning after a night of fasting and have enough energy to find food. This is great ability to have when your food can run away ( think woolly mammoth ) but not so great when you just need enough energy to open the refrigerator.
The Somogyi Effect is caused by the bodies response to night time hypoglycemia. When BG drops overnight the body reacts by secreting a hormone, glucagon, which signals the liver to start converting stored glucose (glycogen) into glucose. This of course raises your BG.
I notice that my before breakfast morning BG is always higher (about 20 points higher) than my bedtime BG. I believe it's the dawn phenomenon at work. Have you experienced either the dawn phenomenon or the Somogyi Effect and how have you controlled it?
Tags: Somogyi, dawn phenomenon, hypoglycemia
Replies to This Discussion
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Permalink Reply by Chloe on
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I've totally have the dawn phenomenon. I'll go to bed at 110 and wind up at 200+ in the morning. The wierd thing is as soon as I start moving around and getting ready for work it drops a good 70+ points. I'm not sure if the temporary high is harmful, but considering how fast I drop, I'm not sure how or if you should correct it.
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Permalink Reply by Mollie on -
It is my opinon that going from 84 - 104 is hardly anything for concern - i would be delighted with such results - you could take another meter read and get 84 - meter reads vary greatly back to back -with the DEXCOM double meter read calibration - i often get back to back readings that vary 15% -20%---sometimes more.
I suffer from the dawn phenomenon - my BS raises up to 80 mg within 20 minutes after i wake. if i wake at 120 - i will easily be 200 by the time i am considering eating(prior to getttin basals straight). I have my basal's set to go from .4 (overnight) to 1.6 at 6:00am and that runs for 1.5 hours, then it falls off to 1.15 for another hour and then i drop to .70 for most of the day.
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Permalink Reply by Debi J. on
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Mollie, I exhibit the same thing: b.g. rises 40 - 60 points in the first hour upon waking. But I was thinking it's not actually dawn phenomenon. I thought dawn phenomenon was always before waking and always at a set time (like 5-7 am-ish).
For me, my b.g. will rise in that hour after getting up whether I wake up at 7 am or 10 am. But if I wake up, check my b.g. without getting out of bed and go back to sleep, my b.g. does not go up. Also, the rise is somewhat smaller on weekends than weekdays - so I was wondering if stress of getting up and going to work has an impact. Finally, if I manage to eat in the first 5-10 minutes, it seems to be diminished although it's hard to tell because you have the added factors of food and bolus insulin. Since I don't always wake up at the same time each day, now I just automatically take a bolus when I get out of bed, otherwise I would change my basals.
I agree that a 20 point rise overnight doesn't bother me at all, it needs to be closer to 40-50 for me to think about it. I experienced Somogyi sometimes and reduced my basal to compensate and that helped - but also sometimes if I've eaten a late dinner with a good bit of protein, my b.g. rises through the night.
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Permalink Reply by Kathy on -
I have a very similar deal, which I think is totally separate from dp or som. effect.
My theory is that when you get up, the body senses a shift and in an attempt to get ready for the day, dumps glucose in your bloodstream to give you energy.
If you already have dp going on, this really adds to the chaos.
On weekends, I sometimes go back to bed after my 6 a.m. test - if I sleep until much bast 10, I will easily have a severe hypo. If I get up at 8 or 9, my bg will immediately start shooting up, so I too take a correction as soon as I get up. Plus, morning exercise will easily send me over 300! (No early morning walks for me).
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Permalink Reply by Jen on
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I have a dawn phenomenon that was extremely hard to deal with before I got the pump. I was regularly going to bed at 6, being 6 at 2 or 3am, and then waking up at 11 or 12. If I went to bed at 10 I would easily wake up at 17. The only way I could stop it was by waking up at 3am and giving myself 2 units of Humalog which I couldn't do every night!
Now that I've gotten my pump my basal rate goes from 0.7 to 1.0 from 2-7am, and then goes back to 0.8 for the rest of the day until 10pm. I think it might need a bit of adjusting, because I've been waking up high a few mornings this past week.
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Permalink Reply by M on
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I do the drink of water thing too! I'm glad I'm not alone in that! Alarms just don't wake me anymore, I seem to be just toooooo tired every night.
I get the 'wake phenomenon' - Not sure if it has an official name, but that's what I call it. My BG steadily rises from the time I get up to the time I eat. I don't like to eat as soon as I get up, so instead I have a couple of units of NR to see me through until breakfast.
I get the bouncy Somogyi effect once in a while too, which always freaks me out. The only clues I have to let me know I've been low overnight is the high BG I wake up with and the fact I feel shattered for the day. Thankfully it doesn't happen often, but it's scary knowing I've slept through a low :(
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Permalink Reply by Doris D on -
It sounds like the dawn p to me atleast that's what happens to me on the other hand when things go bump in the night it's usually me having a low! HA!
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Permalink Reply by Manny Hernandez on -
I have experienced the dawn phenomenon quite often. I am a type 1 and I use a pump too, so the way I deal with it is by having a different rate overnight than I do the rest of the day: it works.
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Permalink Reply by Sherrie E on
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As a Type 2, I have had some success controlling the overnight spikes by drinking a Glucerna shake before I go to bed at night.
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Permalink Reply by Ed Parma on -
Hi Khurt - yep dawn phenomenon happens with me alot. I can be 90 before bed and have 120 in the am 6-8 hours late (120 is rare however, mostly 108-110 in th am). I've tried to control it by not having any kind of carb snack before bed, but I have a habit of having an apple with cinnamon chopped up with a little Tupelo honey over it around 10pm. In the daytime - this snack doesn't raise me up a bit but in combo with the natural phenom you mention above, it does raise me up in the morning. The earlier I get up, the higher the number usually - if I "sleep in" say past 9am, I have a pretty normal am reading.
Take care
Ed
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Permalink Reply by sri on
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I have the opposite effect.I go to bed with a BG of 80 to 90, and have woken up almost every day the last 3 weeks at 4:00 am with a BG of 50 to 55. I take 5 grams of carbs, get the BG up to the 70 to 80 range, and try to get some ZZZZZs. At 8:00 am, my BG hovers around the 70s to 80s. Don't know what's going on.Honeymoon period, perhaps?
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Permalink Reply by Linda G on -
I have a similar concern, but do not take insulin or meds...my blood sugars do pretty wild swings, and I too usually get up in the morning wth B.S. higher than they were the night before. In fact, my sugars often dip down right after a meal (way down), and are high 3 to 4 hours later; (around 144)...which shouldn't be happening that late after a meal.
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