Controlling The Dawn Phenomenon
Do you wake up with a blood glucose level that’s higher than when you went to bed? You might wonder how this could be. Is this “dawn phenomenon” serious, and what can you do about it? Our reader Mishelle commented here, “I don’t eat [much] during the day. [I take metformin morning and night.] My blood sugar is still too high in the morning…sometimes 125–140ish.” How can Mishelle’s glucose levels go up if she didn’t eat anything? She probably has a mild case of dawn phenomenon. Her glucose is going up from sources other than digested food. Some of it is produced by the liver from stored starch and fatty acids. Livers that produce too much glucose are one of the main ways diabetes causes high blood glucose levels. Other organs also produce small amounts of glucose. This is called “gluconeogenesis” for you science freaks out there. Organs do this to keep blood glucose from going too low at night or other times of not eating. From about 2 AM to 8 AM, most people’s bodies produce hormones, including cortisol, glucagon, and epinephrine. All these hormones increase insulin resistance and tell the liver to make more glucose. The idea is to get you enough glucose to get out of bed and start the day. The whole process is apparently started by growth hormones. Everyone has a dawn phenomenon. Otherwise they’d be too weak to get breakfast. But in people without diabetes, insulin levels also increase to handle the extra glucose. People with diabetes can’t increase insulin levels that much, so their early morning blood glucose levels can rise dramatically. Experts disagree on how many people have a dawn phenomenon. Estimates range from 3% to 50% of Type 2s and from 25% to 50% of Type 1s. Is dawn phenomenon a serious problem? It can be serious. According t Continue reading >>
High Blood Glucose Levels Before Breakfast
Tweet If you are regularly having high sugar levels before breakfast, there are a number of causes which could be the reason for it. Below are some of the more common reasons, including an explanation of how they can cause high sugar levels and what action you may wish to take to tackle the problem. For advice on how to spot high patterns, see our guide to dealing with highs and lows. Too little intermediate or long acting (basal) insulin If you are consistently getting high readings before breakfast, it could be that your long acting (basal) insulin is too low. If you take intermediate insulin (such as NPH insulin), consistently high sugar levels in the morning could be the result of taking too little intermediate insulin at dinner time. Action Consider increasing your dose of long acting or intermediate insulin. If increasing your insulin, do so gradually and test your blood glucose regularly to identify whether your blood glucose is going to low as a result. As always, be prepared to test your blood glucose if you feel the symptoms of hypoglycemia. If you at all unsure of how or whether to adjust your insulin, speak to your diabetes health team who will be able to help you. Be careful if you are considering increasing insulin Make sure your health team are happy for you to adjust your own insulin doses and consult them if you are in any doubt. If you increase your insulin, do so gradually to prevent risking severe hypoglycemia from occurring and test your sugar levels regularly to check low sugar levels are not occurring Having a meal with a delayed spike for dinner Some meals have a delayed spike, that is they can cause a significant rise in blood sugar levels that occurs a number of hours after having eaten. Meals that can typically lead to a delayed increase in bl Continue reading >>
The Dawn Effect: Tips For Fixing High Morning Blood Sugars
An early morning spike in the blood sugar can be a sign of poorly-controlled diabetes or something called the Dawn Effect. Here's what you can do. The dawn phenomenon sometimes called the dawn effect, is the term given to an early morning spike in the fasting blood sugar in an individual with diabetes. Typically occurring between 2 and 8 AM, it can be frustrating for those who are making every effort to control their blood sugar. Fortunately, the dawn phenomenon can be effectively managed. Why it Happens Everyone—those with or without diabetes—experiences a rise in blood sugar in the early morning. “There is a surge in growth hormone secretion in the early morning and this appears to be the hormone that may be the most responsible for the dawn phenomenon, at least in people with type 1 diabetes,” says Robert Courgi, MD, a hospitalist and endocrinologist at Southside Hospital in Bay Shore, New York. “The dawn phenomenon is apparently not only responsible for a rise in fasting glucose, but it can also account for an exaggerated rise in post-breakfast blood glucose.” Growth hormone, as well as hormones like cortisol, are “get-up hormones that work to get us started on our day,” explains Yan Yan Sally Xie, MD, an endocrinologist at Long Island Jewish Medical Center in New Hyde Park, New York and North Shore University Hospital in Manhasset, New York. “But all these hormones cause glucose levels to rise.” In a person who doesn’t have diabetes, there is sufficient insulin to cope with the blood glucose, or sugar, when it rises, Dr. Courgi says. “But in someone with diabetes, there’s just not enough insulin to control the sugar,” he adds. The pancreas isn’t able to produce insulin as needed, so the blood glucose rises. The Consequences of High Blo Continue reading >>
