Tuesday, July 14, 2015

Protein and Dawn Phenomenon- My Experience.

What role does protein play in Dawn Phenomenon?  DP is that higher blood sugar number that many wake up to.   It is frustrating and one of the most questionable topics that diabetics discuss.  

In just a few days I was able to create a condition where I went from a state of completely controlled morning blood sugar to DP.  I did not to this on purpose and please don't try this at home!  (wink  wink!)  ;)

My usual morning fasting blood sugar averages around 74 (4.1 mmol/l).   In a few days time I have experienced a nasty return to Dawn Phenomenon and I quickly saw my fasting blood sugars skyrocket!   I actually created a situation where DP would return to my life after three years without having it.  This was an unwitting vacation experiment on my part and a teachable moment that I feel I can pass on to others.

I just spent the past eight days across the country with family members in a food environment that was difficult to control.  Many of you may have experienced this for yourselves.   It is a tough situation to be in.   Our relatives took us out to eat a lot.   They love carbs and sugars.   I worked very hard to control my own food choices and often left a lot of included carbs on my plate.  I did pretty well in that regard.

What I found more difficult to control was my protein and fat portions.   Although I was able to request "no bun" it was hard to find fat choices to add to my proteins and the protein portions were all quite large no matter what I ordered. 
One of my meals was a burger with a fried egg on top.  The burger was 1/2 pound.  A fajita meal contained enough protein for 3 of my usual meals.  Several meals were from local food trucks and so it was not an option to ask for side items like additional butter, sour cream, mayo, etc.  I was also not able to find my usual heavy cream at any establishment or in any of the hotels we stayed in.  I am always trying to point out to others that fat grams should be about twice the amount of protein grams.  I was not able to follow my own advice.  

I took a lot of leftover boxed food back to the hotel fridge but at some point I was eating it. In general I was eating way too much food, too much protein and not nearly enough fat.  I was very successful at keeping to my daily carb limit though.

Each day I saw an increase in after meal and pre-meal blood sugar despite my attempts at control.   For the first few days my morning blood sugar was in the 80's, (4.5)  then crept up to the 90's (5's), then 105 (5.8).

The family members that we were visiting proudly refer to themselves as "foodies" who eat three meals a day and numerous snacks in between.   On our final night, after figuring out that I was a "meat and vegetables" eater the family treated us to a Brazilian Churrascaria (meat BBQ) restaurant.   This is a type of buffet where you can go and get your salad items and then the Gauchos (servers) slice the meats table side.    Eleven types of meat were served!   Just imagine the protein overload!  The restaurant was an expensive treat and I certainly did not want to offend our hosts who were paying the pricey check.  I knew what I was in for and it wasn't going to be pretty. 

Sure enough, my last morning reading there was a 128 (7.1)  It was higher than my bedtime reading. After nearly 3 years on a diabetic ketogenic diet I managed to put myself in the position of reverting back to a state of higher blood sugars in general and brought DP back into my life!  It took so little time to do this!   Think about the significance of this!   

I wanted to make this a teaching moment for those in my groups and for those who follow my blog.  My vacation mistakes were not mistakes of eating extra carbs, potatoes, french fries etc. The mistake was a mistake of extra protein over and above what my body needs.  This reprogrammed my liver in a way that made it store more glycogen (glucose) for use between meals and overnight.  There is a more scientific explanation of this that there is not time for in this post. 

The take away from this is that I hope that some of you will have a better understanding of how too much protein can keep you from experiencing the blood sugar levels that you aim to achieve.   The DP that doesn't seem to ever go away could be tied to protein portions.  This is assuming that you really have been limiting your carbs to the suggested 25 grams a day or less. Eating LCHF has normalized my blood sugars and brought me to an A1c of 5.1.  

Look how quickly I was able to mess with that!  The Ketogenic LCHF diet for diabetes truly is an art and a science as Volek and Phinney point out in my favorite book "The Art And Science Of Low Carbohydrate Living".

My fasting blood sugar this morning was 105 (5.8).  I still have a long way to go to get back to my usual average of 74 (4.1) and this is going to take several days as my liver and pancreas have to readjust to my lowered protein servings again.   It is sad to see blood sugars in this range again after 3 years of great control.   I will get my normal numbers back in a few days.   I hope that my experience has inspired you.   Sometimes my mistakes can keep you from making one or can point you in the right direction.  

Here is a link to an earlier post where I discussed the over eating of protein as well. 
http://ketodiabetes.blogspot.com/2014/02/protein-is-my-nemesis.html