[Cyborg]

Originally Posted by jen_slc

To me, a bg that goes from 100 to 117 to 111 doesn't show much variation, but I guess it depends on your definition of tight control. If those were my levels, I'd say I was perfectly stable and a "spike" to 117 wouldn't be anything to be concerned about! I'm constantly amazed at how differently it affects us all.

So does anyone think the extent of a bg rise due to liver dump varies within one person or do you think our liver dumps tend to be the same within each one of us? i.e. do people experience both mini liver dumps (small or barely noticeable bg rise) and huge liver dumps (very clear bg spike) or do they generally see the same response in themselves time after time (like me, I just get liver dumps that produce HUGE spikes)?

I'm not used to looking at English units so I didn't realize that the spike wasn't as extreme as it appeared to me at first glance.

I am like you, I see a huge spike when I wake and I will go from around 90 to over 150 within 2 hours, even with an increased basal rate. This will be the first topic I take up with my endo on Monday...

[greendavid]

The hormone-mediated insulin resistance of DP is the most important effect for me, as far as I can tell.

For a long time, I have been mystified why my BG would shoot to 235 at 11 a.m. after a small breakfast. (I'm type 2 on metformin and glyburide.) Then, in the late afternoon, I have to gorge on carbs (relatively speaking) to keep from going low.

It is reassuring to read in two different sources (here and here, cited in previous posts) that there is a medical reason for this behavior by my body. Specifically:

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. ... Dawn Phenomenon, and its associated increase in insulin resistance, is the reason most diabetics are far more sensitive to carbs in the morning.
-- http://www.diabetic-talk.org/dp.htm

[Cyborg]

I never found out from my endo what the cause of the problem was but we did seem to be onto a possible solution for now. I asked him the cause but he did not know. He suggested a modification to the basal rates and it seems to be the key. With a little more fine tuning, we may be able to get it to the point where a morning basal test can be accomplished successfully. Here is close to the insulin requirements my body apparently is needing.

basal settings
12 am - 0.9
6 am - 1.8
8:30 am - 1.5
11:00 am - 1.1
10:00 pm - 0.9

Apparently I require a high increase in insulin right before awaking at 6:30 am. This insulin needs to be enough to offset whatever process my body is peforming to increase my bg after waking. I still have some fine tuning here but this is very close and has seemed to reduce a spike in my bg that I was seeing every morning from below 100 and seeing it rise by itself to nearly 170 a few hours later.

[Cinnabon]

Greendavid explained exactly what we have been explaining. It is a true Diabetic mystery. I suffered from this for a REAL long time until I gat a pump.

Cyborg- with a bit of time you will find the correct settings to the DP. This is a true way to stop this liver madness.