High Blood Sugar In The Morning: Is It The Dawn Phenomenon
If you have high blood sugar levels in the morning, you may be experiencing the dawn phenomenon, the name given to an increase in blood sugar that usually occurs between 2 a.m. and 8 a.m., according to the Mayo Clinic. One reason this occurs: During the early hours of the morning, our bodies secrete higher levels of a hormone called cortisol, says Dr. Spratt. When cortisol levels are high, it can make you more resistant to insulin, a hormone that helps regulate your blood sugar levels.
“Some people have a striking dawn phenomenon,” says Dr. Spratt. “You can look at their continuous glucose tracing and see that their blood sugar level suddenly goes up at 3 a.m.” If this is the case for you, your doctor may adjust your insulin medication or suggest you use an insulin pump .
Pinpointing The Cause For Effective Treatment
Its important to understand whats causing your morning hyperglycemia before your doctor can treat you. To pinpoint which of the three reasons is behind your high numbers, check and record your blood glucose before you go to bed, at 3 a.m., and then first thing in the morning. Although it isnt fun to set a middle-of-the-night alarm, continue to do so for a few nights in a row.
If your blood sugar is fairly even when you go to bed and at 3 a.m. but is higher in the morning, you are probably experiencing dawn phenomenon. If your blood sugar is low at 3 a.m., but high in the morning, you probably suffer from the Somogyi effect. If your blood sugar is elevated at 3 a.m. and then higher still in the morning, you probably have waning insulin.
Even if youve identified the reason behind your high morning number, never attempt to correct it on your own. Instead, talk with your doctor. Together, you can find a treatment plan that gets you back on track in the morning.
General Medication Guidelines For People With Diabetes
As per the guidelines issued by the Cleveland clinic, following things should be kept in mind while taking diabetes medication:
- Inform your doctor about your allergies.
- Take the medication in proper dosage. Don’t skip or stop taking the medicines unless told by the doctor. One should take the treatment seriously.
- Keeping a medicine calendar/log book might help you to remember if you have taken your medication.
- Do not wait until you are completely out of medication before filling your prescriptions.
- Check your blood sugar from time to time.
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Why Your Blood Sugar Is High In The Morning And How To Lower It
- Your blood sugar levels might be high in the morning if you are experiencing the dawn phenomenon or the Somogyi effect.
- The dawn phenomenon is most common in people with type 2 diabetes, while the Somogyi effect is more common for people with type 1 diabetes.
- To lower your morning blood sugars, you can try light exercise before bed, limit carbohydrates in the evening, and put more time in between your last meal and bedtime.
- This article was reviewed by Jason R. McKnight, MD, MS, a family-medicine physician and clinical assistant professor at Texas A& M College of Medicine.
- This story is part of Insider’s guide to Diabetes.
People with diabetes have a more difficult time regulating their blood sugar. Those with type 1 diabetes are not able to produce insulin, the hormone that helps the body convert blood sugar into energy. And those with type 2 diabetes cannot use insulin effectively.
As a result, blood sugar levels are often much higher for people with diabetes, especially in the morning. Here’s why.
How Lark Can Help
Lark Diabetes can provide additional support for lowering high morning blood sugar and keeping blood sugar levels within target ranges the rest of the time. The personalized coaching program includes medication reminders and tracking for blood glucose measurements so you can check your history and see how you have been doing with your blood glucose in the morning and at other times of the day.
Lark assists with weight loss coaching, healthy eating to lower blood sugar, and increasing physical activity with tips, logging, and in-the-moment insights to build healthy habits that are just as important for managing diabetes as taking your meds. You can chat with your Lark coach anytime via your smartphone.
High morning blood sugar can come as a surprise if you think you are doing everything right for your diabetes, but it can be a sign that there is room for improvement. With a little troubleshooting, and some help from your doctor, you may be able to lower morning blood glucose and get blood sugar in check the rest of the day, too. Lark for Diabetes can support your efforts to develop healthy habits that keep blood glucose under control for good.
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Why Fasting Sugar Is Higher Than Pp
Fasting sugar higher than postprandial levels is termed as fasting hyperglycaemia. Fasting blood glucose level is determined by the insulin secretion, and whether the body is responding to it. PP sugar level is measured after the meal, hence it depends on the meal and our metabolism.
Generally, fasting sugar is lower than pp. But if this scenario is reversed, then it means that the body is not producing enough insulin, or not responding to it properly. This could be a sign of a serious health issue and in such a situation, the person should contact a doctor.
