How To Prevent The Dawn Effect
At this moment, I believe that you know a bit more about how your body works. Now you know why you have low blood sugar at 3:00 am and high blood sugar after waking up.
It is quite clear which action you have to take if you will have a Somogyi or a Dawn effect. But, both effects give high fasting blood sugar levels so how will you know which effect you are experiencing?
Just continue reading further because you are on the right track
How Do You Treat Hypoglycemia
Treatment for hypoglycemia involves both the immediate steps needed to raise your blood sugar level in addition with the later treatment or medication dose adjustment to prevent recurrence.
To immediately raise your blood sugar level, Dr. Shah advocates the rule of 15eating 15 grams of carbohydrates and then checking your blood sugar level 15 minutes later. Fast-acting carbohydrates include:
- 4 glucose tablets
- 4 ounces of fruit juices
Keep repeating these steps every 15 minutes until your blood sugar reaches above 70 mg/dL, he explains. Once your level has stabilized, its important to then eat a snack or even a full meal to maintain that balance, Dr. Shah adds.
If your symptoms are more severe and/or a person is unable to swallow, you may need an injection of glucagon, he says.
To prevent episodes of hypoglycemia in the future, Dr. Shah says that treatment may involve the changing of prescribed regimens and dosages or adjusting your meal plans.
Rising Blood Sugar: How To Turn It Around
| Image: Thinkstock |
Rising blood sugar signals a need for weight loss and more exercise.
Whenever you have routine blood tests at a physical exam, chances are one of the numbers will be a measurement of your glucose, or blood sugar. A normal blood sugar level is less than 100 milligrams per deciliter of blood after an eight-hour fast. You have diabetes if your blood sugar is 126 mg/dL or higher. But between those two numbers lie many opportunities for action.
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Why Blood Sugar Levels Rise Overnight
When you go to bed, your blood sugar reading is 110, but when you wake up in the morning, it has shot up to 150. Why does this happen?
To understand how blood sugar levels can rise overnight without your eating anything, we have to look at where glucose comes from and where it goes while we sleep.
During the day, the carbohydrates we eat are digested into glucose and absorbed into the bloodstream. Some of this glucose goes to the liver, where it is stored for later use.
At night, while we are asleep, the liver releases glucose into the bloodstream. The liver acts as our glucose warehouse and keeps us supplied until we eat breakfast. The amount of glucose being used is matched by the amount of glucose being released by the liver, so blood sugar levels should remain constant.
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Normal Waking Blood Sugar
After a night of sleep, and without any recently digested food in the system, the bodys glucose level tends to settle down to a healthy, normal level.
In the context of diabetes, this doesnt happen naturally, but it can be achieved with the proper use of insulin and other glucose-lowering medications. Ideally, everyone with diabetes will wake up with blood sugars in the normal range.
However, many people experience what is called the dawn phenomenon. As the body prepares to wake and start moving, it releases stored sugar from the liver into the blood. This can cause a moderate spike in blood sugar. You can read How to Fix High Morning Blood Sugars for tips on how to improve these numbers.
To confirm if this is happening to you, you can wake up in the middle of the night and check your blood sugar. If its in the normal range then, but higher after waking, this is probably the cause. If the spike is small and goes away quickly, then its likely nothing to worry about . The spike from dawn phenomenon is often less pronounced than one you would get from eating a typical meal.
Signs You Are Experiencing Diabetic Ketoacidosis
If you are in DKA, its likely that you are nauseous or vomiting. Your breath may have a fruity or acetone odor as your body tries to offload ketones through your breathing. Its likely that you will be dehydrated with very high BG levels and excessive urination. You might have aches and pains, and perhaps blurred vision. Not fun!
DKA is serious, and can be life-threatening. Because of dehydration and excessive ketone production, the blood becomes acidic. This is caused by a lack of working insulin. Most cells preferentially burn glucose for fuel. Many cells can also burn fat in small amounts. While glucose burns cleanly, fat produces waste products called ketones. Ketones are acid and upset the pH balance, essentially polluting the atmosphere in our bodies.