Blood Sugar: What Causes High Blood Sugar Levels In The Morning
There are two reasons why your blood sugar levels may be high in the morning – the dawn phenomenon and the Somogyi effect. The dawn phenomenon is the end result of a combination of natural body changes that occur during the sleep cycle and can be explained as follows: Your body has little need for insulin between about midnight and about 3:00 a.m. (a time when your body is sleeping most soundly). Any insulin taken in the evening causes blood sugar levels to drop sharply during this time. Then, between 3:00 a.m. and 8:00 a.m., your body starts churning out stored glucose (sugar) to prepare for the upcoming day as well as releases hormones that reduce the body's sensitivity to insulin. All of these events happen as your bedtime insulin dose is also wearing off. These events, taken together, cause your body's blood sugar levels to rise in the morning (at "dawn"). A second cause of high blood sugar levels in the morning might be due to the Somogyi effect (named after the doctor who first wrote about it). This condition is also called "rebound hyperglycemia." Although the cascade of events and end result – high blood sugar levels in the morning – is the same as in the dawn phenomenon, the cause is more "man-made" (a result of poor diabetes management) in the Somogyi effect. There are two potential causes. In one scenario, your blood sugar may drop too low in the middle of the night and then your body releases hormones to raise the sugar levels. This could happen if you took too much insulin earlier or if you did not have enough of a bedtime snack. The other scenario is when your dose of long-acting insulin at bedtime is not enough and you wake up with a high morning blood sugar. How is it determined if the dawn phenomenon or Somogyi effect is causing the high blood sug Continue reading >>
How To Avoid High Morning Blood Sugars
We’ve all been there before. You wake up. Lay in bed for a few before getting your booty up to go kill the workday and accomplish big things. Check your blood sugar. 115 (6.3 mmol/l) stares back at you. You smile to yourself: life is good. Forty minutes later, when you sit down to eat, your CGM gives you a “high” notification, and you’re 180. You have eaten NOTHING. All you’ve done is prepare for the day and prepare food. Now you face the grim potential of chasing your sugars all day long. What the… This isn’t Dawn Phenomenon Many people would blame this rise in blood sugar on dawn phenomenon (DP), 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 2am-6am, with most of it occurring in the middle of the night. Let’s say you woke up at 8:30am and aren’t in the “DP zone.” It’s not DP. Then what? Feet on the floor The moment your feet touch the floor as you roll out of bed, you signal to your body, “Hey, I need energy for all the stuff I’m about to do!” Your body recognizes you haven’t eaten in lord knows how many hours. Your body is also lazy smart and wants the most easily accessible source of energy: the liver. The liver is the Wal-Mart for stored energy, since it’s got everything you need. It stores glycogen that can be easily broken down when fasted or needed for activity, AND is the home of gluconeogenesis, a process where protein is broken down to glucose for energy. Guess what? You’r Continue reading >>
Frequently Asked Questions
The Dumbest & Smartest Things A Doctor Ever Told Me I eat a low fat diet, so why is my cholesterol level still high? Why are my blood sugars higher in the morning than when I go to bed the night before? This typically occurs due to the dawn phenomenon. The dawn phenomenon is the rise in blood glucose levels in the dawn (that is, the morning) due to excessive release of glucose from the liver into the blood. Here is a graph of a person’s blood glucose readings measured with a device (a “continuous glucose monitor”) that automatically measures the body’s glucose level about 300 times per day (each colour represents a different day): As you can see in the preceding graph, every day starting at about 3am this person’s glucose levels started to go up. This individual, like so very many others living with diabetes who have high blood glucose levels first thing in the morning, blamed themselves and attributed their elevated morning blood glucose to having overeaten or snacked the night before. Not so! What they (and you) eat at bedtime (or suppertime) seldom is a significant factor in leading to high blood glucose levels the next morning; heck, the food you ate the night before is long since digested, absorbed into the body, and metabolized well before the following morning’s breakfast. This graph nicely illustrates that point. One colourful term for the liver’s tendency to release glucose into the blood overnight is a liver leak. How much sugar (glucose) gets released from the liver if you have the dawn phenomenon? How about this: Almost as much as is contained in TWO CANS OF COLA! If you have the dawn phenomenon this is something that is not simply to be accepted. Rather, your therapy should be adjusted to fight it so that your blood glucose levels are kept w Continue reading >>
Why Is My Blood Glucose So High In The Morning?
