Dawn Phenomenon: High Fasting Blood Sugar Levels On Keto & IF

Dawn phenomenon also known as the dawn effect is when your blood sugar rises in

the morning but why does it do that and what's the mechanism we're going to

talk about that and we're also going to explain why diabetics and people with

insulin resistance tend to have a greater response and what that means

we're also going to cover what everyone is asking about why does it seem to act

really crazy and inexplicable and super stubborn when I do a keto or a fasting

diet if you look this up on the internet you try to get answers there won't

really be any good answers because they'll explain what it is and show you

that it happens but they won't explain why or why it seems to act strange so in

this video we're gonna make it absolutely crystal clear so that you

know when you're doing a low carb diet why it's doing what it's doing coming

right up

I probably had a hundred people ask me why is my glucose so high in the morning

why is my fasting glucose higher than my after-meal glucose I'm eating a low-carb

diet I've been on keto for such-and-such a period of time why isn't it coming

down and some people have heard about the dawn effect but they don't

understand it and some people just know that their blood sugar is high even

though it's supposed to be lower so we're gonna talk about that and make it

totally clear for you dawn phenomenon is also known as WHGMS

and that stands for worry about my high glucose in the morning syndrome no sorry

that's not really a thing I just made that up but based on the number of

people asking it's it's a real thing and everything seems to be a syndrome these

days right well what's going on here when you're sleeping you don't need a

whole lot of energy cuz you're just kind of chillin there in bed but during the

night your blood sugar drops because you're not eating anything and then

there is a counter mechanism from various hormones and they're basically

cortisol glucagon adrenaline and human growth hormone that they slowly rise

through the night to compensate for the fact that you're not eating so you can

maintain stable blood sugar levels and then what happens is right before you're

about to wake up your body says hey better get you ready for the day better

get you a little jolt so that you can wake up and be bright-eyed and bushy

tail and and ready to go about things so your blood sugar goes kind of steady and

then the cortisol rises and then you have a spike right before you're about

to wake up so your blood sugar is gonna rise a few points and this is called the

dawn effect and in the normal person this rises a few points

it's not a strange thing it happens it's supposed to happen it happens in every

one in the world but in some people it may not be large enough to be really

noticeable unless you just really measure carefully many many times but

most people aren't going to measure the blood sugar while they're sleeping so

they don't notice very much of this so just realize that it's normal the second

thing is that if your insulin resistant now whenever you have a cortisol

response and whenever you have any blood glucose increase whether it's from a

hormonal effect or whether it's because you ate something your cells are

resistant so you tend to have greater blood sugar responses okay blood sugar

tends to go up more in the people who are insulin resistance whether it's a

hormone or whether it's a meal so that's just as simple as that it's gonna be the

normal response but it's going to look like it's a little bit larger because

you are insulin resistant so the cells aren't going to soak up that increase as

fast as if you were insulin sensitive we want to contrast this then with

something called a Somogyi effect and that's different this happens to type 1

diabetics and why is it only type 1 diabetics because they can't produce any

insulin on their own so they take their insulin they eat the day before they

have a certain blood sugar level when when they go to bed and they have a

certain amount of insulin and maybe they take a shot and maybe they have a pump

but through the night very often the inn's that the glucose starts going down

and if they didn't match their insulin and their food perfectly they can often

get a very very low drop they can get very hypoglycemic in the middle of the

night so then when when this natural, normal hormonal boost comes in to raise

blood sugar again then there is no insulin to counteract it so they get

this huge swing but it's because they first had insulin and then they ran out

of insulin so now when the body starts producing glucose there is nothing to

counteract that glucose spike and they wake up with a huge spike of glucose so

this is a different thing you can improve it by stabilizing blood sugar

and becoming more reliant on fat and ketones

but that's a different story but I just wanted to mention it so that you know

about it because some people they throw out the dawn effect and the Somogyi

effect as if it's the same thing but it's not So Somogyi is a type 1 diabetes

thing and the dawn effect is something that happens to everybody people so far

a lot of people are with me they say okay I get it it's called the dawn

effect there's some hormones and yes I'm insulin resistant so the effect is going

