So Whats Making You High
As diabetics we are constantly striving to maintain a perfect blood glucose level. Having a high fasting reading constantly is a cause for major concern and can definitely affect your hbA1c and by extension your health if not corrected. For 3 or 4 days in a row, plan specific blood glucose testing times. You should also prepare your own meals during this testing period so that you are certain of the carbohydrate content. Try to have your last meal at least 2 hours before bedtime. Check your blood glucose at bedtime, wake up around 3 a.m to test again, and take the final reading at your usual wake-up time. Comparing these results can identify what is the underlying cause of your high blood glucose level in the morning. Sometimes it can also be a combination of issues. The table below is a guideline to follow to assist in identifying the problem. Always seek medical advice from your doctor pertaining to medication dosages and modifications.
|Find the Culprit of your Fasting High Blood Glucose Level|
If your 2 hour post dinner time is close to your bedtime there is no need to test again. If it is more than an hour apart include both tests. These are quite a lot of test which will be done over a couple day. Your fingers will be sore but it will lead to discovering your underlying problem.
What Causes High Blood Sugar Levels In The Morning
Commonly known reasons why your blood sugar may be high in the morning include high-carb bedtime snacks and not enough diabetes medications.
Yet two lesser-known reasons may be causing your morning blood sugar woes: the dawn phenomenon and the Somogyi effect. These causes of high morning blood sugar levels are a result of body changes and reactions that happen while you are sleeping.
Exercise Can Help Lower Morning Blood Glucose Levels
Exercise helps lower blood glucose levels in two ways:
Expert tips about exercise for lowering morning blood glucose levels
Dr Kimberly Cukier recommends trying a gentle 10-minute walk after an evening meal. A morning walk can also help reduce glucose levels in the blood.
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Build A Clear Picture Of How Your Blood Sugar Works By Using A Cgm
As weve seen, everyones blood sugar control works differently, so it can be helpful to know whether morning spikes are a problem for you.
Unless you have diabetes, it is unlikely that you check your glucose regularly.
Checking your glucose a few times throughout the day or continuously via CGM can help to show how your body is handling changes in glucose levels during fasting or after meals.
Natural Hormone Cycles Increase Blood Sugar Levels
Many hormones are released in a natural daily cycle, or circadian rhythm. This rhythm is responsible for the changes in our body that occur roughly every 24 hours such as our sleep-wake patterns, changes in hunger and body temperature, and when we feel most energised and alert. The early morning rise in blood glucose is part of this normal daily rhythm.
Glucose is used by cells in the body as the main source of energy. By increasing the supply of glucose first thing in the morning, your body becomes prepared for the day ahead.
The morning rise in glucose is caused by increased levels of other hormones in the morning, including cortisol and glucagon. One of the main roles of both cortisol and glucagon is to signal the liver to start turning its stores of glycogen into glucose. This glucose is released into the blood increasing your blood glucose levels.
In most people, this rise in glucose is counteracted by the production of another hormone, insulin, that keeps blood glucose levels in a normal range. This early morning rise then, doesnt cause any problems.
For people with diabetes however, it can be hard to manage this early surge in blood glucose levels. This is because their body cannot produce enough insulin or the body has become resistant to insulin, so blood sugar levels remain high.
Expert tips for identifying normal glucose rhythms
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Symptoms Of High Blood Sugar In The Morning
If you wear a continuous glucose monitor , or if you routinely check your blood glucose every morning, you can see whether or not you are experiencing early morning hyperglycemia. In addition, you may also experience some of the signs and symptoms of hyperglycemia, which may include:
- Frequent and excessive urination
- Blurry vision
General Physical Activity Recommendations For Type 1 And Type 2 Diabetes
- Total activity time should exceed 150 minutes per week.
- It is recommended to undertake activity daily, at least every other day.
- It is recommended to do strength training twice a week.
- Training should be done regularly.
- Physical activity should be tailored to the patients abilities.
- Activity-based on walking, for example, should be carried out with a controlled number of steps to help achieve the goal.
- A more intensive form of physical activity should be preceded by an appropriate warm-up and finished with exercises calming the body .
