Re: The Dawn Effect

[Guest guest]

> Last night, I had a BS of 119 before

> going to bed. I woke up, and it was 146.

One of the tests you can find in the

literature is the variability of fasting

blood glucose. It should ideally be

fairly constant from day to day.

A variation of FBG over a wide range

from one day to the next is said to be

closely correlated with undetected

hypos at around 3-4 am.

If that is your case then drinking

alcohol is just about the very worst

thing you could do. You might get rid of

your " dawn effect " but you are also

going to deepen your early-morning

hypos for sure! Many medical sources

consider modest early morning hypos

repeated over a prolonged period to be

far be more dangerous than repeated

daytime high BGs over the same period!

> Now, about an hour and a half after

> an egg, 1 oz of cheese and a single

> packet of unflavored oatmeal it's 185.

> Having followed my trends, I know it

> will come back down to around 140

> within the next hour (I just take a

> bit longer than the suggested 2 hours,

> for some reason, but generally within

> 3 I'm OK.)

Breakfast seems always to give the

greatest rise of the day, I don't know

why. The 185 wouldn't bother me and

neither would the 2 and half hours to

get down to 140, provided HbA1c is

acceptable.

> Someone had suggested drinking a glass

> of wine helps with this 'dawn effect.'

I would suggest that you leave out the

wine, that would only confuse the issue.

> The problem is that I'm on Prozac,

> which says 'do not drink with this

> medication' -- and I've found that the

> best way to avoid side effects of it

> is to take it at night.

When does the package insert say to take

it? I have no experience of it but if

the side effects are not serious then

you could obviously try taking it after

breakfast to see if it is having any

influence.

Regards

[Guest guest]

The Doctor and Pharmacist suggested taking the Prozac at

night, as it might make me sleepy, or in the morning if it kept me

awake. I've rotated it around the clock to find the best time to take

it.

For awhile, it was making me feel a bit 'twitchy' (like restless-leg

syndrom) and I was having problems getting to sleep if I took it

too early. I've found that taking it last-minute right before I go to

bed allows me to get to sleep and not have to deal with that side

affect during the day.

SulaBlue

> When does the package insert say to take

> it? I have no experience of it but if

> the side effects are not serious then

> you could obviously try taking it after

> breakfast to see if it is having any

> influence.

>

> Regards

>

>

[Guest guest]

> The Doctor and Pharmacist suggested

> taking the Prozac at night, as it

> might make me sleepy, or in the morning

> if it kept me awake. I've rotated it

> around the clock to find the best time

> to take it.

For not getting twitchy legs, OK, but

have you tried rotating it around the

clock to find the best time for your blood

glucose control?

Just taking a quick look at the Internet

suggests to me that there is a tie-up

between taking fluoxetine hydrochloride

(Prozac) and blood glucose control:

" Fluoxetine may affect the amount of

glucose (sugar) in your blood. If you

take any anti-diabetes medication (e.g.,

glipizide, glyburide, metformin), your

dosage of these drugs may need to be

adjusted when fluoxetine is started or

discontinued. Consult your doctor. "

( http://www.specialty-drugs.com/prozak.html )

and:

" Diabetics: In patients with diabetes,

Prozac may alter glycemic control.

Hypoglycemia has occurred during therapy

with Prozac, and hyperglycemia has

developed following discontinuation of

the drug. As is true with many other

types of medication when taken

concurrently by patients with diabetes,

insulin and/ or oral hypoglycemic

dosage may need to be adjusted when

therapy with Prozac is instituted or

discontinued. "

( http://www.healthyplace.com/medications/fluoxetine.asp )

I have seen recommendations that all

diabetics are well advised to take the

occasional BG reading between 3am and 5am

whenever the opportunity presents itself

naturally anyway and it looks to me as

if that would be even more advisable

when Prosac is taken late at night.

Put it this way: I would!

[Guest guest]

My understanding is that the Prozac 'builds up' in the blood, thus

the reason it takes 4-6 weeks to reach full effect. I haven't noticed

any changes in my glucose re, when I take it. I've *always* had

the 'dawn effect' thing going on.

The 'twitchy leg' isn't just twitchy legs. It's a restlesness that was

driving me batty enough to consider not taking the meds at all

until I found out I could avoid the worst of it if I took it at night. It

does make me somewhat sleepy, too, so taking it during the day

really doesn't work.

SulaBlue

> For not getting twitchy legs, OK, but

> have you tried rotating it around the

> clock to find the best time for your blood

> glucose control?

[Guest guest]

Different things work for differnt people, I eat 1 serving of popcorn

(fiber) around 9pm with fake butter (margarine). It works for me.

not a whiole bag, but just one serving.

> I suffer from " The Dawn Effect. " My doctor told me not to worry

> about it too much (at least when my HBa1C was good) but it irks

> me to no end.

>

> Last night, I had a BS of 119 before going to bed. I woke up, and

> it was 146. GRRR. Now, about an hour and a half after an egg, 1

> oz of cheese and a single packet of unflavored oatmeal it's 185.

> Having followd my trends, I know it will come back down to

> around 140 within the next hour (I just take a bit longer than the

> suggested 2 hours, for some reason, but generally within 3 I'm

> OK.)

>

> Someone had suggested drinking a glass of wine helps with

> this 'dawn effect.' The problem is that I'm on Prozac, which says

> 'do not drink with this medication' -- and I've found that the best

> way to avoid side effects of it is to take it at night.

>

> Any other suggestions?

>

> SulaBlue