# morning bms



## angeladalton (Jun 4, 2010)

My first bm/bs on a morning is always around 9mmols. Anybody have any ideas how I can get it lowered. Through the day my other reading are ok


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## Northerner (Jun 4, 2010)

Hi Angela, welcome to the forum  It sounds like a touch of Dawn Phenomenon, where the liver gives a glucose boost when you wake to help you start the day - except, for diabetics we'd rather it didn't happen!

Are you on any medication? Do you eat soon after waking? It can be a tricky thing to tackle. We are often more insulin-resistant in the mornings too. Are you able to get much physical exercise? May situation is different, as I am Type 1, but I know that my morning levels are much better when I have been able to exercise frequently - I hurt my knee a while ago and my morning levels are creeping up.

Hopefully, some of our Type 2 members will be able to give you some better advice!


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## Andy HB (Jun 4, 2010)

Welcome to the forum Angela. 

Fortunately for me, I haven't had too much problems with dawn phenomenon up to now, so don't have an answer to your question.

But, have you tried altering your diet to see whether it has an effect (e.g. eating your main meal at midday or in the evening or perhaps having a snack before going to bed).

Andy


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## Vicsetter (Jun 4, 2010)

Hi Angela. 
A bit difficult to say without knowing what meds you are on (can you add them to your signature please).  although I'm on Metformin and Insulin I find that a big meal in the evening can raise my morning levels.  I have a theory that a lot of the differences between diabetics is due to varying rates of digestion.  What you eat in terms of carbs and fat content will affect the raise in bloods and the duration that the raised level will last.  I have found it quite possible that you are still digesting last nights meal even when you wake in the morning and you will obviously still have raised levels.
If your bed time BG reading is as low as your pre-evening meal level then it does indeed look like the dawn phenomena.  If your bed time reading is still high then you should eat earlier or less
The use of Metformin/Insulin and other meds will affect the results, it is of course possible to exhaust your night time basal insulin injection (if you are on one) by eating too much.


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## Old Holborn (Jun 4, 2010)

Hi Angela and welcome.


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## angeladalton (Jun 4, 2010)

Vicsetter said:


> Hi Angela.
> A bit difficult to say without knowing what meds you are on (can you add them to your signature please).  although I'm on Metformin and Insulin I find that a big meal in the evening can raise my morning levels.  I have a theory that a lot of the differences between diabetics is due to varying rates of digestion.  What you eat in terms of carbs and fat content will affect the raise in bloods and the duration that the raised level will last.  I have found it quite possible that you are still digesting last nights meal even when you wake in the morning and you will obviously still have raised levels.
> If your bed time BG reading is as low as your pre-evening meal level then it does indeed look like the dawn phenomena.  If your bed time reading is still high then you should eat earlier or less
> The use of Metformin/Insulin and other meds will affect the results, it is of course possible to exhaust your night time basal insulin injection (if you are on one) by eating too much.



Thanks for replying, at present I take gliclazide mr, metformin and exanitde, my main meal is usually on an evening, i have a dog and exercisr that, also my work is quite physical, my gp does not seem to knowwhat to do


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## Emmal31 (Jun 4, 2010)

Hi Angela

Welcome to the forum x


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## Vicsetter (Jun 4, 2010)

Ah Exantide, otherwise known as Gila Monster spit or Byetta.  A friend of mine takes that and seems to get quite good results, albeit with occasional nausea. S afraid I can't help.  There have been posts here on Byetta so you could search for them or wait and someone will help.  Did your GP prescribe your Byetta, I thought you usually started at a hospital diabetic department, do you have a consultant or hospital nurse you can talk to?


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## angeladalton (Jun 5, 2010)

my gp prescribed byetta and i only go to the gp surgery to see the practice nurse who carries out my screening. i have not been referred to a consulatant


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## VBH (Jun 5, 2010)

T2s don't usually get to see consultants.

But yes it looks like Dawn Phenomenon (DP).

Best approaches for most T2s seem to be:
a)  small amount of very low GI carbs, plus protein and fat (handful of nuts or maybe oatcakes with butter and cheese seem to work well)
b)  Small quantity of alcohol - preferably red wine for its low carb content and additional health benefits.

The explanation of dawn phenomenon can be a bit technical, but one of the best articles on it is here: (link)  Dawn Phenomenon


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## Vicsetter (Jun 5, 2010)

Around here Byetta is prescribed by the hospital until they are happy with your progress and then you are passed back to the GP.


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## VBH (Jun 5, 2010)

fair point. It does vary a lot depending on area but I get the impression that most byetta has started to be prescribed by GPs more often these days


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## PhilT (Jun 6, 2010)

Hi Angela, welcome to the forum.


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## dplay (Jun 6, 2010)

Found the site 'by accident' I've found useful info already particularily with regard to running


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