Monday, January 29, 2007


Dawn Phenomenon and Somogyi Effect

A very puzzling aspect of diabetes is the contradiction in everything. Glucose levels can bounce around and there doesn't seem to be a clear cut semblance of rhyme and reason to it all. Some people experience weight gain. Some drop pounds. I fit into that category. Sometimes, I'm satisfied with the food I eat. Other times, I cannot satiate my appetite, no matter how much I eat. I have to be very careful with that, too, not just with the types of foods I consume.

A friend of mine works for a bookstore in Winter Park, Florida, called Bargain Books. It was very nice and extremely appreciated when John gave me two books, Diabetes for Dummies and Cholesterol for Dummies. You can't beat good, caring souls. As I was leafing through the diabetes book, I stumbled upon Dawn Phenomenon in the glossary of terms and decided to explore it online. I have this problem and I know many other diabetics do, too.

My blood glucose level is always higher in the morning than it is at night. Why? It doesn't make any sense that an empty stomach level would be higher. My mother has always said that it's a mystery what diabetes does and how the body reacts to it. Everything can flipflop around and doctors don't always seem to have the answers. My father has maintained that what you ate the day before can have that sort of effect on you the next day. Sounds reasonable enough, but then I stumbled upon that phrase. Everyone experiences Dawn Phenomenon, whether diabetic or not. We all have a biological clock. Technically, this one is referred to as Circadian Rhythms and it is rather simple to explain. Your body uses carbohydrates, protein and fat to store energy and during sleep, you use that stored energy to help keep your chemicals balanced. These "macro-nutrients" are converted to glucose stored in the liver and muscles.

Overnight, your body releases some hormones. They come in the form of Growth Hormones from the anterior pituitary gland, cortisol from the adrenal cortex, glucagon from the pancreatic alpha-cells, and epinephrine, otherwise known as adrenalin. These hormones trigger an increase in insulin resistance and add stored or new glucose to your bloodstream. All of this adds up to higher blood glucose levels and a diabetic can have real problems with it.

This activity normally occurs during the hours from 4am - 11am and explains why my sugar is higher in the morning, but what can be done to resolve it? There are different ways to bring that overnight level down and everyone must experiment on their own. One method is to eat a light snack with a slow digesting fat and protein content, such as peanut butter or deli meats and cheeses. The theory is that it holds your blood glucose level high enough overnight to avoid the problem. Some people eat a green apple, such as a Granny Smith or take vinegar supplements to ward off Dawn Phenomenon or Somogyi Effect, which I will try to explain next. Try eating breakfast when you first get up and test your sugar later. There are different things which may or may not work for you. This is not a disease that has any uniformity to it.

Somogyi Effect is often referred to as Liver Dump and usually occurs in insulin-using diabetics and those who go hypoglycemic during the night. When your glucose level drops too low, the liver kicks in and does its best to stimulate and release glucose. One way to try to determine whether you have Dawn Phenomenon or Somogyi Effect is to test your glucose between 2am - 3am several nights in a row without snacking before you retire. If you test normal, it's likely Dawn Phenomenon. If you test low, it could be Somogyi Effect and setting your target number a little higher before you go to bed may eliminate the problem.

I'm going to try the peanut butter (or cheese) snack before I enter the realm of Sleeptown and see if that helps reduce my glucose in the morning. I've been running around 150-160. If that doesn't help, I might have a small (2 ounce) glass of red wine and see what happens. Alcohol lowers blood glucose and it may do the same thing as eating an apple or taking vinegar pills. Who knows? Like I said, it's a very contradicting disease and it could be either Dawn Phenomenon or Somogyi Effect. Certainly, I will talk it over with a doctor, next time I see one.


  1. Hi, Dave. Saw your comment over on Laurie's blog and I loved your picture (that is New Orleans, right?) so I clicked on over to see your blog.

    I have hypoglycemia, and I almost never eat breakfast. I know that sounds contradictory, but I don't want food in the mornings. Perhaps it's the Dawn Phenomenon. In any event, I keep my blood sugars level by following the CAD plan ( Not a gimmick-- I've been on this plan for over ten years, and it works for me.

    But what I actually started this comment to say is: have you heard of using cinnamon as a dietary supplement to help with carbohydrate metabolism? I just learned about it myself from a (diabetic) friend of my (diabetic) dad. I've been taking it with meals for the past week or so, and I think it helps at least as much as GTF chromium, probably more!

  2. Hi, Laura -

    Thank you for visiting and leaving your comment.

    Yes, that photo was taken in New Orleans, at the St. Louis Cemetery #1, almost 2 years ago. I was on my way to Houston from the Orlando area and had a chance to spend a few hours there.

    I went to the web site you gave. Fortunately, I've never had a real carb problem, but I do miss eating some things, like pancakes and white bread. I'm glad the plan is working for you.

    Are you on any medications? I'm on blood pressure, cholesterol and diabetes pills. I mention cinnamon on several other posts. I've been taking it for months, 1,000 mg/day. That and magnesium and chromium picolinate. Are you familiar with chromium and diabetes? I can't say for sure how much any of them are working because my glucose levels can sometimes be all over the place. I feel that if I wasn't taking those supplements, my numbers would be higher, though. Last night, it was 137. Tonight it was 85. A lot better than my all time high of 438, before I went on anything.

    Good luck and please come back any time!

  3. Sorry, I hadn't had a chance to read all of your posts yet when I left the note. I will look for your cinnamon info!

    I use GTF chromium ("glucose tolerance factor" which is supposed to be more effective than plain chromium picolinate. But I haven't seen any recent studies. I take the cinnamon and GTF chromium whenever I eat carbs.

    I also take Co-enzyme Q-10, calcium, and vitamins.

    I have a long list of meds. I just started taking a new cholesterol drug called Vytorin instead of Lipitor. I take another med called Aldactone for another condition, and I think it helps with carb metabolism. It also keeps my blood pressure really low (both of these are side effects!).

    I will read some more of your blog.

    I live near Beaumont, so you drove right by! (And grew up in La Porte, and went to undergraduate at Loyola, New Orleans, so I've got it all covered!)

  4. Yes, I had read that GTF is more effective than picolinate, but I haven't seen it anywhere. What's interesting is that every doctor has a different opinion on supplements, especially chromium. I think most would agree about cinnamon.

    I definitely have Dawn Phenomenon. I mentioned my sugar was 85 last night. This morning it's 139. I even ate a light peanut butter snack.

    You're definitely on more sophisticated drugs than me. Since I have no health insurance, I am on an older generation of meds, all of which I buy in generic form, like Glipizide instead of Glucotrol.

    I did pass through Beaumont. I mentioned the impending trip to Laurie in a comment and told her I would blow the horn when I get there. I did, but I'm sure she didn't hear it. I was somewhere on I-10. My brother-in-law was at the MD Anderson Cancer Center with leukemia, undergoing a bone marrow transplant. He has since gone into remission.

    Thank you for the interest in reading some of my blog. I guess I kind of got wrapped up in the diabetes thing and have now written a lot about it. I would appreciate your thoughts on anything, though. Tell me if I'm wrong or whatever. I'm hoping others may learn something and the more the voices, the better the answers. Oh, I do write about other things, but this is a relatively new experience for me and I'm still adjusting.