Tuesday, November 29, 2005

Hello, I'm Mr. Dawn Phenomenon

My life changed in October of 2003 when I was diagnosed with type 2 diabetes, though how much my life had changed didn't really dawn on me for almost another two years. At first, I was unworried about the diagnosis. With a fasting blood glucose (FBG) level of 131 and an A1C of 7.1, I was convinced that I was "barely over the line" when it came to being diabetic. This was based on the information that in years past, a person was not considered diabetic until FBG reached something like 200. My conclusion was that the doctor had made a hasty diagnosis, and that I was really pre-diabetic. If I watched what I ate, and got a little exercise, all would be well.

I felt vindicated in my attitude three months later when I returned to the doctor's office. My FBG was 85 and A1C had dropped to 6.0. I had lost about ten pounds as well. My doctor was so pleased with my progress, that he encouraged me to keep up the good work, and to come back in six months (instead of the usual three-month schedule which he keeps with most of his diabetic patients).

Six months later I was back. This time FBG was 95 and A1C still around 6, so I was told he didn't have to see me for another six months. I had, however, gained back some of the weight I had lost. I had also let my diet slip a bit, and had stopped exercising as often. At the same time I was under a lot of stress because my mother was dying of cancer. If I had known then what I know now, I would have gotten a glucose meter and started testing. My good checkups had made me complacent about the seriousness of the disease.

After another six months I returned. My mother had passed away two months prior, and I was back up to around 300 pounds. I exercised very little. My diet wasn't completely shot. I still watched what I ate, but was sneaking more high-carb foods like donuts and french fries, which I had previously avoided. My FBG was 110 and A1C was 6.5. The doctor frowned at my weight gain, but told me I didn't have to come back for another six months.

All things considered, I thought I was doing very well, but nothing could have been further from the truth. In about three months I began to have several seemingly unrelated health problems, the most troubling of which was frequent urination.

In August of 2005 I saw the doctor at my six-month checkup, and things were clearly out of control. My FBG was 154 and my A1C was 8.5. Any doubts I might have had about my diabetes were squashed: I was diabetic.

The jump in the numbers got my doctor's attention too. He prescribed metformin; 500mg twice a day after lunch and supper. He also warned that I was in serious need of exercise, and recommended that I work out about 150 minutes per week.

Progress was slow at first. It took a few weeks for the metformin to start to do its thing. Finding an exercise regimen that I liked was also difficult. I began to cut back on carbohydrates, particularly bread, potatoes, and sweets.
After about a month I began to notice a significant lessening of my appetite. It appeared that the metformin was starting to work. I also began to lose weight. I purchased a nearly-new treadmill from a friend who wanted to give it up, and started using it religiously.

Another big step I took was purchasing a glucose meter. Even though the doc had not told me to test my blood sugar, I was curious to know how I was doing. I began testing pretty frequently, trying to get an idea about what would raise my glucose, and to see how well the metformin was working.

My physician had put me back on a three-month checkup schedule. I returned in early November, 2005 to find significant improvement. FBG was 140 and A1C was 7.5. I had also lost 18 pounds. I was sent off with the encouragement to keep doing what I was doing. Most of the other health problems I was having cleared up. I felt better than I had in more than ten years.

This blog is my record of my progress with this disease. I am learning many things about my body chemistry, about nutrition, about exercise, and about this terrible affliction. One of the things I am beginning to grasp is that this disease is very individualistic. It is hard to find the right combination of controls, because what works for one person may not work for another. I think it is important for each individual diabetic to sift through the screeds of information, suggestions, and opinions to find those tidbits which are helpful. This is not easy. The process requires work and patience. I am working on my own answers and this journal is a tool to help me figure out what works for me. I am allowing others to read it and comment on it because some of the things I do or say may be of benefit to other diabetics. I know that reading about what others have tried has certainly helped me.

