Have you heard of the term “Dawn Phenomenon” or the “Somolgyi” effect? Many people with diabetes haven’t, and yet it happens quite often.

The “Dawn Phenomenon” is a sudden rise in blood sugar between 3:00am and 6:00AM. It occurs in type 1 diabetics and occasionally in people with type 2 diabetes. It is caused by the body’s reaction to hormones that are released when you sleep. The result is an increase in blood sugar due to lack of insulin in the blood stream.

The “Somolgyi” effect, also known as the “rebound” effect, is a period of low blood sugars followed by high blood sugars. It usually happens in the middle of the night. Normally this occurs as a result of taking too much insulin or an oral medication that works at the wrong time.  When the blood sugar is low the body releases hormones and stored sugar is released from the liver which also results in high blood sugars.

How do you know which one you have? This is the fun part! Your doctor will ask you to test your blood sugar between 2:00AM and 3:00 AM a few nights in a row. If the blood sugar is normal or high at this time, suspect the dawn phenomenon. However, if your blood sugar is consistently low during this time, you are experiencing the “Somolgyi” effect, caused by too much night time insulin or too small of a bedtime snack for the insulin given.

What can you do? Ask your doctor about an insulin pump to manage your diabetes.  One of the features that the pump can do well is stop the dawn phenomenon. You can set different basal rates to increase or decrease insulin according to your needs.

Feel free to share your “Dawn Phenomenon” or “Somolgyi” effect stories…what steps did you take to overcome this?

My diabetes patients often ask me if cinnamon will help lower their blood sugar.  Some have reported that they have successfully used cinnamon while others have said cinnamon had no impact on their blood sugar readings.
I decided to do some research on my own.  I found a mix of results.  One study showed that cinnamon may lower blood sugar by decreasing insulin resistance.  In another study, cinnamon had no effect.  A third study suggests its use in the diet as a supplement.  In my opinion, it appears that more research is needed to confirm these findings and it may not yet be time to throw your diabetes pills away for cinnamon!
 
So, is Cinnamon Safe for People with Type 2 Diabetes?

It appears to be. It is classified as a food supplement and not a drug.  Just be aware that large amounts may increase liver problems in people with liver damage.  If you do plan to use cinnamon, speak to your physician first. 

What are your thoughts on supplements to control your blood sugar?

 

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I talk with patients daily about blood sugar testing. When questioned why they are testing less than their doctor has ordered, their excuses are too many to list.

When I hear this, I look back on my own life with diabetes over the past 51 years.  When diagnosed with diabetes that many years ago, I had urine test tape.  When placed in the urine the tape would turn colors.  I would compare it to the color chart and the chart would tell me the range the sugar was in.  I then progressed to the Clinitest which measured the amount of glucose in the urine, this was the only way for diabetics to keep a check on their glucose levels at the time. These tests were unreliable and you can imagine how happy I was when the blood glucose meters became available.  Now, I could actually see a specific number associated with my test.  It improved the ability to control my diabetes and my medications could be adjusted properly. This is why I encourage people to test their blood sugars as prescribed by their doctor.

We have come a long way in diabetes testing management. There are so many types of diabetes blood glucose meters on the market that you are bound to find one that fits your needs.  Blood sugar testing is the most important thing you can do to manage your health and prevent complications.

If you have been managing diabetes for quite a few years - what is your favorite benefit of the new blood glucose meters?

At work I educate people who have diabetes and many of them use an insulin pump to deliver their insulin.  During our conversations I always ask, “What are the features & benefits of your insulin pump?”  Since starting on the pump some people felt their control had improved and they felt more relaxed.  Another benefit mentioned was the move from multiple insulin injections and not having to stick themselves with a needle several times a day.  Since starting with the pump, they now change their site every three days which reduces the number of shots per day from approximately 12 every three days to one injection.  Each “insulin pumper” expressed the feeling of freedom, flexibility and confidence.  An Insulin Pump can be a life altering change.

P.S.  I wear an insulin pump too!

Every day one of my diabetes patients state that they saw a diabetes meter on TV that does not “prick the finger”.  I then explain that this is true, but blood is still needed to check blood sugars. This commercial is advertising a meter that you can test with alternate sites.  You can now use your palms, forearms, upper arms, thighs or calves.   

Follow these simple steps to make alternate site testing (AST) successful:

• Only use the clear cap on your lancing device.
• Rub the site until it is warm to increase blood flow
• Press the lancing device firmly against the skin
• Hold the lancing device down on the skin and press button to lance
• Push up and down on the skin with the lancing device (do not remove from the skin)
• Once you see the proper amount of blood, touch the test strip to the blood drop
• Wait for result

Is AST for Everyone?

If you have frequent low blood sugars, the finger is your best choice because it gives the most accurate blood sugar readings.  Always check with your health care team to see if alternate site testing (AST) is right for you.  

1. First, learn to recognize signs and symptoms of low blood sugar.Most people feel it when their blood sugar drops below 70 mg/dL. Some people feel symptoms at higher blood glucose levels and some do not feel early symptoms at all. If you do not get symptoms, then it is important to check your blood sugar more often.  If you need a review on the symptoms or treatment of low blood sugar click here to learn more.

2. Eat the right amounts of food at the right times.  Skipping or delaying meals is one of the biggest culprits of low sugar.   Be sure to watch the timing of your meals or snacks.

3. Take the right amount of diabetes medicine or insulin at the right time.  If you take too much or take them too close together this can cause a low.  Check your eyesight, as well.  Make sure if you are using a syringe, that you are reading the dosage lines correctly.

4. Plan ahead for exercise or activity.   Check your blood sugar before, during and after.  Consider having a small snack, if needed.  Sometimes just extra activity that you did not plan for can cause low blood sugar.  I have had patients have lows from just extra shopping at the mall or painting their house and not planning ahead.

5. Carry something with you at all times to treat low blood sugar. Be sure to keep something in the car. Glucose gel or tablets work well when you have changing temperatures in the car.  Remember driving with low blood sugar is very dangerous.   

 

What type of glucose do you like to carry with you?   Hard candies?  Juice boxes?  Tell us what works for you.