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WebMD
a day ago
- Health
- WebMD
Diabetes Detective Work: Dawn Phenomenon
File this column under 'Life with Type 2 diabetes can be a pain.' Yesterday, my glucometer flashed a message to tell me that over the past week, my morning blood sugars had been trending upwards. This was followed by a programmed question directed at me: 'Has anything changed?' Look, I know the notification was purely informative and that the inquiry made sense. After all, consistent high blood sugars over time can lead to those nasty complications we all want to avoid. And yet, for some reason, at that moment, the question seemed less of an innocent question and more of an assault. 'No!' I shouted at her screen (I long ago determined that my meter is 'she/her.'). 'Nothing's changed. Everything is the same.' 'Is someone here?' my husband asked as he entered the kitchen. Ignoring his question, I stonily reviewed my activities and intake over the past week. As usual, I consumed a lowish number of healthy carbs, enough to fuel my hour-a-day exercise plan and keep my weight in a good range. Of course, there may have been a slice or two of carrot cake with sugary cream cheese icing for my son's 33 rd birthday. And a little more cake on Mother's Day. Plus a glass or two of prosecco. But nothing horrific. Overall, I decided my exercise, hydration, medications and diet was mostly on target. 'Did I do something wrong?' my husband asked. Once again, I brushed him aside. In diabetes detective mode, I went to find my computer and typed a quick note to my trusty endo. Did he have any theories why my morning sugars had suddenly spiraled upwards? 'Could be the dawn phenomenon,' he wrote. 'Early in the morning, say between 3 and 8 a.m., everyone – with or without diabetes – has a natural increase in hormones that cause the liver to release glucose (energy) to help you to wake up. 'For people without diabetes, the pancreas produces insulin to combat any excess glucose. But for people with diabetes, their bodies may not produce enough insulin to meet the extra burst of sugar, which can cause hyperglycemia or high blood sugar.' 'Arghh,' I responded. Back at the kitchen table, I considered my next move. I had heard of the dawn phenomenon, but despite my interest in most things diabetes, it had never captured my attention, in part because it had never been my problem. 'Can I help?' my long-suffering spouse asked. 'No,' I said. This time I left a kiss on his forehead as I went back to my computer. 'This is between me and my machine.' Coffee in hand, I opened Dr. Google to refresh my memory on the condition. It turned out that it's extremely common. And the symptoms of dawn phenomenon are pretty much the same as other episodes of high blood sugar: dry mouth, increased thirst, blurred vision, headaches, and more frequent trips to the bathroom to urinate. I also found that the dawn phenomenon isn't always to blame for a series of high morning blood sugars. Other factors can be at work, including taking too little medication that wears off early while you sleep or miscalculating how much medication you need to cover your carb vs. protein ratio at dinner. Not to mention consuming too many carbs before bedtime. What I was most interested in, of course, was how to stop my glucometer from asking invasive questions. Which meant finding a solution. Here, things got a bit trickier. For people who manage their Type 2 diabetes with a continuous glucose monitor (CGM) or take insulin via an insulin pump, the solution can be simple. A diagnosis of dawn phenomenon can be made by following the trend of high and lows recorded by the CGM and the flow of insulin can be adjusted accordingly. But for people who use a glucometer and don't take insulin, like me, a solution to the dawn phenomenon can require a bit of trial and error. After investigating the issue further with my endo, I was able to get a handle on the morning highs by adding a bit of evening exercise – a stroll around the block or a quick 10-minute stationary bike ride. Increasing my protein and reducing the amount of carbs at dinner also seemed to help keep my morning sugars in check. The tricky part is that while you can track your morning highs, there isn't a single way to anticipate and manage them. This means it can take a while to figure out what works for you. Which is, as I said earlier, a total pain. However, if you do get symptoms of the dawn phenomenon, don't despair. The key goal is to keep your A1C low, and by taking a proactive stance on high morning sugars, you're doing just that. Not to mention that once you get a handle on things, those pesky questions from a cranky glucometer might be a thing of the past.
CTV News
5 days ago
- Health
- CTV News
Max Domi opens up about his life with diabetes on and off the ice
Max Domi opens up about his Type 1 Diabetes diagnosis at age 12, shares advice for kids, talks tech advances, and his book.