- Foot care is recommended and fitting appropriate footwear.
- It is worth having a unique ID badge informing about the disease.
If diabetes is diagnosed, i.e., the fasting blood glucose level is 126 mg/dl, and above, and symptoms of diabetes are present, or if the level is above 200, the patient is immediately referred to a diabetology clinic.
If such a patients diet and physical activity do not bring the expected results, we can turn to medications that counteract high blood sugar levels. This does not always mean that the patient will have to take medication for the rest of their life, notes Dr. Patrycja Wachowska-Kelly.
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How To Lower Blood Sugar In The Morning
As with any time of the day, lowering blood sugar will usually mean taking medication.
If youre taking other medication for diabetes, just make sure youre taking the right amount at the right time of day. With insulin, you might want to use insulin to lower your blood sugar back to a stable level.
To figure out how much insulin you might need, you can let Hedia assist you in your calculations. Tell Hedia what your blood sugar level is, and the insulin calculator will take your basal insulin into account.
If youll be having breakfast soon after waking, youll probably want to include that in your calculation. If you have a favourite breakfast that you eat most mornings, you can add that to your favourites in Hedias food database for a quick add. Find out more by getting Hedia from the App Store or from !
On the topic of breakfast, it may be worth considering a low-carb breakfast, so as not to push those blood sugar levels even higher.
Regardless of what youre eating, Christel Oerum from Diabetes Strong points out the importance of eating any kind of breakfast. Having regular mealtimes that give you the energy that you need throughout the day ought to allow you more stable blood sugar without the adrenaline swings.
Switch Up Your Exercise Timing
As previously discussed, exercise done too close to bed can result in hypoglycemia. If you tend to exercise in the evening, try exercising in the morning or at lunch and see if it makes a difference in your morning glucose level.
If you are particularly stretched for time, you can also try splitting up your exercise into two smaller time-blocks. This has the added advantage of giving your body more time to recover.
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Causes Of High Blood Sugar At Night
There are many causes of high blood sugar at night, including:
- A dinner or bedtime snack high in carbohydrates: Eating starchy or high-sugar foods late in the day can lead to high blood sugar at night, as well as high blood sugar in the morning.
- Illness or injury: Trauma can trigger a hypermetabolic response , leading to high blood sugar.
- Too little exercise: Exercise helps the body more effectively use insulin, so lack of exercise could contribute to high blood sugar.
- Too little insulin or diabetes medicine: When the body does not produce insulin or does not use insulin effectively and you dont properly take your injectable insulin or diabetes medicine, glucose can accumulate in the bloodstream.
- Menstruation:Progesterone is a hormone linked to a decreased production of insulin, which affects glucose metabolism and can potentially lead to high blood sugar.
- Pregnancy: Hormone levels fluctuate during pregnancy. Diabetes that occurs during pregnancy is known as gestational diabetes.
- Stress: Stress, as measured by levels of a hormone called cortisol, is linked to decreased insulin sensitivity. With this, glucose cannot get into your cells and be used for energy. As a result, glucose builds up in the bloodstream, leading to high blood sugar. When people are stressed, they may also overeat sugary foods or adopt other unhealthy eating habits.
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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Urgent Advice: Call Your Care Team Immediately Or Get Help From Nhs 111 If:
You think you have high blood sugar and:
- you’re feeling sick, being sick or have stomach pain
- you’re breathing more quickly than usual or your heart is beating faster than usual
- you feel drowsy or are struggling to stay awake
- your breath has a fruity smell
- you feel confused or have difficulty concentrating
- you have a high level of ketones in your blood or pee
These could be signs you’re becoming seriously unwell.
You can call 111 or get help from 111 online.
Page last reviewed: 26 May 2022 Next review due: 26 May 2025
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Hormones Raise Blood Glucose
Around 3-4 am each morning, there are a collection of counter regulatory hormones that are signaled in the body: glucagon, epinephrine, growth hormone, and cortisol, which result in a rise in blood sugar.
This change in hormones occurs to stimulate our awakening, to get us moving and to give us energy. This is referred to as the Dawn Phenomenon or Dawn Effect.
