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 >>
Late To Bed, Early To Rise: A Recipe For Diabetes
For most people, not getting enough sleep isn’t a big deal. So what if you aren’t as sharp as usual the next day, or feel a bit groggy? But sleeping poorly night after night—because you are trying to burn the candle at both ends or you work night or rotating shifts—has long-term health consequences. People who don’t average at least six hours of sleep a night are more likely to be overweight or develop various medical problems, including diabetes, as described earlier on the Harvard Health blog. Being overweight is a big risk factor for becoming diabetic. Researchers long thought that the poor eating habits that went along with poor sleep were at the root of sleep-related diabetes. With the help of 21 volunteers who lived in a sleep lab for almost six weeks, researchers from Harvard-affiliated Brigham and Women’s Hospital have shown that lack of sleep plays an even more complex and powerful role. Each of the volunteers followed a carefully scheduled daily program of eating, physical activity, and sleeping. They started out well rested, getting 10 hours of sleep a night for the first six nights. Over the next three weeks, they spent just 5.6 hours in bed each night, and it came later and later each day. The schedule was meant to mimic rotating shift work or extended jet lag. This sleep pattern completely threw off the body’s sleep-wake rhythm, which influences the daily rise and fall of body temperature and blood pressure, and the secretion of many hormones. During the three weeks of abnormal sleep, the participants’ bodies stopped releasing enough insulin after a meal. Muscles need this hormone to absorb sugar (glucose) from the bloodstream. As a result, their blood sugar levels went haywire. Some of the people had blood sugar levels high enough to have Continue reading >>
The Dawn Phenomenon: What Can You Do?
What is the dawn phenomenon that some people with diabetes experience? Can anything be done about it? Answers from M. Regina Castro, M.D. The dawn phenomenon, also called the dawn effect, is the term used to describe an abnormal early-morning increase in blood sugar (glucose) — usually between 2 a.m. and 8 a.m. — in people with diabetes. Some researchers believe the natural overnight release of the so-called counter-regulatory hormones — including growth hormone, cortisol, glucagon and epinephrine — increases insulin resistance, causing blood sugar to rise. High morning blood sugar may also be caused by insufficient insulin the night before, insufficient anti-diabetic medication dosages or carbohydrate snack consumption at bedtime. If you have persistently elevated blood sugar in the morning, checking your blood sugar once during the night — around 2 a.m. or 3 a.m. — for several nights in a row will help you and your doctor determine if you have the dawn phenomenon or if there's another reason for an elevated morning blood sugar reading. What you can do Your doctor may recommend a number of options to help you prevent or correct high blood sugar levels in the morning: Avoid carbohydrates at bedtime. Adjust your dose of medication or insulin. Switch to a different medication. Change the time when you take your medication or insulin from dinnertime to bedtime. Use an insulin pump to administer extra insulin during early-morning hours. Continue reading >>
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 >>
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 >>
Why Blood Sugar Levels Rise Overnight
get the scoop 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. what is the dawn phenomenon? A rise in blood sugar level between approximately 3 A.M. and the time you wake up is called the “dawn phenomenon.” The liver is supposed to release just enough glucose to replace what is being used, and insulin works as the messenger to tell the liver how much is enough. But if there's not enough insulin (as with type 1 diabetes), or if there's enough insulin but it cannot communicate its message to the liver (as with type 2 diabetes), the liver starts to release glucose much too quickly. In addition, levels of hormones such as cortisol begin to increase in the early morning hours, which can contribute to altered insulin sensitivity. The result? Blood sugar levels rise. This is why blood sugar levels can go up between the time you go to bed and the time you wake up. what can you do about it? You might be able to make changes in the timing of your meals, medications, or insulin injections to help prevent dawn phenomenon. First, keep a detailed rec Continue reading >>
Sleep Hacks To Lower Your Blood Sugar