I am puzzled by my blood sugar pattern. I am not on any medications. My morning fasting blood sugar is always the highest of the day—between 120 and 140 mg/dl. The rest of the day it is in the normal range. Why does this occur? Continue reading >>
Why Is My Blood Sugar High In The Morning?
That early morning jump in your blood sugar? It's called the dawn phenomenon or the dawn effect. It usually happens between 2 and 8 a.m. But why? Generally, the normal hormonal changes your body makes in the morning will boost your blood sugar, whether you have diabetes or not. If you don't, your body just makes more insulin to balance everything out. You don't even notice that it's happening. But if you have diabetes, it's different. Since your body doesn't respond to insulin the same as most, your fasting blood sugar reading can go up, even if you follow a strict diet. The boost in sugar is your body's way of making sure you have enough energy to get up and start the day. If you have diabetes, your body may not have enough insulin to counteract these hormones. That disrupts the delicate balance that you work so hard to keep, and your sugar readings can be too high by morning. The effects of the dawn phenomenon can vary from person to person, even from day to day. Some researchers believe the natural overnight release of what are called counter-regulatory hormones -- like growth hormones, cortisol, glucagon and epinephrine -- makes your insulin resistance stronger. This will make your blood sugar go up. You may also have high blood sugar in the morning because: You didn't have enough insulin the night before. You took too much or too little medicine. You ate the wrong snack before bedtime. If the dawn phenomenon affects you, try to: Eat dinner earlier in the evening. Do something active after dinner, like going for a walk. Check with your health care provider about the medicine you’re taking. Eat breakfast. It helps bring your blood sugar back to normal, which tells your body that it's time to rein in the anti-insulin hormones. Eat a snack with some carbohydrates and Continue reading >>
Why Blood Sugar Can Be High In The Morning
You wouldn’t expect hours of sleep and fasting to leave you with high blood sugar. But elevated morning glucose may be more common than you think. Although it’s not a major problem when it occurs from time to time, consistently high morning levels need your doctor’s attention. Causes of Morning Hyperglycemia High blood glucose in the morning typically occurs due to one of three distinct causes: Dawn Phenomenon The “dawn phenomenon” describes high morning glucose that occurs due to a natural rise in hormone levels. During the early morning hours between about 4 and 8 a.m., your body releases hormones like cortisol and growth hormones to get ready for the day. For reasons experts don’t completely understand, your liver produces extra glucose in response to these hormones. People without diabetes secrete more insulin to handle the extra glucose. But for people with diabetes, blood glucose levels can rise too high. Increased blood sugar due to the dawn phenomenon is usually treated with diabetes medication. If you are on insulin, your insulin levels may need to be changed. The Somogyi Effect It’s possible to experience low blood sugar, or hypoglycemia, while sleeping and not even know it. The potentially dangerous problem can occur for a number of different reasons—from not eating enough or taking too much insulin, to drinking too much alcohol. In some people, the body compensates for the hypoglycemia by producing a lot of hormones. This, in turn, causes blood sugar levels to rise. Not everyone wakes in reaction to low blood glucose levels. But being sweaty or having a headache in the morning can be a sign. If you suffer from the Somogyi effect (named after the scientist who first described the condition), your doctor may recommend that you eat a snack befor Continue reading >>
What You Should Know About Diabetes And The Dawn Phenomenon