This is in fact a normal response. This occurs in everyone, diabetic or not.
However, if you have diabetes or prediabetes there is one additional factor that impacts both the overnight glucose production and the rise in glucose with cortisol, and that is decreased insulin production or decreased utilization of insulin.
Is It Normal For Blood Sugar To Rise In The Morning
The bottom line: Yes, itâs normal for blood sugar to increase temporarily in the early morning hours, but your body should quickly take that excess blood glucose into your cells. As long as your morning blood sugar doesnât spike to pre-diabetic or diabetic levelsâor remain elevated for hours upon wakingâyour body is just doing its job.
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So Why Is The Blood Glucose/sugar High In The Morning Commonly In Diabetics
In most patients suffering from diabetes insulin resistance is the primary reason for elevated blood sugars in the morning. The dawn phenomenon and the Somogyi effect can also play a role. In addition to that, depending on the type of the patient, insufficient insulin, incorrect medication dosage, carbohydrate snacks before bed are common causes for morning high blood sugars .
Techniques To Manage Your Blood Sugar In The Morning
Based on your glucose levels and trends, there are a few things you can do to manage your glucose levels so they dont run high in the morning. Some of these strategies focus on adjusting medications to better suit your needs. Other strategies include adjusting your exercise routine, as well as what and when you are eating before bed.
If your glucose levels are in range before bed, they may rise throughout the night without enough insulin. This can be especially true for people who take long-acting insulin in the morning, since it may be wearing off before your next dose.
Consider changing the time of day when you take your long-acting insulin. You may also benefit from switching to either twice-daily basal insulin or ultra-long-acting insulin, or from starting on an insulin pump. Read our article, Are You on the Right Kind of Insulin, to learn more.
Check your blood glucose during the night between 3 am and 8 am. If you are running high during these hours, you may be experiencing the dawn phenomenon.
Talk with your healthcare team about finding the best nighttime insulin regimen for you. If you take basal insulin, you may need to delay the timing of your dose to as close to bedtime as possible. Another option is to try an insulin pump or automated insulin delivery system. AID systems will automatically adjust your basal insulin doses throughout the night to help keep your glucose levels stable.
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Tricks To Help Lower Your Blood Sugar In The Early Morning:
Skip the bedtime snack and limit carbohydrates with dinner.
Having a bigger lunch and a smaller dinner can often lower the morning blood sugar level. This is because there is less sugar available to the body overnight.
Try changing the time you take your prescribed medications.
Metformin, the first-line medication for diabetes, is the best oral medication for reducing insulin resistance in the liver. Sometimes moving the evening metformin dose from suppertime to bedtime can help lower early morning glucose levels.
Exercise increases sugar uptake by the muscle. This increased sugar uptake lowers the amount of sugar in the blood for many hours after the activity. A safe exercise plan can greatly lower all of your blood sugars.
Drinking plenty of waternot flavored or diet drinkskeeps you well hydrated. Sugar always travels with water, so it is important to keep up with the bodys need for fresh water to balance the blood sugar.
If you are on insulin, there might be a problem with your insulin dose.
The first step is to find out if your blood sugar is running high or low in the middle of the night. If you have low blood sugars overnight, this needs to be corrected first in order to prevent the subsequent rebound effect.
How can I help my doctor figure out why my blood glucose is high in the AM?
Diagnosing And Treating Hyperglycemia
Diagnosing hyperglycemia is done by assessing symptoms and performing a simple blood glucose test. Depending on the severity of the condition and which type of diabetes the patient is diagnosed with, insulin and a variety of medication may be prescribed to help the person keep their blood sugar under control. Insulin comes in short, long and fast-acting forms, and a person suffering from type 1 diabetes is likely to be prescribed some combination of these.
Individuals who are either diagnosed with type 2 diabetes or are considered at risk for the disease are recommended to make alterations to their diet, lifestyle habits and exercise routine in order to lower blood sugar and keep it under control. These changes generally help to improve blood glucose control, individuals with type 2 diabetes may require medication eventually. These can include glitazones, acarbose, glucophage or sulphonylureas.
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