As a diabetic, you probably already know how important it is to eat right, exercise, and take your meds. Here’s something you may not know about controlling blood sugar: Sleep plays a vital role in maintaining normal blood sugar levels. Get less than six hours on most nights and you're three times more likely to have elevated blood sugar levels, according to research published in the Annals of Epidemiology. Even just one sleepless night can interfere with your body's ability to use insulin (and therefore regulate glucose), according to Dutch researchers. Too little sleep also leads to more weight gain: In a national survey of 87,000 people, one-third of participants who slept less than six hours were obese. And when researchers at Columbia University analyzed 20 years' worth of data on more than 68,000 women, they found that those who got five hours or less weighed about five pounds more and were 15% more likely to become obese than those who slept seven hours. Most adults need between seven and nine hours a night, yet one in five Americans regularly sleeps less than six hours, and nearly 70% of women report frequent sleep troubles, according to national polls. The best strategy to improve sleep, according to experts: Hit the sack and set your morning alarm for the same time every day (even on weekends)—maintaining a consistent sleep schedule keeps your biological clock in sync so you rest better. Here are 9 more tips to help you sleep well and stay healthy: Skip afternoon coffee breaks The caffeine from your favorite latte can stay in your system for about eight hours; even if you can fall asleep, you may not be resting soundly. Alcohol has the same effect: Though sipping a glass or two of red wine may make you drowsy, a few hours later, the alcohol levels in your Continue reading >>
Dawn Phenomenon And The Somogyi Effect
Overview The dawn phenomenon and the Somogyi effect cause high blood sugar levels, especially in the morning before breakfast, in people who have diabetes. Dawn phenomenon The dawn phenomenon is a normal rise in blood sugar as a person's body prepares to wake up. In the early morning hours, hormones (growth hormone, cortisol, and catecholamines) cause the liver to release large amounts of sugar into the bloodstream. For most people, the body produces insulin to control the rise in blood sugar. If the body doesn't produce enough insulin, blood sugar levels can rise. This may cause high blood sugar in the morning (before eating). Somogyi effect If the blood sugar level drops too low in the early morning hours, hormones (such as growth hormone, cortisol, and catecholamines) are released. These help reverse the low blood sugar level but may lead to blood sugar levels that are higher than normal in the morning. An example of the Somogyi effect is: A person who takes insulin doesn't eat a regular bedtime snack, and the person's blood sugar level drops during the night. The person's body responds to the low blood sugar by releasing hormones that raise the blood sugar level. This may cause a high blood sugar level in the early morning. How can you tell the difference? The Somogyi effect can occur any time you or your child has extra insulin in the body. To sort out whether an early morning high blood sugar level is caused by the dawn phenomenon or Somogyi effect, check blood sugar levels at bedtime, around 2 a.m. to 3 a.m., and at your normal wake-up time for several nights. A continuous glucose monitor could also be used throughout the night. If the blood sugar level is low at 2 a.m. to 3 a.m., suspect the Somogyi effect. If the blood sugar level is normal or high at 2 a.m. to Continue reading >>
Why Is My Blood Glucose Level Higher In The Morning Than At Bedtime?
High morning blood glucose levels before breakfast can be a puzzle. If you haven't eaten, why did your blood glucose level go up? There are two common reasons for high before-breakfast blood glucose levels. One relates to hormones that are released in the early part of sleep (called the Dawn Phenomenon). The other is from taking too little insulin in the evening. To see which one is the cause, set your alarm to self-monitor around 2 or 3 a.m. for several nights and discuss the results with your health care provider. It is completely natural to think that your blood sugar should be lower after a night sleep. After all, you have not eaten anything for many hours. But the body needs glucose 24 hours a day, and if you are not getting it from food, your body will turn to stored glucose in the liver. Your pancreas needs to make insulin to deal with this glucose, just as it does for glucose derived from the food you eat. Unfortunately, in many people with diabetes, insulin production during periods of fasting is as bad as or even worse than during eating. Therefore, the sugar may rise overnight because glucose being produced by the liver is not matched by adequate insulin from the pancreas. Certain medications, including glyburide (brand name Micronase or DiaBeta), glipizide (brand name Glipizide) and glimepiride (brand name Amaryl), improve meal-related insulin production more than fasting insulin production. As a result, many people who take these medicines have higher glucose levels in the morning than before bed at night. Sometimes a snack at bedtime with protein, some healthy fat and a slowly absorbed carbohydrate, such as two teaspoons of peanut butter on a half-slice of stone-ground whole-wheat bread, may actually lower the morning glucose because it prevents you from e Continue reading >>
- Postprandial Blood Glucose Is a Stronger Predictor of Cardiovascular Events Than Fasting Blood Glucose in Type 2 Diabetes Mellitus, Particularly in Women: Lessons from the San Luigi Gonzaga Diabetes Study
- Why do I have high blood sugar levels in the morning?