to be a little bit larger but I've done this now for 3-4 months and might wake

up with a glucose of 120 and the weirdest thing is that it stays the same

until I eat something it's like what's up with that it makes no sense and as a

matter of fact it does but we really need to dig into the picture when you

keep it simple but we're going to make it very clear so let's say that this is

the normal non insulin resistant person and they do what most people do they eat

bread and cereal and toast and orange juice and they do this and they get away

with it for 20-30 years before they break their carbohydrate tolerance so

the red line here is their nighttime glucose so the body is healthy it's

balanced it's maintaining a glucose and then right before they're about

to wake up they have their cortisol spiked and then the blood sugar rises a

few points so let's say the green line here is about 80 and then the orange

line is about a hundred and the blue line is about 120 so we start about 85

90 and then we wake up and it might be 95 or a hundred or something and then we

eat a breakfast and we've listened to the official guidelines of what's

healthy for you you should eat many meals you should eat 300 grams of carbs

per day and breakfast is the most important meal because you got to really

load up on the blood sugar so that you make it through till almost to lunch

or at least till the morning snack we follow the guidelines then we have some

toast with a jam and we have some milk with cereal and we have orange juice and

some sugar in the coffee so we get about a hundred and twenty grams of carbs in

in our systems at that point but let's think about what's happening and when

people think about blood sugar they very often they have no idea how much blood

sugar is we talk about the levels but realize that a hundred milligrams of

blood sugar for the per deciliter for the average person is only five grams it

is a flat little teaspoon of sugar that's all the sugar that you have in

your system so you're sleeping all the way through the night and you have one

teaspoon of sugar circulating and as you burn up a few little grains of sugar so

to speak then your liver makes a few more grains and you maintain this level

so when you wake up and your blood sugar went from ninety to a hundred what

really happened this cortisol put one half a gram of sugar into your blood you

didn't eat anything yet there is no load of food

or carbohydrate in your system your liver just made a half a gram of sugar and it

put it directly into the bloodstream so now instead of four and a half grams you

have five grams of sugar no big deal but then you just ate 120

grams of carbs that is going to be turn some of its already sugar it's going to

start spiking it very very quickly here and some of it is starch and that's

going to take another 10 15 20 minutes to break down and turn into sugar and

the entire thing is going to be absorbed in a couple of hours so two hours is a

hundred and twenty minutes 120 grams means one gram per minute or sixty grams

per hour is going to get into a system into the bloodstream in a system that

can hold five to six grams all right so that means that this is an emergency we

got a handle one gram a minute for the next two hours in a system that uses

sugar much much slower and that can only hold four five six grams at a time

ideally in diabetics when it rises up to 200 well now they have 10 grams of sugar

