One of the interesting things that I deal with is a rise in blood glucose overnight. I go to bed with a BG of 84 mg/dL (last night), and wake up with a BG of 104 (this morning)! My last meal was about 12 hours ago so what happened?!
This can be the results of two different processes: Dawn Phenomenon and Somogyi Effect.
The dawn phenomenon is a natural part of our bodies circadian rhythm. The evolutionary process developed this so that our ancestors could get up in the morning after a night of fasting and have enough energy to find food. This is great ability to have when your food can run away ( think woolly mammoth ) but not so great when you just need enough energy to open the refrigerator.
The Somogyi Effect is caused by the bodies response to night time hypoglycemia. When BG drops overnight the body reacts by secreting a hormone, glucagon, which signals the liver to start converting stored glucose (glycogen) into glucose. This of course raises your BG.
I notice that my before breakfast morning BG is always higher (about 20 points higher) than my bedtime BG. I believe it’s the dawn phenomenon at work. Have you experienced either the dawn phenomenon or the Somogyi Effect and how have you controlled it?
I had read that illness can affect blood glucose but I did not understand how much so. On Sunday morning I work up with vertigo. I have had vertigo in the past caused by fluid buildup from an upper respiratory infection. Usually I go to my family physician, get an anti-biotic and after a week or so I am back to normal. This was different.
I had to infection or fever but I felt like I was on a merry go round. The effect on my blood sugar was dramatic. I went from having good control to having almost no control. I was taking more Novolog but my BG readings were still going up. Normally I am in the 90-100 range before a meal but now I was in the 130-200 range. Wacky stuff.
I have only had this disease for about a year and I guess I was used to the ease of the honey moon period. Now I may have to deal like everyone else.
I spent most of Sunday in bed waiting for it to pass. It did not and today I went in to see the family physician. He did not find any infection and thinks I am suffering from benign positional vertigo. He prescribed meclizine and sent me home.
A few people commented on my post regarding the use of control solution. I stand corrected. Control solution is just to test that the meter is working correctly not to calibrate it.
Blogging has really helped me get in touch with other Type 1 and I am learning quite a bit from the exchange. I did not know that the BGMs were that inaccurate. Sheesh! 15% rate of error!!! Maybe that 210 reading was only 195. Or maybe it was 225.
I also did some research on the FDA web site and found out that other factors such as Hematocrit may affect the accuracy of blood glucose readings including A1C. Anemia and Sickle Cell Anemia are two conditions that affect hematocrit values.