3) THE BASIC CAUSES OF TYPE 2 DIABETES
l) The "Dawn Phenomenon"
Many but not all individuals with type 2 diabetes suffer from the "dawn phenomenon" or the "dawn effect". In the process certain body hormones are activated before an individual wakes up. These hormones increase the amount of blood sugar in preparation for waking up by activating the liver to produce blood sugar from its store of carbohydrates. In individuals with this dawn phenomenon, blood sugar levels can be quite high upon rising even though the individual hasn't eaten in eight to twelve hours. Solutions to this problem have ranged from not eating for 4 hours before bedtime to taking vinegar with the evening meal to taking a Meglitinides (Prandin™ or Starlix™) half an hour before the evening meal. Byetta, Januvia, and metformin are medicines which tend to significantly reduce the dawn phenomenon as they act to reduce the release of blood sugar from the liver. Trial and error will establish which is best for any individual. This effect can be quite stubborn to treat.
This phenomenon used to be atributed to the "Somogyi Effect" where the ingestion of simple carbohydrate before bedtime gives an increase in insulin one to two hours later followed by a significant drop in blood sugar one or two hours later. But this has been largely discredited. Since most people sleep for eight hours and the "Somogyi Effect" takes two to four hours to run its course, it seems highly unlikely that the Somogyi Effect is the cause of the Dawn Phenomenon.
Next Chapter: 4) DIABETES AND HEART DISEASE
a) Introduction
b) Small Blood Vessel versus Large Blood Vessel Disease
c) Large blood Vessel Mechanisms
d) Blood Lipid Chemistry
e) Diabetes and "Heart Failure"
f) Peripheral Arterial Disease (PAD)
g) Blood Proteins, Diabetes and Heart Disease
h) Genetic Risk Factors for Diabetes and Heart Disease
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