Tag Archives: Dr. Richard Bernstein

Have You Heard of “Dawn Phenomenon”?

"You gotta consider that free fatty acids may be causing insulin resistance....blah, blah, blah...which if it occurs in the liver, they may both be right!"

“You gotta consider that free fatty acids may be causing insulin resistance….blah, blah, blah…which if it occurs in the liver, they may both be right!”

It refers to somewhat mysterious higher-than-expected blood sugars in the early morning hours, as between 6 an 9 AM.  Even if you don’t eat breakfast; that’s why it seems mysterious.  Assuming you slept all night, why would your blood sugars be too high, even before breakfast?

Dr. Richard Bernstein talks about it at DiabetesHealth.  Dr Bernstein is a great resource for folks with diabetes, and to physicians who treat diabetes.

Peter at Hyperlipid suggests that dawn phenomenon isn’t as simple and straightforward as Dr. Bernstein says.  In fact, Peter seriously questions, Dr. Bernstein’s explanation that it’s caused by the liver removing too much insulin from circulation. For those who don’t click through, I’ll summarize by saying Peter found evidence that nighttime growth hormone elevations (this is normal) lead to lipolysis (breakdown of body fats into free fatty acids to be used by various tissues for energy) and the FFA’s cause a degree of insulin resistance, leading to higher blood sugar levels in the early morning.

As a practical side note, some people with diabetes (should I start using PWD’s?) seem to suppress Dawn Phenom by drinking alcohol at bedtime.


Filed under Diabetes Complications

What’s Dr. Bernstein Got Against Tomatoes?

Eat greens for vitamin K

Looks reasonable to me

Dr. Richard Bernstein cautions his diabetic patients and readers of Diabetes Solution to keep a tight lid on consumption of tomatoes.  An excerpt from page 149:

If you have them uncooked in salad, limit yourself to one slice or a single cherry tomato per cup of salad.

His concern is that tomatoes will raise your blood sugar too high.

That doesn’t make sense to me.  A 3-inch diameter tomato has 7 grams of carbohydrate, 2 of which are fiber.  So the digestible carb count is only 5 grams.  That’s not much.  So do tomatoes have a high glycemic index?  Unlikely, although it’s hard to be sure.  Good luck finding a reliable GI for tomatoes on the Internet.

I think Dr. Bernstein’s wrong about this one, which is rare.  I suppose it’s possible that tomatoes deliver some other substance to the bloodstream that interferes with carbohydrate metabolism, but Dr. Bernstein doesn’t mention that.

Do tomatoes play havoc with your blood sugars?

Steve Parker, M.D.


Filed under Carbohydrate, Vegetables