To many fellow diabetics, the name of my blog will make perfect sense. I frequently experience what is commonly called "dawn phenomenon". Dawn phenomenon occurs when one's fasting blood glucose reading is higher upon waking, than the previous night at bedtime. The difference for me is often 25 to 30 points. Last night, for example, at bedtime my BG was 114 (best reading I've had so far, by the way). This morning it was 140. There are a few theories about what causes such swings, but nobody seems to have a definite handle on it. Furthermore, while some physicians take it seriously enough to prescribe insulin for their patients, others, like my doctor, just shrug their shoulders at it, preferring to only monitor the A1C average. My case is more frustrating because of its inconsistency: some mornings I have it, and some mornings I do not. So far, I have not found any kind of pattern to account for it, and therefore am at a loss to counteract it.

In closing this first post, I want to touch on a topic which I think is most important. There is a lot of talk (particularly at the ADA) about "diabetes management". I would like to make it clear that I am not interested in diabetes management. I am interested in diabetes control. A mere difference in semantics, you say? Not to me. In my mind, the word "management" denotes reacting to situations which are out of one's influence. "Control", on the other hand, has a more confident connotation. It is proactive. The only way to deal effectively with this disease is to hit it head on.

Finally, it is important to have hope. That is why I will be including news about treatment and research breakthroughs on this blog. When I was diagnosed in 2003, I began researching this disease. I am convinced that within eight to ten years there will be a cure for type 1 diabetes. A cure for type 2 will soon follow. Even closer to us are advances in treatment such as non-invasive insulin delivery, non-invasive glucose monitoring, more effective medications to treat insulin resistance, and more studies on the effects of nutrients and supplements on blood glucose. About 170 million people worldwide have diabetes. If all those people were in the same country, it would be the world's eighth largest nation. The market potential alone is enough to spur tremendous amounts of research into treatments and cures. And that is good news for diabetics. Have hope, fellow sufferers, some day this scourge will end.


Anonymous Bonni M. said...

Hey Mr Dawn! I've just been diagnosed with typeII during a hospital stay and I am interested in what you know about dawn phenomenon. I had done some research on the net, trying to find out why my blood sugars were normal (like in regular people normal) all the time, but high in the morning (sometimes 145, sometimes 114, but always higher than 99 or below). What do you know about this and how do I stop it from happening??? Please respond to bonnilovesjc@usa.net, if you just want to e-mail me. I'd really appreciate it!

6:54 AM  
Anonymous Anonymous said...

Mr. Dawn, i also have the so called dawn phenomenon. i was wondering if the previous night's number was 140 instead of 114, what will the outcome be. i have been having a snack of tomatoe, cucumber and some nuts, a piece of cheese just before going to bed to see if this will make a difference. still experimenting. Good luck in bringing the morning numbers down.

8:47 PM  
Blogger NTN said...

Hi Mr Dawn,

I wish I had Type 2 Diabetes instead of Type 1. Check this out: http://www.drmcdougall.com/med_hot_diabetes.html

6:24 AM  
Anonymous Buy Generic Viagra online said...

i also want to now about dawn phenomenon.

6:07 AM  
Blogger RachelleLouise said...

Hi there, diagnosed with type 2 just over a month ago. It's nice to read your blog! It's such a frustrating thing trying to understand the numbers, I haven't met with a dietician yet so that should help. I know quite a bit about healthy eating (doesn't mean I've practiced it) but my sugar counts just don't make sense to me. My doctor said the goal was 140 or less in the morning, I've hit that and the 130's only about four times in the last month, and, all of those tests were taken early in the morning. I just tested here in the 9 am hour and my fasting was 178! I haven't eaten anything yet! What is going on? It seems the dawn phenomenon is at work? Have you found anything to help negate it?

9:36 AM  
Anonymous Anonymous said...

There is a lot of information on how to cure diabetes. Get the transfats out of the cells. Celss can not function right with this devastating chemical in them. Take a lot of omega 3 oils which you entire body needs to function. Take minerals, particularly chromium, magnesium and vanadium. You will see a tremendous difference. Also, eliminate artificial sweetener, starches, white bread. It will be worth the effort.

