Don't understand why.....

[Omlette]

Yesterday, I stayed on plan. I wasn't feeling great nor hungry last night, so I just had a slim fast low carb (2 ecc, no sugar alcohols 4 total carbs), 20 g prot about 8 p.m. for my dinner. I went to bed at 9. I checked my bs this morning, and it was 123. Now, WTH would it be that high when I didn't have carbs last night?

I know that I experience the dawn effect, but it has been getting better. This morning was terrible. I still didn't eat breakfast until nearly 10, and my bs was 104 by the time that I ate.

I wander what I can do differently at night. The only time I truly have a problem with my numbers in first thing in the morn. My post-meal numbers are fine.

suggestions:

[gitfiddle]

Mo, if I had an answer, I'd write a book! ;)

It could be glucogenesis if your bs dropped too low while you were sleeping. Protein from meat does produce some glucose, but I don't know about the shakes.

The first thing I do when I get unexplainable dawn effect is start a record of what and when I ate the night before, what meds or supplements I took in the evening, how well I slept and if I had enough hours, whether I felt stressed when I woke up, etc. Of course, I'm an anal accountant, you may not need to do all that.

I did find that two weeks after I switched my thyroid to evenings I started getting fbs of 120 -130, which freaked me out. When it didn't clear up after a few more weeks, I switched it back to mornings and in a couple more weeks I'm back down to 95 -110 again. Still not low enough, but at least I'm not freaking out any more. I don't have a clue if it had anything to do with the med. At first I thought maybe I had a virus. I was also getting a cortisol or adreneline surge between four and five a.m. That's gone now too (I hope!).

If it's a trend, it could be anything from stress to inflammation to beta cells to liver. I just read Dr. Mikes answer to an off-topic comment on one of his latest blogs, and that's about what he said.

Hope all that rambling makes sense! :paranoid: :D ;)

[Omlette]

I supposed to take my thyroid medicine 2xper day. I frequently only take it once per day, but it is after I get out of the shower in the morn.

Last night, I went to bed earlier than normal - 9 pm - which I needed to do. I slept great. Woke just a little while before 5. My alarm normally goes off at 5. I had been up about 1.5 hours when I took it. That is not abnormal for me. Between 6 p.m and 6:30 a.m. I did not have anything to eat except 1/2 of a fish stick and a protein drink.

I don't think it was the protein drink. I drank one this morning with my breakfast. Checked my bs at 40 min after eating and 1.25 hrs after eating. at 40 mins, it was 134 and at 1.25 hrs it was 91. It was 104 before I ate breakfast.

I definitely have to do some research. I am pretty anal about recording or needing to know numbers/food/etc and why something happens.

[Omlette]

Okay, so more craziness. I took my bs this morning - 113. Not too bad considering that it used to always be at least 10 points higher.

Why so crazy? because I ate a bowl of cheerios before going to bed! Total carb count for the bowl was 30-32 carbs. I had Mexican for dinner. Finished that about 7:30. I didn't eat outside my carb limit for dinner.

So, the night that I don't eat much and have low ecc, my bs goes nuts, but it doesn't on the morning after eating carbs just before bed.

I guess I will keep experimenting. Of course, the cheerios weren't an experiment, they were a craving. I won't eat those often because they bloat my stomach.

[gitfiddle]

Mo, the carbs before bed might have kept your bs from falling so low that your liver felt it had to create more glucose. :confused:

Have you ever been to bloodsugar101.com? Dr. Bernstein used to have a lot of posts in his forum regarding dawn effect too.

[Omlette]

I used to go to his sight last year. I haven't been there in a while though. I will go take a look.

I was thinking along the same lines as you. Maybe my body didn't have to work so hard. I wonder which is better in the beginning stage - make it use up the excess glucose causing the dawn affect, or feed it at night?

[Belfrybat]

I agree with Carol -- having such a low ECC "meal" the night before would have taken you low overnight and your liver went to work. Even though I eat light in the evenings, I make sure to get at least 10-12 ECC. (my personal PP/Bernstein eating plan allows for 20) Otherwise the dawn phenomena is greater. Also, even if I have a high morning reading, I still eat something. If I don't my bgs will continue to rise. Then there's the times I do everything right, eat what I've eaten dozens of times before and my morning bgs. are just plain high. I'm trying to learn not to stress myself out about those times but it's difficult. I don't remember if you are taking insulin, but if I'm running over 100 in the am., I will inject one unit of R for every 10 points I'm over. Then I eat my normal 10-15 ECC brekkie.