- Why Is My Fasting Blood Sugar High in the Morning?
Correcting Morning Blood Sugar Highs — Know The Causes Of These Spikes And Ways To Treat Them
Today’s Dietitian Vol. 14 No. 11 P. 18 Jill is frustrated. Her type 1 diabetes seems out of control, and she comes to your office at her wits’ end. She says she’s doing everything right: counting carbs, taking her insulin as prescribed, monitoring her blood glucose levels four times per day. A look at Jill’s testing logs and most recent blood work confirms there’s a problem. She has a hemoglobin A1c of 9.2, and her blood glucose levels are all over the map. Her numbers generally are fine before she goes to bed but incredibly high in the morning. Recently, her physician increased her nighttime basal insulin dose to counteract the morning highs, but things seem worse now than ever. Her breakfast bolus doesn’t seem to be effective, and her high blood glucose levels persist into the afternoon. “Fluctuating blood sugars can be very frustrating,” says Eileen M. Sturner, RD, LDN, CDE, BC-ADM. “RDs can play an important role in helping patients get to the bottom of problems such as morning highs. Working with patients to gather the appropriate data and facilitating the sharing of those data with the healthcare provider that’s managing their diabetes can have life-changing results.” Hyperglycemia In type 1 diabetes, the pancreas can no longer provide either the steady drip of basal insulin that keeps blood sugar levels stable between meals or the bolus release of insulin that directs the uptake of glucose after eating. Patients must take basal insulin to keep their fasting blood sugar levels steady and bolus insulin to match their carbohydrate intake and correct highs. The primary cause of hyperglycemia in type 1 diabetes is carbohydrate intake that isn’t matched with bolus insulin dosing. Perhaps Jill is underreporting her carbohydrate intake, administer 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 >>
When Blood Sugars Rise Overnight
Jewels Doskicz, RN, is a freelance writer, patient advocate, health coach, and long-distance cyclist. She and her daughter both live healthfully with type 1 diabetes. Going to bed with normal blood sugars, but always waking up high? You may be seeing the effects of something called dawn phenomenon. People living with Type 2 diabetes may see blood sugar shifts hallmarked by a rise in early morning blood sugars and high morning glucose readings, according to Diabetes Health. Historically, this phenomenon was thought to only affect those with Type 1 diabetes. What is "Dawn Phenomenon"? This phenomenon reflects an abnormal early morning increase in blood sugars that usually happens between the hours of 2 a.m. and 8 a.m. according to the Mayo Clinic. This is one of the reasons why your health practitioner may ask you to get up and check some middle-of-the-night blood sugars. What causes this phenomenon? Overnight, the body may release increased levels of glucose and hormones. The liver is the culprit for the glucose release and the hormones cortisol, glucagon, and adrenalin may be thrown into the mix as well. The end result is insulin resistance and/or extra glucose dumped into your blood stream in the wee-hours of the morning. All of this may equate to high morning blood sugars. How do I know if this is affecting me? Set your alarm clock between 2-3 a.m. and check overnight blood sugars to help pinpoint trending. Armed with this information at your next appointment, your health care provider can help you trouble shoot those pesky morning highs. High sugars can also result from a bedtime snack, not enough insulin or a need for diabetes medications to be adjusted. Researchers suggest a preventative approach with long acting insulin "before their A1c reaches above 7.0%." To le Continue reading >>
Diabetes And Sleep: How High Blood Sugar Steals Sleep Time
It’s probably far from obvious, but your diabetes could be the reason that you’re having trouble sleeping. Type 2 diabetes affects nearly 30 million Americans—and the numbers are growing. Though most of us are aware that the disease has a serious impact on a person’s diet and blood sugar, fewer are familiar with the many related health woes that diabetes can cause—and how they can negatively impact sleep. Take a closer look at the surprisingly intricate relationship between diabetes and sleep—plus how people with the condition can get a better night’s rest. Diabetes and Sleep: A Vicious Cycle? The relationship between diabetes and sleep is complicated, and experts still have a lot to learn about how the whole thing works. What they do know? How much sleep you get could play a role in whether you develop type 2 diabetes in the first place. First, there’s the growing connection between sleep and obesity. Being overweight is a major risk factor for type 2 diabetes. (Believe it or not, up to 90% of people who are diagnosed with the disease are also obese.) What’s more, evidence shows that there are several ways that skimping on sleep could lead to weight gain: When you’re zonked, you don’t have the energy to exercise. Research suggests that people who stay up late spend more time sitting than people who wake up early. Feeling tired means you’re less likely to make healthy food choices, too. When you’re exhausted, pizza or takeout just feel easier (and more tempting) than a big kale salad. Staying up late means more time to eat. People who stay up into the wee hours at night have been found to eat 550 more calories than those who go to bed early. Lack of sleep messes with your hormones. Sleep deprivation causes your body to pump out more of the stre Continue reading >>
Why Is Blood Sugar High In The Morning?