How Long Does It Take To Lower Blood Sugar On A Low Carb Diet
Lessons LearnedLow Carb ExperienceHigh Carb ExperienceTake insulin at meal start, after, or not at all.Critical to take insulin before mealsEasier to track boluses one or two unit boluses stop lowering blood glucose in ~2 hoursHarder to track boluses large doses can still be lowering glucose at 4+ hours
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Wait Why Is Your Blood Sugar Up In The Morning
Why is it that your blood sugar levels will rise overnight? You dont eat anything, so how can you possibly add any glucose to your system?
Well, those who suffer from type II diabetes will find this is most problematic. The body still creates glucose throughout the night. It needs to, whether youve eaten something or not. This natural process is called gluconeogenesis, and there is nothing you can do to stop it nor would you want to. In a healthy person, this process doesnt cause a major problem.
Those with diabetes will find the gluconeogenesis process is increased. That means your body produces more glucose naturally than it would if you were healthy.
Lets not forget that the stress hormone cortisol also plays a part. This increases slowly on a morning until it reaches a peak early in the morning. The cortisol will elevate the blood sugar levels, so you end up with naturally higher levels on a morning.
To keep your blood sugar levels down, you need to keep your cortisol and gluconeogenesis levels down. Theres no need for extra medication when you follow the seven tips that will follow.
Signs Of High Blood Sugar In The Morning
High blood sugar is significant when its too high. Thats when its called hyperglycemia. Hyperglycemia is usually defined as above 126 mg/dL or 7.0 mmol/L in a period of fasting . This will be the clearest sign of high blood sugar in the morning.
Before breakfast, you usually would have had a period of at least eight hours without eating . As such, hyperglycemia during a period of fasting is particularly important here: youll know that the high blood sugar wasnt caused by any recent meals.
Other signs of high blood sugar in the morning will be the usual symptoms of hyperglycemia:
- Blurred vision
- Increased urination
Of course, its normal to feel somewhat groggy and thirsty when waking. Its important to distinguish between hyperglycemia and the I-hate-Mondays morning tiredness. And the best way to do that is to test your blood sugar.
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Can Fasting Too Long Raise Blood Sugar
Fasting means abstaining from eating or drinking anything but water for eight hours. After fasting, a carbohydrate metabolism test is conducted which measures blood glucose levels.
While fasting, blood sugar levels can drop very low. This prompts the secretion of the hormone glucagon, which increases the blood glucose level. A normal person can balance these increased glucose levels by secreting insulin.
But diabetic people either can’t produce enough of this hormone to balance the glucose levels or they’re not able to use the hormone effectively . Eventually, diabetic people will have higher blood sugar levels after fasting.
Fasting for too long would force the body to turn to the stored fats for energy. So, to fulfil the energy requirement, our body will start converting fats to glucose. Ultimately, the glucose levels will show noticeable increase.
When To Get Urgent Medical Attention
Contact your diabetes care team immediately if you have a high blood sugar level and experience the following symptoms:
- feeling or being sick
- a fever for more than 24 hours
- signs of dehydration, such as a headache, dry skin and a weak, rapid heartbeat
- difficulty staying awake
These symptoms could be a sign of a more serious complication of hyperglycaemia, such as diabetic ketoacidosis or a hyperosmolar hyperglycaemic state, and you may need to be looked after in hospital.
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If You Are Taking Levemir During The Morning
Levemir is a long acting insulin that has duration of between 18 and 24 hours.
If you take Levemir in the morning, this can mean that the effects of the insulin can wear off during the night.
This may also be the case, albeit to a lesser extent, if you are on a split dose of Levemir, that is taking an injection during the evening and an additional dose at breakfast.
What Can You Do About High Morning Blood Sugar
What to do about high morning blood sugar levels depends on how often you see them and what the causes are. It is important to take steps to address high blood glucose because consistently high morning values can indicate increasing A1C values and a higher risk for diabetes complications.
These are some possible strategies for getting high morning blood pressure into range.
- Increasing physical activity, including in the late afternoon or evening.
- Limiting the carbs you have at dinner or bedtime to 30 to 45 grams, such as 2 slices of bread, a piece of fruit and ½ cup of oatmeal, or a cup of pasta.
- Adjusting the timing and/or dose of insulin or other medications.
- Changing medications.
Your doctor can help you decide how to approach high morning blood glucose values. It is never safe to change medications without asking your doctor.
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What Is The Somogyi Effect
A second possible cause of high blood sugar levels in the morning is the Somogyi effect, sometimes also called rebound hyperglycemia. It was named after the doctor who first wrote about it.
If your blood sugar drops too low in the middle of the night while you are sleeping, your body will release hormones in an attempt to rescue you from the dangerously low blood sugar. The hormones do this by prompting your liver to release stored glucose in larger amounts than usual. But this system isnt perfect in a person with diabetes, so the liver releases more sugar than needed which leads to a high blood sugar level in the morning. This is the Somogyi effect.