[Omlette]

Brigit-Carol - No, I am not on insulin. I haven't been on anything since I had my daughter last year. I am fortunate that my bs's do not continue to rise in the mornings. They will go down 5-10 pts between 6:30 and 9 a.m. without eating.

I don't not eat on purpose, it is just the way that my schedule is in the mornings. I have always been bad about eating after I get to work or while driving. Now, my commute is not that far, so I wait until I get to work. The problem is that when I leave the house, I take my son to school, then my daughter to daycare, so it is another hour before I get to work. I don't take time to eat at home because I don't have time. About the best I could do would be to drink a protein drink while I put on my makeup.

I may just make sure that I have something small each night before I go to bed. I'll see if that helps.

[nrobles]

As long as my AIC is in the normal range, I don't worry that much about slightly elevated morning FBS although I do all in my power to "keep it normal". My AIC used to be over 9 before PP. Now its consistently close to 5.0 which is within the normal range. Worry is stress and stress increases cortisol which increases glucose so why worry?

[Omlette]

My A1C (last fall) was in the 5 pt range. My endo was having a fit about my morning bs levels. I was pregnant at the time. The levels were usually between 120 & 135. Now the bounce between 111 & 125. All my post meal numbers are fine pretty much no matter what I eat. So, with me it is more about me being a pre-diabetic and not ever becoming a full fledge diabetic.

[laughingW]

Have you guys seen the write-up on higher FBS with low-carb, that Peter the hyperlipid guy wrote? It's very interesting. He says, in an LC person with a lower overall HbA1c, that a higher morning FBS just means the person hasn't eaten yet. But a SAD eater it's a different situation.


A LC eater has a FBG of 5.5mmol/l, technically pre diabetic, but blood insulin is 3.5 IU/ml. This is VERY low. Glucose is in very short supply but blood glucose is maintained by physiological insulin resistance, ie the muscles are full of triglycerides assembled from free fatty acids (NEFA) from lipolysis. The LC eater has breakfast, with enough protein from his eggs or particularly casein from his yoghurt to raise insulin from 3.5 IU/ml to 5.0IU/ml. This inhibits lipolysis enough to reduce NEFA in the bloodstream, intramuscular triglycerides fall and muscle insulin sensitivity returns. There's minimal glucose coming from the gut and so plasma glucose drops to between 4.0 and 5.0mmol/l, probably nearer 4.0mmol/l. It fluctuates between 4.0 and 5.0 after and between each LC meal. In the early hours of the morning there is a growth hormone surge and NEFA from lipolysis peak early morning to give insulin resistant muscles and an elevated FBG.

........

A SAD eater has a FBG of 5.5, prediabetic, because he is prediabetic. His muscles and liver are permanently and pathologically insulin resistant. His pancreas is cranking out 50 IU/ml of insulin to just keep that FBG in the 5.5mmol/l range. He eats bagels, jam and a large mocha for breakfast and his blood glucose hits 15mmol/l. His pancreas ups the insulin output as high as it can get it, perhaps to 150 IU/ml and just manages to to get blood glucose back down to 5.5mmol/l before lunch. Lunch is pasta and the cycle repeats.

More at

http://high-fat-nutrition.blogspot.com/2008_08_01_archive.html

[nrobles]

Actually, I am a diabetic. I was on metformin and the "civilized" diet for years. No weight lost for any length of time. Up and down, up and down... On PP I'm in remission. As long as I eat properly I'm off all meds. For a year now. My fbs occasionally spikes. Big deal! I used to run around with a BS of 400!! But I am very careful with my choices. This weekend i'm at an oncology meeting that never happened due to Hurricane Omar who never came. I had a great deal at the resort so I decided to come anyway. Armed with my newfound nutritional knowlege, I choose PP foods at the lavish breakfast buffet. I kept my glucometer at home because I'm being a good boy.