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Having a FreeStyle Libre Continous Glucose Monitor (CGM) has been extremely helpful to get immediate feedback with glucose control.  The biggest issue I've had with it has been keeping the sensor (white disc on the back of your arm) in place.  I've learned that proper skin cleaning is important along with sensor positioning.  Even so, the sensor can loosen from sweat and this can just easily happen lounging around a pool at a resort in Costa Rica as it could from a day of intensive work in hot weather.  Even though the sensor seems secure, it can easily be pulled off with your tee-shirt.

This has happened once too many times so I've been using an overlay of Tegaderm to prevent catching on shirt sleeves as well as Skin-Prep to get the Tegaderm and sensor to stick better.  This seems to work reasonably well unless I experience a lot of perspiration.

With my blood sugar now staying primarily in the healthy range (3.9-6.9 mM) and steady, it has become easy to defer breakfast as the Dawn Phenomenon typically takes until early afternoon to wear off. As a result, I've been deferring breakfast until mid afternoon or until late afternoon / early evening (one meal a day). Without eating, my blood tends to gradually fall into the low 4 range by late afternoon.I monitor my blood glucose with my FreeStyle Libre to help me determine the best time to eat. Since gluconeogenesis is demand-driven, I expect that the Dawn Phenomenon may possibly diminish over time with decreasing hepatic insulin resistance. As my focus is to become insulin sensitive and this can only be done by minimizing insulin levels, I am going to continue with time-restricted, LCHF diet and see where it takes me.

To minimize the Dawn Effect, it appears that not consuming food and having low-intensity exercise (eg, walking) after supper are helpful. It also appears that having higher-intensity exercise (compared with walking) in the morning does not quickly drive down serum glucose but seems to have somewhat of an opposite effect - at least initially. This may be because the high-intensity exercise demands glucose from gluconeogenesis.  Riding my bike seems to be the best at driving down serum glucose but it usually takes 15-20 minutes before I start to see downward movement.  There is also typically an slight increase in glucose before a decrease.


Date Milestone
2015-10 Diagnosed diabetic, prescribed Metformin and Januvia.
2017-10 Prescribed Janumet XR to replace Metformin and Januvia.
2018 Prescribed Dapagliflozin (Forxiga/Farxiga).
2019 Janumet adjusted with lower metformin content.
2019-11-02 Started using FreeStyle Libre glucometer.
2019-11-11 Stopped taking Janumet (Metformin & Januvia).
2019-11-20 Blood sugar trending higher, sometimes deferring breakfast until noon as per blood glucose.
2019-12-02 On vacation, stopped taking Rosuvustatin.
2019-12-12 Starting regularly deferring breakfast until noon or later (2 or 1 meal/day).
2020-01-11 Stopped taking ‎Forxiga. Now only taking Telmisartin (Micardis) and ASA 81 mg daily.
2020-01-28 Stopped taking Telmisartin.
2020-06-06 Stopped taking 81mg ASA.