Dawn Phenomenon vs Symogyi Effect

Hi, looking for some input here. My cat is usually high BG in the mornings. I've seen a couple of lows (ie yesterday he was only 81)...but typically he is in the pinks or reds first thing in the morning and its very discouraging. Later in the day, he gets blues and greens.

So I did some reading about Dawn Phenomenon and Symogyi effect. How do I know which, if any, my cat might be showing me. He is only on 0.5u at night so I am thinking it can't be Symogyi - too much insulin and bouncing.

Any others experiencing this high mornings? Do you change dose? Get up in the middle of the night to test?

I am so discouraged every morning when I see pinks and reds :cry: :cry:

Juliet and Silver.

 

As to telling the difference, I'm not much help there but I can say Hidey was/is the same way. The only way I was able to level his AMPS was to get an automatic feeder and make sure he gets a mid-night feeding. When he was on insulin he was getting 5 small meals a day, I have been able to cut it down to 3 feedings now, but one of them is still 1 AM. The mini meals definitely helped Hidey's numbers.

 

Thanks, that's good info. I thought food made them go UP in numbers though?

I cant leave food out or in a food timer actually as I have another cat who is very overweight and I cant risk her eating what is meant to be for Silver. Hmmmm, wonder what else I can do to bring his AMPS down??

Juliet and Silver

 

I had to resort to 3 timed feeders since I have 3 cats and they all managed, but if thats not an option maybe give a small feeding RIGHT before you go to sleep at night??

 

Ok I could do that.

But doesn't that make them go up? Or is this to stop them going too low at night and bouncing in the morning? I still find this a bit confusing.

 

I'm not one to give "specifics" but the best way to put it is small meals are easier on the body, not to mention if they get too hungry that can raise bg as well. When you have small meals it keeps the pancreas and liver working,producing "natural" insulin (so I've been told and it worked lol)

 

I know that actually - but its just NOT possible in my household. Both cats get two meals a day. I am out 12 hours a day at work, I'm not getting up in the middle of the night and a timed feeder does not work for me.

What I'm hoping to find out on this thread is the difference between Dawn Phenomenon and Symogyi effect and how to tell which one is happening.

Juliet and Silver

 

They're totally different things, so it's not really something we can "compare"

Dawn Phenomenon has to do with natural hormones the body produces in the early morning and we have no control over that. Even cats that aren't diabetic have some degree of D.P.

Bouncing is the livers' reaction to either a fast drop or a low number (anything lower than it's been used to living at). Bouncing is totally normal (although one of the most frustrating parts of this dance) but most of the time as they spend more time in lower numbers, the liver re-learns that it's OK to be there and doesn't react so violently. But (there's always a "but") ...some cats will bounce all the way to OTJ!

China's been doing the dance over 18 months and is what I'd call "tightly regulated"...she still bounces in reaction to a really low number. It's a self-preservation mechanism that's "built in", so there's a limited number of things we can do to try to "control" it. One of the first things I had to accept when we started was "Cats bounce until they don't"

Silver is still very new to the dance (although I'm sure to YOU, it feels like it's been forever!!) It's going to take time for his body to re-learn to live at those lower numbers.

 

I know - I have been researching the two and I know what they both are. But you cant say what Silver is doing UNTIL we have those consecutive 2-3am tests in. I was not saying we could compare them, but we do need to know which one is going on as to what to do about it.

If its the Somogyi effect - what you call bouncing - then there are some things I can do about it. DP - nope, cant do anything.

I do research for a living so I may be a newbie but not completely dense

What is the Somogyi effect?
Also known as "rebound hyperglycemia" the Somogyi effect is a pattern of undetected hypoglycemia (low blood glucose values of less than 70 (3.8) followed by hyperglycemia (high blood glucose levels of more than 200 (11.1). Typically, this happens in the middle of the night, but can also occur when too much insulin is circulating in the system. The cause of the Somogyi effect is said to be "man-made"—that is, a result of insulin or diabetes pills working too strongly at the wrong time.

What is the dawn phenomenon?

Named after the time of day it occurs, not some high brow researcher, the dawn phenomenon is the body's response to hormones released in the early morning hours. This occurs for everyone. When we sleep, hormones are released to help maintain and restore cells within our bodies. These counterregulatory hormones (growth hormone, cortisol and catecholamines) cause the glucose level to rise. For people with diabetes who do not have enough circulating insulin to keep this increase of glucose under control, the end result is a high glucose reading in the morning.

 

From one of our long time Lantus users who has reviewed countless spreadsheets as well as reading numerous research and clinical articles.

Excerpt from this post

 

5.2 in the middle of the night...so I guess he likes to go low at night. Good info to know.

 

We had the same problem with Chris Farley early on. You can look at his spreadsheet at the end of September where we started getting PM+10 tests when we got up to feed him. I tried taking his dose up to bring down those mornings and we just got a steeper drop. I took his dose back down and started feed him at the +9.5-+10 time. No more higher mornings just like that. And yes, we set the alarm and got up to feed him until we got the timed feeder set up. Then we put him in a room by himself at night with the feeder until he got used to the sound. Once he figured out what the sound of the feeder was, no other cat was beating him to that food :lol: We had some pretty tired days there for a while, but we needed to figure out if the food would stop the high mornings. It did and we were able to make the adjustments needed to not have him running high anymore, and 2 months later be off of insulin.

 

Thanks Melanie. That might be the answer. Being awake at +10 might be difficult but if it brings down the high AMPS then worth a try.