What IS the “Dawn Phenomenon” in diabetes. The Dawn Phenomenon (also known as the Dawn Effect) was defined over 30 years ago in T1D as the elevation of blood sugars during the night and early morning hours and an even greater rise in blood sugar after breakfast. Soon after, the Dawn Phenomenon was observed in T2D as well.  The current definition of the Dawn Phenomenon is the need for insulin to prevent the rise of blood sugar levels in the early morning hours of predawn and dawn. So, after 30 years of research, what do we know about the Dawn Phenomenon—and what do we know about how to deal with this phenomenon? The Biology of the Dawn Phenomenon In normal, non-diabetic people, blood sugar and insulin secretion remain very constant overnight. Just before dawn, insulin can rise a small amount. In this sense, the Dawn Phenomenon exists in non-diabetic people as well—the phenomenon isn’t as large and because non-diabetics are not insulin resistant, their body secretes insulin and the cells respond by taking up the sugar from the blood, causing only a slight, mostly unnoticed rise in blood sugar. However, in diabetic individuals, the Dawn Phenomenon is much more significant. Anywhere from 10-50% of people with T2D and T1D experience the dawn phenomenon. It is believed that the rise in blood sugar during the early morning hours is due to the release of glucose from the liver—this can be referred to as a liver dump. This is due to the rise in growth hormone, cortisol, glucagon and adrenaline (epinephrine), all of which can function to stimulate the release of sugar and the synthesis of new sugar (glucose) from the liver. Why the rise in these hormones? Because during the night, the blood sugars will drop—and when they drop below a certain level, the body reads Continue reading >>
Why Do I Have High Blood Sugar Levels In The Morning?
Some people experience very high blood sugar levels in the morning. But what implications does this have for a person's health? There are two main causes of high blood sugar in the morning, the dawn phenomenon and the Somogyi effect This article explores these two causes of high blood sugar levels in the morning. It also discusses what risk factors may cause people to experience them and gives practical advice around how to better manage blood sugar levels. Contents of this article: The dawn phenomenon The dawn phenomenon has to do with natural body changes that occur during the sleep cycle: Midnight - 3 a.m. While most people are sleeping, their body has little need for insulin. During this period, however, any insulin that may have been taken during the evening causes the blood sugar levels to drop off drastically. Between 3 - 8 a.m. The body automatically begins to dish out stored sugar (glucose) in preparation for the upcoming day. In addition, hormones that actively reduce the body's sensitivity to insulin are also being released. During this time period, counter-regulatory hormones are being released. This can interfere with insulin, which may lead to a rise in blood sugar. These include growth hormones, such as: cortisol glucagon epinephrine These events are all happening simultaneously as bedtime levels of insulin are beginning to taper off. Each of these events ultimately plays a part in causing blood sugar levels to rise at "dawn" or in the morning. Who the dawn phenomenon affects Although people with diabetes are generally more aware of the dawn phenomenon, it actually happens to everyone. However, it affects people with or without diabetes differently. Typically, people who do not have diabetes tend not to notice these high blood sugar levels in the morning. Continue reading >>
7 Morning Rituals Proven To Lower Morning Blood Sugar Naturally
If you’re a diabetic, you may find that your blood sugar levels are at their peak in the morning. This is due to the fasting period overnight. It’s common for blood sugar tests to require a period of fasting beforehand to get the best natural levels. You need to get your blood sugar levels down right away. The good news is you don’t necessarily need to rely on medication. While you will want to take medication in the way that your doctor has prescribed, you will still want to follow these seven-morning rituals. It is possible to reverse type II diabetes and focus on a healthier and more natural lifestyle. Even if you’re not a diabetic, you will want to keep your morning blood sugar levels down. Here are the seven must-follow morning rituals that have proven to lower the blood sugar levels on a morning completely naturally. Wait, Why Is Your Blood Sugar Up In the Morning? Why is it that your blood sugar levels will rise overnight? You don’t 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 you’ve 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 doesn’t 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. Let’s 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 hi Continue reading >>
