Dawn phenomenon.

[Guest guest]

Okay, my BS was 149 this morning about 9:30 am. At 3:30 am it was

117, so in those 6 hours it went up. I had breakfast, took 500 mg

of metformin and took a half hour walk. Immediately after the walk,

before my pill kicked in, it was down to 129. Yesterday after my

walk it went down to 82 and the day before down to 94.

Last week when I was diagnosed I was running 302, 260, etc.

My doc called me and said my results of my blood work from last week

were back and my cholesterol 244 and others very bad. When I told

her my BS was running in the 80s to 130s mostly during the day after

just a few days of metformin, low carb diet, supplements and

exercise, she seemed surprised and said it does not usually work

that fast. I am hoping she will not insist on the insulin.

Does high cholesterol and bad blood fats go along with diabetes?

Also, my blood pressure is borderline.

I am afraid I will have a heart attack and I am catching this too

late. I am 52.

I am following a modified low-carb diet, in that I am eating fish

for protein, and watching my cholesterol. Also walking 60 to 90

minutes a day, but may up that. I have just started all this so I

guess it will take a while to work.

Margaret

[Guest guest]

Maragret,

It sounds like you are making good progress! I eat a low carb diet

(very low carb) fish, chicken, veggies. Also, I have found that my

body is different than what other people suggest which is that if I

eat a very small dinner and no snack my AM fasting number is much

lower. Go figure. My doctor suggested that I take metformin with my

dinner to see if that helped, but I have not needed to do that. (I

only take metaformin in the morning). I have also found that exercise

at night brings down my AM fasting number, but most days I am too

tired to workout at night.

Your milege may vary-- try different things (change only one thing

for about a week I found helps before changing again) to see what

works for you.

Mimi

>

> Okay, my BS was 149 this morning about 9:30 am. At 3:30 am it was

> 117, so in those 6 hours it went up. I had breakfast, took 500 mg

> of metformin and took a half hour walk. Immediately after the

walk,

> before my pill kicked in, it was down to 129. Yesterday after my

> walk it went down to 82 and the day before down to 94.

>

> Last week when I was diagnosed I was running 302, 260, etc.

>

> My doc called me and said my results of my blood work from last

week

> were back and my cholesterol 244 and others very bad. When I told

> her my BS was running in the 80s to 130s mostly during the day

after

> just a few days of metformin, low carb diet, supplements and

> exercise, she seemed surprised and said it does not usually work

> that fast. I am hoping she will not insist on the insulin.

>

> Does high cholesterol and bad blood fats go along with diabetes?

>

> Also, my blood pressure is borderline.

>

> I am afraid I will have a heart attack and I am catching this too

> late. I am 52.

>

> I am following a modified low-carb diet, in that I am eating fish

> for protein, and watching my cholesterol. Also walking 60 to 90

> minutes a day, but may up that. I have just started all this so I

> guess it will take a while to work.

>

> Margaret

>

[Guest guest]

>

> Okay, my BS was 149 this morning about 9:30 am. At 3:30 am it was

> 117, so in those 6 hours it went up. I had breakfast, took 500 mg

> of metformin and took a half hour walk. Immediately after the walk,

> before my pill kicked in, it was down to 129. Yesterday after my

> walk it went down to 82 and the day before down to 94.

If you were 117 at 3:30 am, and were higher 6 hours later, I bet that around

5:30 or 6:30 you were low and your liver fought the low by releasing

glucose... resulting in the 149 at 9:30.

Try a small snack before bed (someone mentioned milk and graham crackers)...

or maybe just a cup of milk.

See if that helps or hurts your 9:30 reading. Try it for a couple of days.

If it doesn't help, then stop it. You may be surprised.

Mike

[Guest guest]

-

> Try a small snack before bed (someone mentioned milk and graham

crackers)...

> or maybe just a cup of milk.

>

>

Milk is not a recommended snack before bed. It IS a recommended

treatment for a hypo. Typically the bedtime snack to help with dawn

phenomenon is supposed to be a protein. If you have a carb it should

be very little and mixed with protein. I worry about people drinking

milk and graham crackers at bedtime. A good combo for an instant high

BG. Please check the links I posted for this condition for help in

figuring out what to do about it.

[Guest guest]

>

> -

> > Try a small snack before bed (someone mentioned milk and graham

> crackers)...

