A DIABETIC DIARY, Part Eight

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.