just wondering

[KrisinNM]

I was just wondering if anyone knows if there is a correlation between being a "morning person" and the intensity if Dawn Phenomena? I have been a morning person all my long life and my sugars start rising the minute I wake up, even with a big jump in basal rate starting an hour before my usual waking time.

[rzrbks]

Good point.

I, on the other hand, am a middle of the night person and have no problem with "Dawn Phenomenon." But then, I don't think my body even knows what Dawn is.


Unless you're talking about Dawn Wells, and in that case...............{{walks away whistling Sweet Mystery of Life}}

[duck]

That is very interesting! I am NOT a morning person, and have never struggled with Dawn Phenomenon...

[Clint]

I am a morning person and I seem to have this issue as well...

[rzrbks]

Just Googled "Dawn Phenomenon" for images and got this

[nantomsuethom]

and Thomas is a morning person and does have dp issues

I just raised his morning basal not that long ago, the highest basal of the day

interesting

[Harold]

Dawn time to go to bed. :1eye:

[HeatherP]

I don't know if I'd be called a morning person, but I do wake up pretty fast. My sugars go south pretty easily after taking my insulin. I have had a number of dangerous hypos in the a.m.'s (back when I was on N). I do have problems sometimes w/ my fasting sugars. Seems like I'm sort of the opposite of Kris.

Heather

[debaroo]

yup im the dawn person to ...in fact i test sometimes at 3am and im fine perfect reading i wake up 5 hours later and man im high..i wore a sensor and it showed to that i would go low and not feel it and the liver kicking in ..diabetes such an interesting diease :nerd:

[may]

How do you know the liver is kicking in .
Can't a morning sugar go higher without the liver playing a part.
I don't know, it may work that way..
just wonder how a person can know that's what it is ??

[debaroo]

i just always thought if your going low and dont feel it or wake up the liver kicks in ...thats what ive always been told

[may]

And, that may be correct.

But then I wonder why we hear the horror stories that when peoples bs go so low they have to call the ambulance, and some even die. Why didn't their livers kick in if that is a safety value?

[KrisinNM]

This condition is called Somogyi affect, there is a good description on Med-line. Sometimes suspected DP is treated by increased insulin dose in the evening which exacerbates Somogyi. One of those merry-go-round thingies.
Looks like my suspicions about DP are holding up :)

[Harold]

And, that may be correct.

But then I wonder why we hear the horror stories that when peoples bs go so low they have to call the ambulance, and some even die. Why didn't their livers kick in if that is a safety value?
Glucose is stored in the muscles for immediate use and stored in the liver to get you through between meals. Fasting decreases the amount of stored glucose and when insulin levels exceed available glucose then one goes low.

[may]

Thanks Harold...that was "very helpful" and In plain languae where I could understand it. That would seem like a very natuaral thing.

Krisin, I read about the Somogyi...but I didn't understand it!

In thinking I am understanding Harolds explanation that glucose is stored in the muscles and liver for when we need it...
Does that mean that with the dp (the early morning rise) that the liver or the muscles has just risen us up some so that we don't go to low.
Isn't it wonderful for that protection...and a good thing that our body is doing that?

It seems like when we are getting that protection that people freak and hate that morning rise. My next question would be, wouldn't be best to just flow with that morning rise instead of constantly fighting it?

Personally it happens to me sometimes.
I don't fight it...it's for about 4-5 hrs in the morning.
I just figure its what my body wants to do!

OR Am, I suppose to be fighting the dp?

[Clint]

from what I have read about DP, is that upon waking, your brain says 'I need to get the body going' so it tells the liver to dump some glucose in our blood to get us going...

[may]

Thanks, and I'm understanding now that is what the dp is!

So, do you work at fighting that, or do you just accept it as being natural?

[mark-TN]

This gets very complicated, but I will give it a go to try to explain it. The ideal situation thru the night would be to have just enough background insulin floating around to keep our BG’s level through out the night. A typical DP (of coarse everyone is different) for a Type 1 if just the right amount of background insulin is present to prevent gluconeogenesis thru the night is a rise in blood sugar starting just prior to waking up. If additional insulin is not injected this rise will go on for several hours. (gluconeogenesis is the conversion of amino acids from your own bodies protein (ie muscles) to glucose; this occurs when there is not enough insulin present for the body to use stored glucose for fuel) I have seen this “DP” explained many ways, with the following making the most sense: The liver is constantly deactivating circulating insulin throughout the day. This deactivation is accelerated in the early morning hours and can last for several hours after arising. This is just normal human biology that occurs and apparently is our body preparing us for a new day. This phenomenon is no problem for non diabetics; the pancreas just releases more insulin to compensate for the accelerated deactivation of insulin by the liver. Those of us without a properly functioning pancreas, especially Type 1’s, must compensate with injected insulin in the right amount at the right time to stop or prevent gluconeogenesis from occurring.

So where does the “Somogyi effect” come into play? How can a low sugar turn into a high sugar without eating? Let me start by saying that the liver plays a vital role in blood sugar control. In very simple terms it can be said that the liver’s job is to raise blood sugar and the pancreases job is to lower blood sugar. The problem is the liver always assumes that is has a properly functioning pancreas working alone side it to keep blood sugar in a meticulously narrow range. Although both of these organs have a very important job to do, and must work as a team, they do not communicate directly with each other. When we are dependant upon injected insulin for controlling blood sugar levels we are forced to do this with very limited information at our disposal. If you have too much circulating insulin you use up the glucose circulating in your blood stream first, since this is the most readily available. When your blood glucose lowers to a certain level (for me it is at around 55mg/dl) your liver will sense this and release counter regulatory hormones that with signal yet other hormones to be released to effect the release of glucose stored in various tissues in the body. If this glucose release uses up a good bit of your circulating insulin your liver with eventually sense a low level of circulating insulin. When it senses low levels of circulating insulin it assumes that your pancreas will release more insulin to replenish this low level. In anticipation of this assumed release of insulin the liver will release even more hormones aimed at releasing even more glucose to balance out this release of insulin that never happens. There is a very limited supply of stored glucose so your body will quickly start converting amino acids into glucose (gluconeogenesis) . Couple this with the added problem of dawn phenomenon and you can see how you can go to bed with a very good BG and wake up to one that is unbelievably high.

If you have way too much circulating insulin for what your bodies needs are at the time the liver will try to counter act, but it will eventually run out of resources (stored hormones) . The livers job will be done and it will hand it off to other mechanism aimed at trying to raise your bs. Everything but your most vital organs with go into conserve mode and do its best to keep you alive on very limited glucose. Eventually you will go into convulsions. Convulsions are your bodies last ditch effort to release all the stress hormones it can muster. Death from a low sugar in bed is rare. You would have had to take a good size over dose of insulin. You have more of a chance of being killed in a car accident as the result of an even less sever low sugar than from what I described above.

Mark

[may]

Thank you kindly Mark,
I have printed that reply, so I can read it over and over.
I know you worked hard on posting such a good reply, and I want you to know how much I appreciate your time and knowledge.
Thanks again!

[duck]

Let's keep this going: Anyone else who is or is not a "morning person" have or not have dawn phenomenon (did that make sense? :) ).

This has been an interesting observation...