Why Do Blood Sugars Spike Overnight

Dealing With Unexplained Blood Sugar Spikes

You can do everything right to keep your diabetes under control — eat a smart diet, exercise, take medications as prescribed, and follow your doctor’s instructions for blood sugar monitoring — and still wake up in the morning with unexplained blood sugar spikes. Even in people who don’t have diabetes, blood sugars fluctuate constantly, says Linda M. Siminerio, RD, PhD, director of the University of Pittsburgh's Diabetes Institute. But when you have diabetes and wake up with an increase in blood sugar levels, you shouldn’t ignore it. If high blood sugar happens once in a while and you're able to get it under control quickly with insulin or exercise, it may be nothing serious. “Maybe you have high blood sugar in the morning because you went to a party last night and had a bigger piece of birthday cake,” Dr. Siminerio says. “Or it snowed, and you couldn’t go for your morning run the day before.” But if you consistently wake up with blood sugar spikes and don’t know why, you need to investigate the cause. You may need to adjust your diabetes treatment plan, possibly changing your medication. You won’t feel right if you have high blood sugar, a condition known as hyperglycemia, says Anuj Bhargava, MD, president of the Iowa Diabetes and Endocrinology Research Center in Des Moines and founder of My Diabetes Home, an online platform that helps users track their blood sugar and manage their medication. When your blood sugar is too high for a few days or weeks, it can cause more frequent urination, increased thirst, weight loss, blurry vision, fatigue, and nausea. It also can make you more susceptible to infections. When you have high blood sugar for a long time, it can damage the vessels that supply blood to your heart, kidneys, nerves, and eyes, and caus Continue reading >>

The Bedtime Snack Unraveled

Despite what you may have heard, it is not only “okay,” but actually VERY IMPORTANT to eat a bedtime snack! The common response to this is, “But I thought we weren’t supposed to eat after (insert time here)?” Let’s unravel this myth, by looking at the following three arguments: 1) Bedtime snacks provide unnecessary calories. If it were all about calories, then this argument may be legit, but…it’s not. So much more goes into metabolism than just calories; food quality and the type of macronutrients (P, F and C) consumed, timing of when you’re eating, hormone regulation, sleep, and the list goes on! The reason it’s important to eat a bedtime snack is because, in order to support your metabolism and therefore maintain your weight/promote weight loss, you need stable blood sugar levels. The reasoning for the combination of carbohydrate and fat before bed is because the carbs bring your blood sugar levels back up slightly (they’ve been falling since dinner or the time you last ate) and the fat slows the assimilation of the carbs into your blood stream, promoting nice stable blood sugar levels all night long. When blood sugar levels are stable, your fat BURNING hormone, glucagon, can do it’s awesome job (not to mention, the other sweet benefits of balanced blood sugar levels, including consistent energy levels, focus, stable moods, and no cravings just to name a few). If you take your blood sugar levels for a daily—maybe hourly—rollercoaster ride, you are creating an enviroment that your fat STORING hormone, insulin, THRIVES in! By following the Three-Three Rule that I outline in my article, Back to the Basics, you’re setting yourself up for success by promoting stable blood sugar levels all day long. Who wouldn’t want to create this same type Continue reading >>