We dont tend to burn much fat at a time, so small amounts of ketones can usually be broken down and burned off along with glucose. Its necessary to have enough glucose in the body cells so there is a fuel source, and we also need to have insulin to move the glucose into the cells, where it can be used for energy. If there is no insulin, the glucose cant get inside the cells. The cells are then forced to burn fat as an energy source, and this causes large amounts of ketones to be produced.
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What Are Considered Normal Blood Sugar Levels
You might not have diabetes now, but do you know the risk factors?
In 2015, 22% of Canadian adults were pre-diabetic and the number of Canadians suffering from diabetes has increased by 44% in the last 10 years. As the leading cause of blindness, kidney problems, and non-trauma amputations, it is important to protect ourselves against diabetes.
But its not all bad news, diabetes is often a preventable disease. Knowing whether you have normal blood sugar levels is one of the best indicators of risk. If your blood sugar levels are high, mindful eating and lifestyle changes can reduce your risk of developing diabetes.
Read on for all the hottest tips on how to manage your blood sugar levels and prevent diabetes.
High Blood Sugar: Hidden Dangers
In the short term, high blood sugar levels can zap your energy, cause excessive thirst and urination, and blur your vision. High blood sugar levels can also lead to dehydration, dry and itchy skin, and infections. Minimizing the time spent above your target blood sugar range can help you feel your best and will help prevent complications and injury to your body.
Over time, high blood sugar affects many parts of the body. Chronic high blood sugar can start to cause noticeable changes, including:
- Memory problems
- Vision problems like blurriness, diabetic retinopathy, and blindness
- Gum disease that leads to tooth loss, which can make eating healthy foods difficult due to problems chewing
- Heart attack and stroke due to increased plaque build-up in the vessels and other vascular issues
- Kidney disease, which can lead to the need for dialysis or a kidney transplant
- Nerve damage that can cause decreased sensation in the feet and legs which increases the risk for wounds to turn into serious infections and even amputation
Nerve damage from high blood sugar can also cause a variety of symptoms including:
- Pain and tingling in the feet and hands
- Difficulty emptying your bladder
- Problems during the digestion process after eating, which can cause food to sit in the stomach too long and lead to nausea, vomiting, and erratic blood sugar levels
Checking your blood sugar frequently and taking immediate action when it is above range can reduce your risk of complications.
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How To Lower Morning Blood Sugar
Whether a morning high is caused by the dawn phenomenon or something else, here are a few things you can try to lower your blood sugar levels:
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Physical activity when you wake up can help bring your glucose level down. Even going for a walk can be helpful.
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To learn about exercise guidelines and glucose management strategies, click here.
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Read Adam Browns take on walking the most underrated diabetes exercise strategy.
Eating a light breakfast can help keep a morning high from increasing even more. Taking your mealtime insulin will help lower your blood sugar.
Adam Brown suggests eating a breakfast that is low in carbs, and notes that sometimes mealtime insulin has to be adjusted in the morning. One of his favorite breakfasts is chia pudding, since it has little impact on glucose levels see what else he eats for breakfast here.
Catherine Newman has six popular, low-carb, delicious recipes in The Morning Meal.
Intermittent fasting and time-restricted feeding approaches to meal timing can also help people keep morning blood sugar levels in range. Read Justine Szafrans Intermittent Fasting: Stabilizing My Morning Blood Sugars to learn more.
For additional ways to navigate mornings, read seven strategies from Adam Brown in A Home Run Breakfast with Diabetes.
This article is part of a series on time in range.
This Isnt Dawn Phenomenon
Many people would blame this rise in blood sugar on dawn phenomenon , which has a similar endpoint, but a different mechanism. Dawn phenomenon is the result of hormones releasing in the body in the early morning predominantly growth hormone, cortisol, epinephrine, and glucagon which in turn increase insulin resistance. The current basal insulin from the pump or long-acting injections is no longer enough, and blood sugars rise.
That hormonal surge happens around 2 am-6 am, with most of it occurring in the middle of the night. Lets say you woke up at 7:30 am and arent in the DP zone. Its not DP. Then what?