okay so the insulin produced is in response to the threat to the load to

the anticipation because your body knows how much car you ate even when it's

sitting in the stomach your body is really really smart and intelligent

because when you put something in your mouth and you taste it your body knows

what's in that food and it starts preparing the digestive response and the

insulin responses and so forth so it knows we got an emergency we got a big

job ahead of us and we got a process through a hundred and twenty grams of

carbs in a system that can hold about five that takes a lot of insulin and the

body is so amazing that it takes decades to break the system even when we

abuse it to that degree for another visual illustration so this is roughly

how much this is representing how much glucose was in your bloodstream and this

is how much has to pass through the bloodstream in the next two hours that's

a big deal okay so your body can handle it as long as it has some reserves as

long as it's healthy as long as the cells haven't been totally clogged up

then you can process through this but after 20 years you're increasing for

every time you do this you increase your insulin resistance and you build up and

eventually when your body can't keep up anymore when you broke it

then you got type 2 diabetes after doing that whether you have diabetes or

insulin resistance you're somewhere on that on that gradient now you decide hey

I've learned a lot from these great YouTube videos so now I'm gonna do

something about it so you go low carb high fat lchf you go

keto you start doing intermittent fasting you do 18 6 you do 24 you do 6

36 and all eight 36 whatever all that good stuff

but you're doing the low carb and the intermittent fasting and now you notice

that you're waking up with blood glucose of a hundred and twenty and you have

noticed that your a1c used to be 10 and now it's like 5.6 so it looks

like you're making progress and you might have lost 30 50 pounds which is

what a lot of people tell me so it seems like it's working that you're getting

your a1c down you're getting your your weight down but you also heard that the

fasting glucose for low carb diet is supposed to be around 80 or even 75 so

what's up you've done it for three months and and you're wondering there's

some wrong with me no there isn't so let's go

back to this example and let's contrast it and talk this through through the

night I don't know what your blood sugar is but let's assume that it's somewhere

in the middle of this range it's sitting around a hundred and then you have these

hormonal effect you get this dawn effect and now your blood sugar jumps 20 points

so what does that mean again during the night you might have had four or five

grams of blood sugar grams of sugar in the blood and then the hormones kick out

another one to two grams so this is what we have to realize this is not a big

deal it is two grams of sugar this is not an emergency this is not a big deal

for the body it doesn't have to turn on all the alarms and ring the bells and

start making a bunch of insulin because you made one or two grams of sugar so

then you wake up and you have six grams of sugar in the blood and you don't have

breakfast because you've learned about intermittent fasting

so you add zero grams of sugar and you're thinking hey I didn't eat

anything my blood sugar is supposed to come down but your body says hey no big

deal I'm chilling I I have this totally under control if if it goes high or if

you eat something I'll do something about it but this is not a big deal I'm

backing off on the insulin because there's nothing really here to process

all that happened was you added one to two grams of sugar all right so then

you're fasting and then comes time for your meal and now you're doing the right

thing you're eating a low-carb diet maybe keto let's say you're eating twice

a day and you're keeping it at 20 grams of net carbs per day so this meal has 10

grams of carbs alright the body says hey I got

something I've got a little bit of protein that's going to need a little

insulin I got carbs I got lots of good fat to fuel me

but there's no emergency but the body senses I got something the time to do

something about this time to increase a little bit of insulin and now because

you made some insulin your blood sugar comes down because you ate so this is a

totally different animal than this guy because we're trained to think that

blood sugar is always supposed to come up when we eat well if you understand

this now then you'll see why that's not necessarily the case that the body

behaves differently but it always behaves intelligent contrast this this

these 10 grams because you eat protein and fat and vegetables and foods that

are high in fiber high in fat they absorb very slowly so these 10 grams

they have 3 4 5 hours to get out in the bloodstream so now we're talking two to

three grams per hour and the body's is alright I'll make a little bit of

insulin but it's not going to take much and that's why the blood sugar comes

down and it it levels out again in this case it's an emergency because we go

from this much glucose and we have to process through this much glucose in

this case we had a little bit of more but it's no big deal

and it's still no big deal when we eat because we just add that much more and

we got basically all day to take care of it so why worry about it so this is why

it's so important to understand the big picture everyone is freaking out about

blood sugar the only treatment for insulin resistance and diabetes are

drugs to lower blood sugar but that's not the problem look at all the other

videos so that you understand what insulin resistance is and what

treatments and metformin and insulin what that does that it doesn't solve the

problem it perpetuates the problem and it pushes it further in the wrong

direction if you do in the low carb and you're in this situation that

stubborn blood sugar around 120 is a good thing that means you're doing the

right thing your body is not in an alarm state it's chilling it doesn't have to

work so hard so the big picture includes a1c and insulin you want to calculate

your home iír and you want to understand that what you're after is not glucose

don't worry about it what you're after is the long term insulin resistance you

want to become insulin sensitive meaning that the cell gets into a place of

balance where it starts wanting some food instead of being force-fed

all the time if you like this we have lots of good videos on related topics

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big picture not just the details thanks for watching see you next time