Dawn Phenomenon

Dawn Phenomenon: During prime sleeping hours your body may release a high dose of blood sugar. The effects of this early morning release can be problematic for Type 1 diabetics. The Dawn Phenomenon is difficult for diabetics because it leaves them working desperately for control of their blood glucose levels. This is not the most appealing wake up call.

Still, a high blood glucose reading in the morning does not prove that a diabetic has experienced dawn phenomenon. If the insulin in a diabetic wears-off during the night, then that diabetic will have a high blood glucose reading in the morning.

Other Causes
Various hormone releases that can occur naturally during sleep can also create a resistance to insulin within the body of a Type 1 diabetic. These hormones include…

  • Cortisol
  • Epinephrine
  • Glucagon
  • Human growth hormones

Prevention Possibilities
MayoClinc.com provides some remedies doctors may pass along to their patients to better manage the dawn phenomenon.

  • Not eating a carbohydrate snack at bedtime
  • Adjusting your dosage of medication or insulin
  • Switching to a different medication
  • Using an insulin pump to administer extra insulin during early morning hours

A diabetic can work toward better-managed diabetes. Your doctor can help supply an action plan.

Lifestyle and Education Changes
Like the control of diabetes, symptom reductions in the dawn phenomenon depend on the adoption of certain lifestyle alterations. As with the control of diabetes, those changes focus on the foods you eat, and the times in which those foods are eaten. Those changes will have a direct impact on the total amount of required insulin each day.

Many experts suggest the addition of a protein based bedtime snack to help reduce the effects of high blood glucose if the patient is susceptible to the dawn phenomenon. The food digests slowly and can help regulate blood sugar over a longer period of time. Insulin alterations may also be required in an effort to compensate for the occurrence of a swing in glucose levels.

Don’t Skip Breakfast
Most experts insist that skipping breakfast because of high blood glucose is a bad idea. In most cases the addition of breakfast can stop the flood of blood sugar into your system. Diabetics need to understand and appreciate the value of regulated meal times and sleep patterns to the successful managed care of their diabetes.

The Dawn Phenomenon May Actually be Normal
Your body was designed to act and react in a certain way. In a typical body the dawn phenomenon does not cause a problem because the pancreas is able to regulate blood glucose while the hormones listed above are sent to do what they are supposed to do. So, when this situation occurs in a Type 1 diabetic it is not exactly strange, but it is difficult for the diabetic to control.

How Glucose is Released
The liver stores glucose in the form of glycogen. If the body senses a need for glucose, it conducts the needed biochemical changes. Appropriate hormones signal for completion of a process called glycogenolysis. That is the name that biochemists use to describe the conversion of stored energy in the liver (glycogen) into usable energy (glucose).

The sleeping body also carries out a process called gluconeogenesis. During gluconeogenesis, the body converts amino acids into glucose. Like the release of stored glycogen the creation of glucose from amino acids occurs in response to hormonal signals.

The body does not count on the signal from a single endocrine gland. The body of the sleeping diabetic responds to signals from several different glands. The pituitary gland produces growth hormone. The adrenal cortex produces cortisol. The alpha cells in the pancreas make glucagons. The outer layer of the adrenal gland sends out a chemical called epinephrine. Those hormones manage to raise the blood glucose level.

Those hormonal signals cause the cells to become more insulin resistant. Together, the production of those signals triggers the release of stored energy and are responsible for the resulting rise in the level of the blood glucose.

Caught Unaware
Because sleep is important to the diabetic it can be hard to live with the dawn phenomenon because it means allowing your blood glucose to get out of control while you sleep. Sleep is important, but so is managed care. This is why a plan of action based on your doctors best advice may help regulate the glucose shifts allowing you to stress less while you sleep.