WebMD
16-05-2025
- Health
- WebMD
What Friends Ask Me About Diabetes
As someone who was diagnosed with gestational diabetes in 1984 and full-blown diabetes not long after my second pregnancy in 1992, it's easy to forget the shock of first getting the news that you have type 2. As I've written before, I went home from that first doctor's appointment stunned and scared, worried not only about myself, but my unborn child. But in the years since, as I've lived and learned more about the symptoms and signs of the chronic disease and how my body reacts to carbohydrates, exercise, and medication, my fear has eased. It was replaced by a desire to figure out the best way to live as a person with diabetes. It hasn't been easy. I'm not always successful at keeping my sugars in range, or in avoiding foods that I know will boost my readings (I'm looking at you, Haagen Dazs chocolate chip). Yet, overall, I have headed off many of diabetes' dreaded complications so far (knock on wood) and generally feel able to do most of my normal activities, which include weightlifting, walking, and cycling. I was reminded of all of this when a friend came to me, newly diagnosed with LADA (latent autoimmune diabetes in adults) and frightened by the idea of having to wrestle with the disease. Meanwhile, a second pal, who has been prediabetic for a while, suddenly was confronted by an A1c of 7, which pushed her into full-blown type 2. Despite their two different varieties of diabetes diagnoses, both had been advised to watch their diets and given prescriptions of metformin to help lower their glucose levels. Though they had met with their doctors, they had questions. And while I'm not a medical doctor, I tried to allay some of their fears. Among their issues: Should I take a biguanide? Everyone is, of course, different. I've had friends who don't take them right away and try diet and exercise, and those who choose to go on them when they are still considered in the 'prediabetes' stage. As someone who has been taking them forever, I'm a fan. They're cheap, extremely well-tested, and may have other benefits in preventing breast cancer as well as anti-aging properties. Although I've never experienced side effects, at the start some people experience upset stomachs, but generally, it's worked well for me. Do I have to live this way forever? Some people, by severely restricting carbohydrates and adding lots of exercise to their lives (particularly if they had been overdoing food and not exercising beforehand) may be able to 'reverse diabetes.' But while I follow a balanced, mainly low-carb diet and get an hour of some sort of exercise every day, that hasn't happened for me. As a person with type 2 diabetes who has never been overweight (save for a year after the birth of my second child when those pesky pounds refused to move), I still have well-controlled type 2. Do you ever get used to pricking your finger two, three, or four times a day? Yes, and no. To be honest, I don't think anyone loves stabbing themselves to squeeze out blood in the morning, noon, or night. Luckily, there are new technologies that measure your blood sugar for you and give you a more accurate ongoing idea of your glucose ups and downs over a day and night. I've not yet opted for one, but more and more, I see the small, unobtrusive stick-on cubes on the upper arms of both young and old people. So if mechanically drawing a drop of blood from your finger freaks you out, you do have options. Will I eventually have to take insulin? Once again, it depends. With the newer injectable diabetes drugs on the market – and a weight loss pill waiting in the wings – people who once couldn't lose pounds or lower their blood sugars may be able to avoid insulin by getting everything in better range. For people with LADA, the chances of needing insulin are higher, since in this form of diabetes, the pancreas stops making insulin, more like type 1 than type 2. Two personal notes here: I took insulin during my second pregnancy, and it really was not a big deal. It allowed me to better manage my sugars, and by using fast-acting insulin, I was able to eat the occasional cup of ice cream. Unless you have a terrific fear of needles, insulin pens are quite small and go into fat, not muscle, which means they are not – honestly – at all painful. What else? Watch out for stress. Sometimes, your sugar can be high without reason, and sometimes, it can go low. The more you pay attention to your patterns (Does it jump after eating a certain fruit? Does it drop after a particular exercise class?), the more you can try avoiding these extremes. Getting a diagnosis of type 2 diabetes is scary. But with new drugs, new technologies, and a little attention to your diet and exercise, you can fight the fear and take charge. Like I tell my friends, it's not easy, but well worth it.