Chronic Somogyi Rebound

The rebounding blood sugar following undetected diabetic hypoglycemia can easily become chronic when the high morning blood sugar data is misjudged to be due to insufficient nighttime insulin delivery. Chronic Somogyi rebound is a contested explanation of phenomena of elevated blood sugars in the morning. Also called the Somogyi effect and posthypoglycemic hyperglycemia, it is a rebounding high blood sugar that is a response to low blood sugar.[1] When managing the blood glucose level with insulin injections, this effect is counter-intuitive to insulin users who experience high blood sugar in the morning as a result of an overabundance of insulin at night. This theoretical phenomenon was named after Michael Somogyi, a Hungarian-born professor of biochemistry at the Washington University and Jewish Hospital of St. Louis, who prepared the first insulin treatment given to a child with diabetes in the USA in October 1922.[2] Somogyi showed that excessive insulin makes diabetes unstable and first published his findings in 1938.[3] Compare with the dawn phenomenon, which is a morning rise in blood sugar in response to waning insulin and a growth hormone surge (that further antagonizes insulin). Background[edit] A person with type 1 diabetes should balance insulin delivery to manage their blood glucose level. Occasionally, insufficient insulin can result in hyperglycemia. The appropriate response is to take a correction dose of insulin to reduce the blood sugar level and to consider adjusting the insulin regimen to deliver additional insulin in the future to prevent hyperglycemia. Conversely, excessive insulin delivery may result in hypoglycemia. The appropriate response is to treat the hypoglycemia and to consider adjusting the regimen to reduce insulin in the future. Somogyi Continue reading >>

Common Questions About Blood Sugar

How often should I test my blood sugar? This is a very common question, and the answer isn't the same for everyone. In general, you should test as often as you need to get helpful information. There's no point in testing if the information you get doesn't help you manage your diabetes. If you've been told to test at certain times, but you don't know why or what to do with the test results, then testing won't seem very meaningful. Here are some general guidelines for deciding how often to test: If you can only test once a day, then do it before breakfast. Keep a written record so that you can see the pattern of the numbers. If you control your blood sugar by diet and exercise only, this once-a-day test might be enough. If you take medicine (diabetes pills or insulin), you will probably want to know how well that medicine is working. The general rule is to test before meals and keep a record. If you want to know how your meals affect your blood sugar, testing about 2 hours after eating can be helpful. Test whenever you feel your blood sugar is either too high or too low. Testing will give you important information about what you need to do to raise or lower your blood sugar. If you take more than 2 insulin shots a day or use an insulin pump, you should test 4 to 6 times a day. You should test more often if you're having unusually high or low readings, if you're sick, under more stress than usual, or are pregnant. If you change your schedule or travel, you should also test your blood sugar more often than usual. Talk to a member of your health care team about how often to test based on your personal care plan. What should my test numbers be? There isn't one blood sugar target that's right for everyone with diabetes. It's important to work with your health care team to set Continue reading >>

The Dawn Phenomenon – T2d 8

The occurrence of high blood sugars after a period of fasting is often puzzling to those not familiar with the Dawn Phenomenon. Why are blood sugars elevated if you haven’t eaten overnight? This effect is also seen during fasting, even during prolonged fasting. There are two main effects – the Somogyi Effect and the Dawn Phenomenon. Somogyi Effect The Somogyi effect is also called reactive hyperglycaemia and happens in type 2 diabetic patients. The blood sugar sometimes drops in reaction to the night time dose of medication. This low blood sugar is dangerous, and in response, the body tries to raise it. Since the patient is asleep, he/she does not feel the hypoglycaemic symptoms of shakiness or tremors or confusion. By the time the patient awakens, the sugar is elevated without a good explanation. The high blood sugar occurs in reaction to the preceding low. This can be diagnosed by checking the blood sugar at 2am or 3am. If it is very low, then this is diagnostic of the Somogy Effect. Dawn Phenomenon The Dawn Effect, sometimes also called the Dawn Phenomenon (DP) was first described about 30 years ago. It is estimated to occur in up to 75% of T2D patients although severity varies widely. It occurs both in those treated with insulin and those that are not. The circadian rhythm creates this DP. Just before awakening (around 4am), the body secretes higher levels of Growth Hormone, cortisol, glucagon and adrenalin. Together, these are called the counter-regulatory hormones. That is, they counter the blood sugar lowering effects of insulin, meaning that they raise blood sugars. The nocturnal surge of growth hormone is considered the primary cause of the DP. These normal circadian hormonal increases prepare our bodies for the day ahead. That is, glucagon tells the liver 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 >>

