[2sweet4now]

I wake up quite easily between 8:30 - 9:00 a.m.! I guess I am NOT a morning person. I am one of those DP individuals - however, since being on the pump -I'm waking up between 90 - 115 bs!

[Finn]

Originally Posted by BriOnH

that. I find it strange that on the weekends, when I can sleep in I'll wake up low at 11am, but on weekdays when I work I am usually around 180 mg/dl 11am(wo breakfast, never been a breakfast person).

HA! That happens to me too! It drives me nuts because it really puts a damper on trends I thought I was seeing with my blood sugars. In the late night/very early morning hours I am very insulin resistant (basil rate is low but if, for some reason, I need a correction bolus, it takes alot of insulin). What's up with that? Could there be more than one definition of DP?

[duck]

Originally Posted by Finn

HA! That happens to me too! It drives me nuts because it really puts a damper on trends I thought I was seeing with my blood sugars. In the late night/very early morning hours I am very insulin resistant (basil rate is low but if, for some reason, I need a correction bolus, it takes alot of insulin). What's up with that? Could there be more than one definition of DP?

Possibly. From what I read in the books I have and some sites, DP is marked by a rise in blood sugar in the pre-waking hours...One book I have says 3AM (its a manual that the hospital sent me home with years ago). None of them say it happens after waking.

What would be more conclusive, though, is CGMS of those of you who say if you wake early, you get a blood sugar rise worse than if you sleep in. My understanding of DP is you get a rise starting at X time no matter what, and you stay high until you correct...

[JediSkipdogg]

Originally Posted by duck

Possibly. From what I read in the books I have and some sites, DP is marked by a rise in blood sugar in the pre-waking hours...One book I have says 3AM (its a manual that the hospital sent me home with years ago). None of them say it happens after waking.

What would be more conclusive, though, is CGMS of those of you who say if you wake early, you get a blood sugar rise worse than if you sleep in. My understanding of DP is you get a rise starting at X time no matter what, and you stay high until you correct...

What do you consider waking up with a normal BG every morning, but having a carb ratio 4x higher than the rest of the day? For the rest of the day my carb ratio is about 1:19, then for breakfast it's 1:5. During this breakfast time my BG will spike extremely high many times into the 300 and occasion 400 (if I grab a donut for breakfast also) but it always returns to normal 3-4 hours later. My doctor and I call that the DP. Your definition aboves calls that not the DP. So what do you call it duck?

[Cyborg]

Doesn't look like much correlation here...

I'm a morning person and I have strong DP as soon as I wake.

[duck]

Originally Posted by JediSkipdogg

What do you consider waking up with a normal BG every morning, but having a carb ratio 4x higher than the rest of the day? For the rest of the day my carb ratio is about 1:19, then for breakfast it's 1:5. During this breakfast time my BG will spike extremely high many times into the 300 and occasion 400 (if I grab a donut for breakfast also) but it always returns to normal 3-4 hours later. My doctor and I call that the DP. Your definition aboves calls that not the DP. So what do you call it duck?

It's called other hormones, "normal" people suffer from the same thing, they just don't know it. DP starts when you are still asleep, if you have another problem, name it something else. Or heck, go take it up with ADA/JDRF and ask them to re-define DP.

Are you hungry/able to eat when you wake?

[duck]

Originally Posted by Cyborg

Doesn't look like much correlation here...

I'm a morning person and I have strong DP as soon as I wake.

Yeah, this is the first I've seen anyone claim they are not morning people yet get DP...Then again, they could all be like Spike and living in denial that they are of the evil human subset known as "morning people"...:smartass:

(just kidding, just kidding)

[JediSkipdogg]

Originally Posted by duck

It's called other hormones, "normal" people suffer from the same thing, they just don't know it. DP starts when you are still asleep, if you have another problem, name it something else. Or heck, go take it up with ADA/JDRF and ask them to re-define DP.

Are you hungry/able to eat when you wake?

From http://www.diabetic-talk.org/dp.htm

So, what does all this have to do with a high fasting BG? Overnight, usually between 4am and 11am, your body releases some hormones. These are Growth Hormone (GH) from the anterior pituitary gland, cortisol from the adrenal cortex, glucagon from your pancreatic alpha-cells, and epinephrine (adrenalin). These hormones cause an increase in insulin resistance, raising your BG. In addition, these hormones trigger glycogenolysis and gluconeogenesis, adding stored or new glucose to your bloodstream. Dawn Phenomenon, and its associated increase in insulin resistance, is the reason most diabetics are far more sensitive to carbs in the morning.

That last part is exactly what I have. So it's not 100% DP, but it's associated with it caused by it. I have no DP overnight though.