3:10 PM  
Anonymous Anonymous said...


just read your blog and hope your doing ok. Dr just said I either had pre diabetes or Type II

He is scheduling me for heart tests and so far I have taken a nuclear stress test, a echo sonar heart test, and another one on a bike in a few weeks.

Just trying to wrap my mind about haveing to deal with this. I am 58
I also have psorasis which is a auto immune thing also.

Dr told me to get a flu shot as ppl die that have diabetes from the flu. I have always been able to fight colds and flu pretty well.

any words on flu or colds ?



6:03 PM  
Anonymous Tom said...

A very interesting blog. If you trip over any clinical research being done on Dawn Phenomenon, please pass it on. When I was first diagnosed with type 2, 6 years ago, there was nothing available on it. I thought my morning exercise was causing a 10 to 20 point rise when I tested before an after an hour's aerobic workout. It took quite a while to trip over the fact that my sugar starts at about 80 or 90 at 3 AM, and hits about 200 at Noon, before returning to under 100. When I tried researching online, I found Dawn Phenomenon, "which only affects Type I patients". But then I found chat rooms filled with frustrated Type IIs who were not finding any medical help. I've been on Metformin, at progressively stronger doses. It's never had any effect. My readings are almost always back under 140 2 hours after eating, except before Noon, nothing stops the rise to a Noon high. So far, I have not been able to associate exercise, diet, liquor or even deserts with the morning readings (with the possible exception of Blueberries, after not eating any for months, I ate about a half cup a day and my morning reading fell by 20 points for two weeks, then climbed back up even though I continued the berries). My doctor doesn't know of any medical sources that deal with Dawn Phenomenon for Type IIs. So if you find any, please pass them along.


10:46 AM  
Blogger Sepharad said...

I am sorry not to see any continuing posts about your experiences. Dawn phenomenon is driving me nuts too.

5:50 AM  
Anonymous Donna G said...

Mr. DP--I, too, have type 11, use diet & exercise to control my numbers and have dawn phenomena. I'm religious about food/exercise and lifestyle changes to control my diabetes and had them in the excellent range apart from the dreaded dawn phenomena reading. Then 4 back-to-back crises hit after several years of crisis that I think triggered my diabetes. Stress shot my numbers up. Stress does a number on blood sugar due to cortisol surges (fight or flight hormone.) Dawn phenomena is tied to normal cortisol, adrenelin surges that get us up. You mentioned ginseng helped lower your numbers. It's an adaptogen that helps your body lower or control cortisol. I've recently tried another adaptogen, Rhodiola rosea to lower my overall numbers after reading several medical articles and books suggesting it. (The Blood Sugar Solution, and The Life Extension magazine article, Reducing the Risks of High Cortisol.) If stress induced cortisol is causing your dawn phenomena one of the adaptogens might help. 2 days, 2 tabs of rhodiola and my climbing numbers sank back to the excellent range. I also find that eating a small snack before bed helps my DP (usually an apple with nutbutter for me)so I am not going longer than 7-8 hours without food. Holy Basil tea and Ginseng tea are adaptogens. Would love to hear if anyone has similar success with lowering their dawn phenomena with adaptogens.

4:12 PM  
Blogger Michael Devaney said...

The first thing you need to do is find another doctor! Any doctor that allows your numbers to get that high without major alarm is not doing you any good. In fact he is doing you harm. You simply cannot go 3-6 months thinking your numbers are "better" than before. To shoot for numbers of FG 140 or less is INSANE. Ideally your FG should be less that 86.

And yes there IS a cure for type 2 diabetes. Cut your Carbs!!! Period. In your case since you are highly insulin resistant you need to cut to 30 grams or less daily. You need to be on a LCHF (low carb, high fat) diet. Do NOT let your doctor tell you fat is bad. Their reasoning is based on totally outdated and misinterpreted research from the 70's and 80's. Good fats (olive oil, coconut oil, avocados) are not only good but necessary for your overall health. You follow this diet and I assure you your diabetes will be CURED - not just managed or controlled.

8:39 AM  
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8:42 PM  

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