> > or maybe just a cup of milk.

> >

> >

>

> Milk is not a recommended snack before bed. It IS a recommended

> treatment for a hypo. Typically the bedtime snack to help with dawn

> phenomenon is supposed to be a protein. If you have a carb it should

> be very little and mixed with protein. I worry about people drinking

> milk and graham crackers at bedtime. A good combo for an instant high

> BG. Please check the links I posted for this condition for help in

> figuring out what to do about it.

According to the very first link you sent

http://diabetes.about.com/od/monitoringdiabetescontrol1/a/downsomogyi.htm

At the bottom of the page it says:

" Go to bed with a blood glucose level a little bit higher than usual, which

might prevent you from having hypoglycemia overnight.

Also, you might need to add some carbs and fat to your dinner or bedtime

snack, in order to have a slower digestion and available carbs during the

night, for example yogurt with nuts or a slice of whole wheat bread with

peanut butter. "

To top it off, YOGURT is one of the things recommended (basically milk)...

Nutritional info for common, lowfat, no sugar added fruit flavored yogurt

(I know few people who can eat and enjoy plain fat free yogurt) compared to

skim milk are:

Yogurt Skim Milk

0 0 Fat

11 12 Carb

5 9 Protein

Based upon this information it seems that skim milk fits the bill quite

nicely, it's got some carbs and contains more protein than the yogurt, which

will slow down the digestion.

No place does it say you shouldn't have some carbs as/with the snack, in

fact, it recommends it.

A graham cracker (2 " x 1/2 " ) is 5 grams of carbs, so a 1/2 sheet of graham

crackers would be 10 grams of carbs.

Whatever you choose to have for a snack, don't over do it. I'd try a cup of

skim milk for starters. If that helped a little the next day, you could

consider a little graham cracker (assuming of course, you like graham

crackers and milk) ;-)

Keep in mind that it also depends on how long it's been since you last ate

too. If you are going to bed at 3:30 AM, when was your dinner? If it was

3-4 hours, you may need a more significant snack... if it was closer to

3:30, you may just want to up the carbs in your dinner instead.

Bottom line, there is more 'art' than 'science' to balancing your food and

medicines to maintain a healthy blood sugar. Some people react very

differently given the same situations.

You need to experiment a little and keep some records to know what the trend

is.

Personally, I would also consider it safer to assume you are having a low

during the night and try to treat that and see if it helps, than to assume

it's a situation where you need to reduce your carbs... because that could

result in a serious low during the night. I'd much rather wake up to a

blood sugar of 150 than I would have a low during the night (of course I

strive for the balance to have an acceptable waking sugar without having a

low during the night). Some people sleep soundly or don't have as strong of

a reaction to a low, and I believe this is much more dangerous than an

occasional 150 waking blood sugar.

Mike

[Guest guest]

> To top it off, YOGURT is one of the things recommended (basically

milk)...

>

Yogurt is different than drinking plain milk, just as eating a piece

of fruit is different than drinking juice. I still stand by what I

said because drinking milk IS a recommended treatment for a low.

No matter what a person takes for a bedtime snack they need to take

their BG BEFORE eating a snack and then upon rising again.

To really be certain you actually NEED a bedtime snack, one should set

aside 3 days in a row and take a BG reading before bedtime without a

snack, set an alarm for 2 a.m. and take another reading. Then do a

fasting BG and see where the problem is. I can tell you just eating a

snack at bedtime like recommended CAUSED a higher morning reading for

me. Testing shows the real problem rather than assuming or guessing.

A person who is NOT on insulin does not have to worry about a " serious

low " in the middle of the night.

It is the standard diabetic dietician advice and counseling to always

eat a protein WITH a carb so that it slows down how high BG goes up.

Believe me there are a lot of people eating the wrong type of snacks

or too big of ones at night and having problems. Sometimes all that is

needed is a spoonful of peanut butter to solve the probem. Why eat

more than necessary to treat.

[Guest guest]

The point you missed in this site is that they recommend if you have a

carb you should have FAT AND PROTEIN with it. Look at the

recommendation..............yogurt and nuts or bread with peanut

butter...............no carb alone. My point was not having just

carbs. Key......yogurt is eaten with nuts not alone.

