Understanding Liver Dump or Dawn Phenomenon in Diabetes
Liver dump, dawn phenomenon and dawn effect are all common terms that describe the same condition.
It is an abnormally high early-morning fasting increase in blood glucose.
It usually occurs between 4:00 AM and 8:00 AM. It occurs in everyone's body, but it has more impact on diabetics than normal bodies. It is more common in people with type I diabetes than in people with type II diabetes. Understanding the phenomenon can go a long way towards helping diabetics manage it.
The liver is responsible for the increase in glucose levels in the bloodstream.
The brain, vital organs, the creation of red blood cells, and muscle tissue are constantly consuming glucose to function (24 hours per day). When the glucose levels in the bloodstream drop, the brain sends a message, via hormones, to release more glucose. At the same time, these same hormones signal the pancreas to reduce the amount of insulin that is produced and released into the bloodstream.
In a normal body, the balance of glucose and insulin levels will be regulated. However, diabetics have an impaired control over this balance.
Type I diabetics and insulin-dependent type II diabetics do not produce, either enough or, any insulin. The insulin in their system is dependent upon periodic injections. When the hormone insulin is out of balance with the other hormones (cotisol, glucagon and epinephrine), the liver will release too much glucose.
Also, as the result of normal hormonal changes. The body's internal clock recognizes that it is morning, and the wake-up process begins.
The hormones cause the increase in blood glucose levels.
No one actually knows what the exact cause of the phenomenon is, but many believe that it is increases in the hormones cortisol, glucagon and epinephrine, that causes increases in insulin resistance. Insulin resistance is a breakdown in cellular communication, resulting in reduced amounts of insulin attaching to cell membranes, which, in turn, results in the cells not taking glucose in to burn as energy.
Insulin resistance is the primary cause of elevated blood glucose levels.
Also, while sleeping, the body carries out a process called gluconeogenesis. During gluconeogenesis, the body converts amino acids into glucose. Like the release of stored glycogen the creation of glucose from amino acids occurs in response to hormonal signals. The body, during sleep, responds to signals from several different glands. The pituitary gland produces a growth hormone. The adrenal cortex produces cortisol.
The alpha cells in the pancreas make glucagons. The outer layer of the adrenal gland sends out epinephrine. Those hormones raise the blood glucose level.
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