How To Fix High Morning Blood Sugars (dawn Phenomenon)
There are various possible causes of a high blood sugar level in the morning: The Dawn Phenomenon which is a natural rise in blood sugar due to a surge of hormones secreted at night which trigger your liver to dump sugar into your blood to help prepare you for the day. Having high blood sugar from the night before which continue through the night into the morning. Reactive hyperglycemia which is also called the Somogyi Effect. This is when a low blood sugar in the middle of the night triggers your liver to dump sugar into your blood in an attempt to stabilize your blood sugar. Why Are My Blood Sugars High in the Morning? There is a simple strategy for diagnosing the source of high blood sugars in the morning. Test your blood sugar before bed. Test your blood sugar in the middle of the night. Test your blood sugar in the morning. It takes a little bit of effort, but you only need to do it a few times to diagnose the issue. TheSomogyi Effect is less common than the Dawn Phenomenon, according to an article published by The Polish Journal of Endocrinology. To diagnose either of these phenomena, scientists recommend checking blood sugar levels for several nights specifically between 3 a.m and 5 a.m. or using a continuous glucose monitoring system (CGM). Many healthcare practitioners are now offering the use of a loan CGM for a few days which can be helpful to observe nighttime blood sugar activity. How to Fix High Blood Sugars in the Morning The Dawn Phenomenon refers to a surge of hormones excreted by your body in the early morning hours. These hormones rise each night around the same time to prepare your body to wake. Basically, your body is starting the engine, releasing some fuel, and prepping to go for the day. The Dawn Phenomenon occurs in all humans regardless of whet Continue reading >>
Why Is My Blood Sugar High In The Morning? Use This Chart To Find Out!
One Drop Guide: Why is my blood sugar high in the morning? Whatsone of the most frustrating things to deal with when you have diabetes? Waking up to a high morning blood sugar! You havent eaten, taken insulin, or moved for hours, so whats the deal? Well, there are actually some good explanations for those mysterious morning highs, and some steps you can take to prevent them. Check out the this mobile-friendly One Drop Guide Why is my blood sugar high in the morning? to figure out what the cause might be and what todo about it. Continue reading >>
Managing Morning Blood Sugar Highs: How To Treat The Top 3 Causes
A high blood sugar reading first thing in the morning can throw off your whole day — and signal a chronic problem. Despite their best efforts to control their blood sugar levels, some people simply wake up with elevated blood sugar. Starting your day this way isn't just alarming: If it becomes a pattern, high morning readings can make it difficult to achieve your long-term diabetes management goals. Whether you have type 1 or type 2 diabetes, a morning blood sugar high can be due to several causes. But with a little detective work and the help of your diabetes care team, you can isolate the cause and take steps to correct it. Here are three common scenarios: 1. The Dawn Phenomenon This occurs during the night while you're asleep and the body releases stress hormones. This phenomenon usually occurs between 3 a.m. and 8 a.m. and involves growth hormone, cortisol, and adrenaline, which trigger the production and release of glucose from your liver. The end result of this chemical cascade is an increase in blood sugar. “These hormones are designed to get us up and moving in the morning,” says endocrinologist Renee Amori, MD, assistant professor of medicine in the division of endocrinology at the Drexel University College of Medicine in Philadelphia. While everybody experiences these natural changes in hormone levels, in people with diabetes the body may not adjust appropriately. This can lead to higher-than-normal blood sugar at the start of the day. Testing for these elevated first morning blood sugars is one way to diagnose people with type 2 diabetes. 2. The Somogyi Effect High morning readings can also be caused by the Somogyi effect, a rebound response that occurs when the body overcompensates for a low blood sugar reaction at night. If you take blood sugar–lowe Continue reading >>