As for the being hungry, I can eat or not. I eat breakfast since that's the most important meal of the day. But there have been mornings where I just skip it alltogether and then about 3 hours after I wake I'm in my 1:19 carb ratio. I only have to give the 1:5 carb ratio if I eat when I first wake up. Once I eat, then about an hour or so later, I'm back to 1:19 again.

[duck]

Originally Posted by JediSkipdogg

From http://www.diabetic-talk.org/dp.htm

So, what does all this have to do with a high fasting BG? Overnight, usually between 4am and 11am, your body releases some hormones. These are Growth Hormone (GH) from the anterior pituitary gland, cortisol from the adrenal cortex, glucagon from your pancreatic alpha-cells, and epinephrine (adrenalin). These hormones cause an increase in insulin resistance, raising your BG. In addition, these hormones trigger glycogenolysis and gluconeogenesis, adding stored or new glucose to your bloodstream. Dawn Phenomenon, and its associated increase in insulin resistance, is the reason most diabetics are far more sensitive to carbs in the morning.

That last part is exactly what I have. So it's not 100% DP, but it's associated with it caused by it. I have no DP overnight though.

As for the being hungry, I can eat or not. I eat breakfast since that's the most important meal of the day. But there have been mornings where I just skip it alltogether and then about 3 hours after I wake I'm in my 1:19 carb ratio. I only have to give the 1:5 carb ratio if I eat when I first wake up. Once I eat, then about an hour or so later, I'm back to 1:19 again.

I know a lot of people who can't eat in the AM, or rather could skip eating and not suffer for it. A LOT of that has to do with the cortisol, HGH and other hormones that help curb appetite while asleep (or else you would get hungry and wake up in the middle of the night). So (and this is duck's theory) those same hormones are making you insulin resistant in the AM...I'd bet most of us suffer from that to some degree.

I never said there was only one "morning sugar increase" phenomenon. And besides, none of us fits into the tidy little box they teach doctors about "diabetes".

[Cyborg]

Originally Posted by duck

DP starts when you are still asleep, if you have another problem, name it something else.

I don't believe that is true as with some people the bg does not start to rise until after I awake. I can get up early in the morning to use the loo, before my normal wake up time, and that alone can kick off the DP.

Originally Posted by JediSkipdogg

As for the being hungry, I can eat or not. I eat breakfast since that's the most important meal of the day. But there have been mornings where I just skip it altogether and then about 3 hours after I wake I'm in my 1:19 carb ratio.

Have you done any morning basal testing? I'd interested in knowing what your bg does if you don't eat until lunch time.

Originally Posted by duck

So (and this is duck's theory) those same hormones are making you insulin resistant in the AM...I'd bet most of us suffer from that to some degree.

I know for sure I'm more insulin resistant in the morning, due to higher carb ratios being required, even when the DP is controlled via the pump.

[duck]

Originally Posted by Cyborg

I don't believe that is true as with some people the bg does not start to rise until after I awake. I can get up early in the morning to use the loo, before my normal wake up time, and that alone can kick off the DP.

Then call it something else. Cyborg, if you slept until 1PM, your sugars would still rise upon waking, right? Would a post-noon rise still be called "dawn phenomenon"? I'm not trying to be facetious, serious question. Maybe "DP" is too broad a term?

[Cinnabon]

Before my pump I had severe dawn Ph.

[Cyborg]

Originally Posted by duck

Then call it something else. Cyborg, if you slept until 1PM, your sugars would still rise upon waking, right? Would a post-noon rise still be called "dawn phenomenon"? I'm not trying to be facetious, serious question. Maybe "DP" is too broad a term?

If the increased insulin resistance, hormone release, etc., all occur, but the the glycogenolysis and/or gluconeogenesis doesn't occur until you rise, what makes it not DP?

During my last appointment I talked to my endo about what was happening when I wake and that I thought it was a liver dump. He wouldn't say one way or another what exactly it was, but he did not say it wasn't DP. I will pose the question again and dig deeper on my next appt 10 days from now.

[duck]

Originally Posted by Cinnabon

Before my pump I had severe dawn Ph.

So...you suffer from it, but you correct it with insulin (and a pump)...

[duck]

Originally Posted by Cyborg

If the increased insulin resistance, hormone release, etc., all occur, but the the glycogenolysis and/or gluconeogenesis doesn't occur until you rise, what makes it not DP?

During my last appointment I talked to my endo about what was happening when I wake and that I thought it was a liver dump. He wouldn't say one way or another what exactly it was, but he did not say it wasn't DP. I will pose the question again and dig deeper on my next appt 10 days from now.

I see what you're saying, and no matter how it is defined, I know you want to get it handled...But if DP and the defining rise in BS (um, blood sugar) occur while asleep, and you wake up normal and go high as a result of waking up, then is that still DP?

This would make an interesting diabetic conference...