>

> According to the very first link you sent

>

http://diabetes.about.com/od/monitoringdiabetescontrol1/a/downsomogyi.htm

>

> At the bottom of the page it says:

>

> " Go to bed with a blood glucose level a little bit higher than

usual, which

> might prevent you from having hypoglycemia overnight.

>

> Also, you might need to add some carbs and fat to your dinner or bedtime

> snack, in order to have a slower digestion and available carbs

during the

> night, for example yogurt with nuts or a slice of whole wheat bread with

> peanut butter. "

>

>

[Guest guest]

>

> To really be certain you actually NEED a bedtime snack, one should set

> aside 3 days in a row and take a BG reading before bedtime without a

> snack, set an alarm for 2 a.m. and take another reading. Then do a

> fasting BG and see where the problem is. I can tell you just eating a

> snack at bedtime like recommended CAUSED a higher morning reading for

> me. Testing shows the real problem rather than assuming or guessing.

>

> A person who is NOT on insulin does not have to worry about a " serious

> low " in the middle of the night.

Fine, it didn't work for you. But the first link you posted recommended a

snack (just different kinds) to treat both the Dawn Phenomenon and the

Somogyi Effect. Dawn Phenomenon recommended a simple protein snack, and

Somogyi recommended a carb/protein.

Since the orginal poster *DID* take a reading at 3:30, and it was 117, I

think that is pretty inconclusive considering there was 6 hours between then

and their wake time. Waking at 2 would add *less* info, rather than more,

because of the time they get up.

Yes, metformin doesn't typically cause an extreme low. However, everyone is

different. From Walgreens website, the metformin info states:

" This medicine usually does not cause low blood sugar, or hypoglycemia, but

this effect may occur if you do not consume enough calories from food,

juices, fruit, or other sources. The symptoms of hypoglycemia include

chills, cold sweat, dizziness, drowsiness, shaking, rapid heartbeat,

weakness, headache, fainting, tingling of the hands or feet, or hunger. It

is a good habit to carry glucose tablets or gel to treat low blood sugar. "

The original poster is newly diagnosed, and as started taking oral meds AND

started to significantly modify their diet... even to the point that their

own doctor was amazed at the significant change in blood sugars.

I stand by my suggestion.. it's not intrusive to the sleep schedule, it

involves a really minor amount of carb intake, it's monitored, and in my

opinion, a simple process to do, simply add a small snack prior to bedtime.

I also don't see how one could consider there is too much of a problem or

risk from 1 or 2 days of the *potential* of a slightly higher blood sugar,

when you are advocating 3 days of testing and the promise of no relief from

a known higher blood sugar during those three days.

By the way, if you have a link saying that milk is not recommended as a bed

time snack, I'd really like to see it. I understand it can treat a low, but

it's also got protein, which would make it acceptable for a carb/protein

snack.

Mike

[Guest guest]

> The point you missed in this site is that they recommend if you have a

> carb you should have FAT AND PROTEIN with it. Look at the

> recommendation..............yogurt and nuts or bread with peanut

> butter...............no carb alone. My point was not having just

> carbs. Key......yogurt is eaten with nuts not alone.

Based upon the nutritional information, milk is not a carb alone.

Also look at

http://www.dlife.com/dLife/do/ShowContent/inspiration_expert_advice/expert_colum\

ns/garnero_0106.html

(another link you supplied)

It specifically states:

" Have a snack with protein before bedtime, like a piece of toast with peanut

butter, or some cottage cheese, or yogurt, or some nuts and small piece of

cheese. "

Note, the effective use of 'or' before and after 'yogurt'. And, how it

specifically emphasises PROTEIN, without the mention of fat.

The point here is to have protein (or fat) with the carbs to slow down the

digestion process. If I were also trying to lose weight, I would lean

towards the protein and not the fat (maybe a 1/2 of a turkey sandwich).

From yet another of your links,

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

It simply states:

" Setting your bedtime BG target a bit higher, will usually prevent you from

having a hypoglycemic event overnight. "

So, you can see, it's not a 'black and white' situation, and none of this

disproves my suggestion.

The all also include one valuable bit of advice, and that is to discuss your

diet and medications with your physician. If you need to alter your food

intake to cope with these, it is best to seek input from your doctor.

Mike

[Guest guest]

For users of insulin that's very good advice.

Take care. Barry UK

Re: Dawn phenomenon.

" Go to bed with a blood glucose level a little bit higher than usual, which

might prevent you from having hypoglycemia overnight.