High Blood Sugar Facts
- Low high blood sugar is abnormally high blood levels of insulin in the blood. Hyperglycemia is a hallmark sign of diabetes and prediabetes, and diabetes is the most common cause of it. Severely elevated glucose levels can result in a medical emergency like diabetic ketoacidosis or hyperglycemic hyperosmolar nonketotic syndrome .
- The primary symptom of hyperglycemia is excessive amounts of sugar in the urine. Other symptoms and signs of high blood sugar levels in the blood are blurred vision, hunger , and headaches.
- Other conditions that can cause high blood sugar are pancreatitis, Cushing’s syndrome, unusual hormone-secreting tumors, pancreatic cancer, certain medications, and severe illnesses.
- Insulin is the treatment for people with type 1 diabetes, and life-threatening increases in glucose levels. People with type 2 diabetes may be managed with a combination of different oral and injectable medications. Hyperglycemia due to medical conditions other than diabetes is generally treated by treating the underlying condition responsible for the elevated glucose.
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Understand Cortisol And Its Impact On Blood Glucose
We all live stressful lives, but some of us have a harder time reducing or releasing our stress. That fact may play out in restlessness, poor sleep, insomnia, or feelings of anxiety or constant tension. Cortisol is the stress hormone that mediates the fight or flight physiologic response. And it has a direct bearing on our glucose levels.
Prolonged cortisol stimulation will raise blood glucose levels, notes Dr. Jason Fung, who wrote an entire chapter on the stress hormone in his 2016 bestseller The Obesity Code.8 In it he describes how cortisol, released from the adrenal glands, sends a message to the body to release glucose to prepare for a perceived threat, spurring gluconeogenesis in the liver. In prehistoric times, that surge of glucose energy was usually used up fighting or fleeing from the threat. But in current days, often that stress goes unreleased, the energy not used, which can lead to prolonged higher glucose levels
I, too, discovered the same stress impact, especially with sleep. Since this spring, I am doing yoga in the early evening, focusing on other stress reduction activities and wearing earplugs and an eye shade to help ensure a better night sleep. Doing so drops my FBG back into the normal range the next morning.
Drinking a glass or two of wine at night can lower readings, too, because the liver metabolizes the alcohol first before turning to gluconeogenesis, but I dont want to drink daily.
Why Does Blood Sugar Go Up At Night
There are many factors that can cause your blood sugar to increase at night. For example: what food you ate during the day, how much and when you exercised, whether you ate snacks before bed, the timing of your insulin doses, and your stress level. You can experience different patterns of high blood sugar at night. You may start with high glucose when you go to bed, start the night in range but go high several hours later, or spend most of the night in range until the hours just before you wake up. By identifying your bodys patterns, you can figure out what is causing your high blood sugar and how to address it.
Common causes of a glucose increase at night include:
Finding The Cause Of Your Morning Blood Sugar High
Though the three most likely causes of high morning blood sugar can all be treated, first you have to know which one is the source of your condition. “If youre not sure, you might have to take the somewhat inconvenient step of waking up to check your blood sugar levels in the middle of your sleep pattern ” suggests Amori. Heres why:
- Consistent blood sugar from bedtime until about 3 a.m. and then a rise suggests the dawn phenomenon.
- Low blood sugar at 3 a.m. suggests the Somogyi effect.
- Blood sugar that increases from bedtime to 3 a.m. and then is even higher when you wake is probably due to waning insulin.
Using a continuous glucose monitor enables you to get this information without having to wake up for it. “These monitors potentially help identify patterns and severity of high and low blood sugars,” explains Amori.
How To Lower Morning Blood Sugar Without Medication
Dr. Danielle Weiss is the founder of Center for Hormonal Health and Well-Being, a personalized, proactive, patient-centered medical practice with a unique focus on integrative endocrinology. She enjoys giving lectures and writing articles for both the lay public and medical audiences. Dr. Weiss is Assistant Clinical Professor of Medicine at the University of California, San Diego.
Diabetes is a chronic disease where the level of glucose in the blood is too high . People with this condition often worry about high blood sugar levels in the morning. This is so common that it has a name: the dawn phenomenon. As our body prepares to wake up in the morning, it releases a surge of hormones, which can work against insulin and cause blood sugar level to rise. Also called the dawn effect, this can affect anyone and isn’t usually a problem because the body naturally produces insulin to correct it, but the bodies of people with diabetes may not be able to respond the same way. This results in consistently high blood sugar levels in the morning.
It is possible to lower your blood sugar level without medications through lifestyle and dietary changes. If simple lifestyle changes don’t work, people with diabetes should consult with their healthcare provider to determine the best approach to lower their blood sugar level in the morning.
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