Here you'll find info about why blood sugar is high in the morning, along with tips and resources to lower those numbers! A while back I had a client sending me her blood sugar charts every few days and on those charts she always made some notes if she had questions. Every time she sent them through, I noticed she had 3 big question marks (???) against her morning blood sugar results. And on another morning when her morning blood sugar levels were high at 160 mg/dl (or 8.9 mmol/l). She had written: I don't understand. 97 mg/dl (or 5.5mmol/l) last night when I went to sleep. I didn't eat anything because I didn't feel well. Humm… I was also over in one of the online diabetes groups I'm involved in today and this message popped up. I'm struggling with my morning BS number. When I went to bed around 11PM my BS was 107. I'm waking up with my BS between 120 – 135. I did put two pieces of string cheese next to my bed and when I woke up around 3am, I ate one. Since I was told to eat protein at night. When I woke up 3 hours later my BS was 130. I didn't want to eat anything large since it's so close to 140 (my goal is to keep it below 140). So I had 1 piece of toast (sugar free wheat bread) and just a tiny bit of peanut butter. I checked it an hour later and it was 161! What am I doing wrong? Do these morning situations sound familiar to you? Are you constantly questioning: Why is blood sugar high in the morning? I mean, logically we'd think that it should be at it's lowest in the morning right? Well don't panic, there is a reason for it, so let's explore why morning blood sugar is often higher. And at the end, I'll also point you toward some resources to help you lower those levels. Why Is Blood Sugar High In The Morning? Although it would seem logical that your body would Continue reading >>
How Staying Up Late Screws With Your Blood Sugar
Your body could pay the price for too many late nights: Skimping on sleep may raise your diabetes risk, finds recent research from the University of Chicago. In the study, young, healthy men who were limited to just 4.5 hours of shuteye for 4 consecutive nights showed 30 percent higher levels of fatty acids in their blood than when they were allowed to snooze for 8.5 hours. Here’s what might be happening: When you’re short on sleep, your body tends to pump out growth hormone for longer periods of time, and secrete higher levels of stress hormones like cortisol and adrenaline. Those hormonal changes seem to prompt cells in your body to release more fatty acids into your bloodstream, says lead study author Josiane Broussard, Ph.D. All those fatty acids make it harder for your body to produce enough of the hormone insulin, which regulates blood sugar. Without enough insulin, your glucose can build up in your blood, instead of being absorbed by your body. This can cause your blood sugar to skyrocket, putting you on the road to diabetes. Usually, only people who have diabetes or who are obese have elevated fatty acid levels. But if you consistently miss sleep over time, the study suggests you could be on your way to developing both of those conditions. The good news: You should be able to reverse the effects. According to Broussard, the preliminary data hints that simply getting enough solid shuteye may help regulate your blood sugar and improve other metabolic parameters. Need help falling—and staying—asleep? Follow our sleep doctor’s tips for the 5 Best Ways to Snooze Better Every Night. Continue reading >>