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Blood Sugar And Diabetes
In a person with diabetes, the story is much more complex. The body has largely or entirely lost the ability to regulate blood glucose levels, and as a result glucose levels are likely to be volatile and to inhabit a much wider range of values:
| Below 70 mg/dLBelow 3.8 mmol/L | Low Blood Sugars . When blood sugars drop below this level, you may start feeling hunger, shakiness, or racing of the heart. Your body is starved for sugar . Read how to detect and treat low blood sugars. |
| 70 mg/dL to 140 mg/dL3.8 mmol/L to 7.7 mmol/L | Normal Blood Sugar. In this range, the body is functioning normally. In someone without diabetes, the vast majority of the time is spent in the lower half of this range. |
| 140 mg/dL to 180 mg/dL7.7 mmol/L to 10 mmol/L | Elevated Blood Sugars. In this range, the body can function relatively normally. However, extended periods of time in this zone put you at risk for long-term complications. |
| Above 180 mg/dLAbove 10 mmol/L | High Blood Sugars. At this range, the kidney is unable to reabsorb all of the glucose in your blood and you begin to spill glucose in your urine. Your body may begin to turn to fat for energy and release ketones in your urine. |
Great Bedtime Snacks For People Living With Diabetes
For some people, a healthy bedtime snack helps to prevent glucose swings during the night. By eating a small snack that is full of protein and healthy fats , your body may be better able to avoid an overnight high but if you take insulin, be sure to cover the carbohydrates in your snack even if it only requires a small dose of insulin.
Here are some snack ideas:
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Plain nuts or seeds try eating a small handful
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Raw vegetables, such as carrots, celery, cucumbers, or tomatoes, with a small amount of hummus or peanut butter
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Plain yogurt, and you can add berries or cinnamon
Remember, a bedtime snack is only helpful for some people. To see if it works for you, youll have to carefully monitor your glucose before bed, during the night, and when you wake up.
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Normal Blood Sugar Levels Chart
Every substance present in our body has an optimum level. Above or below that specific range, that particular substance is harmful to our health. And so is sugar. There is a certain range of blood sugar which is considered as standard for almost all age. However, there might be some changes in the level considering different factors like age and other co-morbidities. Lets look at the chart:
| Time |
|---|
| 5.7-6.4% | 6.5% |
Sometimes, random blood is also taken. In this case, the glucose level of 200 mg/dl is considered a diabetic condition.
Going through the chart you will notice certain terms regarding blood sugar which you need to understand in order to evaluate your own glucose level. So, I will just give a small brief regarding those:
- Fasting blood glucose: Here, blood sugar is tested after abstaining from food and drink for at least 8 hours.
- Postprandial blood sugar:In this case, blood sugar is tested 2 hours after a meal to access if its at the optimum level after having a meal or not.
- Random blood glucose: Blood is tested at any time of the day.
- HbA1c: It refers to a blood test which is done to evaluate the average level of blood glucose over the past 3 months. HbA1c is also known as glycosylated haemoglobin or A1C. Moreover, fasting is not required before carrying out the test.
Is It Safe To Sleep With High Blood Sugar
Glucose levels that are occasionally a little high at night generally dont pose serious, immediate health concerns. Most people with diabetes cannot avoid some high glucose levels. However, frequent or long-term highs particularly extremely high levels can be dangerous. It is important for people with diabetes to reduce high blood sugar as much as possible for two key reasons:
Frequent hyperglycemia can lead to major health complications caused by damage to blood vessels and nerves, which can affect your eyes, heart, kidneys, and other organs. This occurs when glucose levels are too high over a long period of time.
Very high glucose levels can be a sign of diabetic ketoacidosis . This occurs mainly in people with type 1 diabetes and can be life-threatening. For more information on DKA, read Ketosis vs. Ketoacidosis: Whats the Difference.
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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.
Recommended Target Blood Glucose Level Ranges
The NICE recommended target blood glucose levels are stated below for adults with type 1 diabetes, type 2 diabetes and children with type 1 diabetes.
In addition, the International Diabetes Federations target ranges for people without diabetes is stated.
The table provides general guidance. An individual target set by your healthcare team is the one you should aim for.
| Target Levels |
|---|
*The non-diabetic figures are provided for information but are not part of NICE guidelines.
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