Living with Diabetes: Dealing with the Dawn Phenomenon
OK, so I’ve been a tad frustrated lately.
A few months ago, my primary took me off one of two medicines I am on for diabetes. It seems this one sometimes makes people dip, an I had seen three or four pretty big dips. Add that to the fact that I had gotten my A1C from an eye-opening 9.8 down to 5.9 in about four months. I had changed a lot of things, including eating habits and exercise.
So you can understand why I was pretty excited that I was being pulled off a medicine.
However, as I figured, my daily readings went up ever so slightly. Not in a way that really made me worry too much, but a tad. Especially in the morning.
In fact, the readings are above where I should be nearly every morning. But, then come lunch, dinner, and after readings … they are fine and normal.
My primary — as well as the diabetes educator I see a few times a year — explained to me that this was actually normal because of something the body does. As long as my other readings were fine, they wouldn’t panic — and neither should I.
Still, higher numbers have to mean something, right? I was all worried my next A1C reading was going to shoot up through the roof.
So, despite not having an appointment until late January, I truly needed to see where I was and got my blood test done. As I thought, my A1C went up, but only to 6.1. Something, I think, that is quite manageable. I want to get it back under 6 again, without a doubt, but I breathed a sigh of relief with that number.
The numbers, though, have still been up.
And even after exercise. I can’t figure that one out. Let me explain this.
I checked my blood one day and it was in the low 90s. I went out and shoveled snow — yes, exercise and it gets your heart pumping — and came back in and it was like 103.
Then I did some serious shoveling after waking up today. This was a solid workout. Now, I didn’t check before (silly), but after it was like 171. I was extremely shocked.
This leads me to the reason for this post — the Dawn Phenomenon. Apparently this happens in all people, diabetic or not. But for diabetics, it’s obviously noted.
From the American Diabetes Association:
All people have the “dawn phenomenon,” if they have diabetes or not.
The dawn phenomenon is a surge of hormones that the body produces daily around 4:00 a.m. to 5:00 a.m.
People with diabetes don’t have normal insulin responses to adjust for this, and may see their fasting glucose go up.
The rise in glucose is mostly because your body is making less insulin and more glucagon (a hormone that increases blood glucose) than it needs. The less insulin made by the pancreas, the more glucagon the pancreas makes as a result. Glucagon signals the liver to break down glycogen into glucose. This is why high fasting blood glucose levels are common in people with type 2.
Steps that may help:
- Eat dinner earlier in the evening
- Do something active after dinner (such as going for a walk)
If your fasting glucose continues to be high, your health care provider may prescribe medication.
I don’t eat dinner that late, but maybe I need to have my evening snack a little earlier, which is extremely doable. And, maybe, if this keeps up, I’ll see about going back on the one medicine I stopped to see if there is a difference. My main goal is — and has been — avoiding insulin. For those who have read my blog, you know that was discussed several months ago and I’ve responded strongly to that.
One thing is for sure — I need to exercise more in the winter. I’ll start working on that, too, as I need to figure that out. This is a time when many people slow their exercising down and I just need to focus and get on it. And start getting to 10,000 steps per day and whatever else.
Speaking of winter exercise — what do you do to stay active when the cold hits?
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