when things go bump in the night

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?

WTF - man with diabetes thrown off train

Ask Manny Hernandez: A Bilingual Blog
Last Sunday, a 65-year-old St. Louis man was kicked off a train by Amtrak personnel in the middle of a national forest in Arizona, mistaking his diabetic shock for drunk and disorderly behavior.

Every time I read news like this I get a twinge of fear up and down my spine. I have experienced a few lows (30s) and as a dark skinned man in a mostly white and Asian neighborhood near Princeton,NJ and I wonder how I would be treated. I can imagine a night spent in a Princeton jail cell slowing dying while my family wondered where the hell I was.

I have a medical alert bracelet but I don't feel confident that the authorities would notice.

High low! High Low! It's up and down we go!

Recently I have been noticing some odd BG behavior. Last weekend while on the way to my daughters dance recital (she's 6 and a little princess) I experienced a low of 37. I normally check my BG before and about two hours after each meal but I started to feel odd about an hour after eating. My wife was driving and I noticed that I was feeling hot and sweaty even though the car A/C was set for 60. My thinking felt fuzzy. I pulled out my glucometer (my hands had started shaking by this time ) and stared at the reading for a moment. 37. My wife must have noticed something was wrong because she said, "Everything OK?". "No", I said, I need sugar.

We scrambled around to find some hard candy. We have two young kids and yet there was no candy to be found in the car. I normally carry a backpack with my glucometer, test strips, lancets, Novolog Flexpen, flex pen needles, and BD glocose tablets. I carry the backpack everywhere. That day I decided to take the meter and leave everything home. My wife found a packet of sugar from her last trip to Dunkin' Donuts and saved the day.

This has never happened before. The previous day I had a similar experience after eating dinner. My BG was down to 49. Today, it's happening again, about two hours after lunch. BG is 85. Wait! No. It's now 100. Wait no!!

Did I take too much insulin? Not likely. I took the same amount I always take for this amount of food.

Too much fat in the meal? No more than any other meal. 11.7g. I had a Weight Watchers meal, Texas Toast and an Apple.

Lunch June 23 2007

I am tracking my insulin and BG readings on the SugarStats.com web site and will be able to create some interesting reports that may help shed light on what's going on.