My Experience With Gestational Diabetes

Explanation of gestational diabetes & personal reflection of what to expect if you are diagnosed during your pregnancy. Not to worry, it’s can be managed! When you’re pregnant many people love to say “Now you can eat for two!” or “Your pregnant, this is the time you can eat what you want!” Unfortunately, these words of wisdom are not entirely accurate. Every mom-to-be dreads the glucose tolerance test, which involves ingesting a high concentration of glucose (a form of sugar) mixed with water to see if you have gestational diabetes. It’s a grueling test because you have to sit in a doctor’s office or clinic for a few hours while they take blood samples before and 2-3 times after you drink the solution. Before the test, you have to fast for 8 hours and this alone makes mamas pretty aggravated but then with the drink solution you have to deal with a sugar high! Waiting for the results, you cross your fingers and hope that the last 24-28 weeks you’ve had a balanced, healthy diet. I knew that I had increased my carbohydrate and sweet intake more than before I was pregnant, but I was hoping the test would still be negative. Unfortunately, when I got the call from my doctor who then said I had gestational diabetes, my first reaction was guilt. How could I have done this to my baby? Gestational Diabetes 101 I want to make sure I disclose this up front, I am not a doctor, I’m just sharing my experience with gestational diabetes. My daily pregnancy routine consisted of exercising five times a week and eating healthy on most days. However, I knew I could have eaten healthier in the last trimester, but I didn’t (those darn cravings and ravishing bouts of hunger!). As I learned more about gestational diabetes, I realized that our bodies change so much during p Continue reading >>

15 Ways High Blood Sugar Affects Your Body

High blood sugar symptoms Glucose, or sugar, is the fuel that powers cells throughout the body. Blood levels of this energy source ebb and flow naturally, depending what you eat (and how much), as well as when you eat it. But when something goes wrong—and cells aren't absorbing the glucose—the resulting high blood sugar damages nerves, blood vessels, and organs, setting the stage for dangerous complications. Normal blood-sugar readings typically fall between 60 mg/dl and 140 mg/dl. A blood test called a hemoglobin A1c measures average blood sugar levels over the previous three months. A normal reading is below 5.7% for people without diabetes. An excess of glucose in the bloodstream, or hyperglycemia, is a sign of diabetes. People with type 1 diabetes don’t make insulin, the hormone needed to ferry sugar from the bloodstream into cells. Type 2 diabetes means your body doesn’t use insulin properly and you can end up with too much or too little insulin. Either way, without proper treatment, toxic amounts of sugar can build up in the bloodstream, wreaking havoc head to toe. That’s why it’s so important to get your blood sugar levels in check. “If you keep glucose levels near normal, you reduce the risk of diabetes complications,” says Robert Ratner, MD, chief scientific and medical officer of the American Diabetes Association. Here’s a rundown of the major complications and symptoms of high blood sugar. No symptoms at all Often, high blood sugar causes no (obvious) symptoms at all, at least at first. About 29 million people in the U.S. have diabetes, but one in four has no idea. Another 86 million have higher-than-normal blood sugar levels, but not high enough to be diagnosed with type 2 diabetes. That's why it’s a good idea to get your blood sugar test Continue reading >>

Waking Up With High Glucose Levels

Waking up with high glucose or blood sugar levels, or “Dawn Phenomenon,” occurs in more than 80 percent of adults with type 1 diabetes.1 Personal continuous glucose monitoring (CGM) and your insulin pump provide tools that can help you control Dawn Phenomenon. After wearing your personal Continuous Glucose Management (CGM) system for at least 24 hours, you can upload the data into CareLink® Personal Software. The software provides a “Sensor Daily Overview” report. This report can place up to seven days of data on one 24-hour time plot. This really helps you see glucose spikes during a particular time period. For example, look at the early morning hours. Is there a consistent upward spike around 5:00 AM? If not 5:00 AM, is there one earlier or later in the morning? If you see a spike, you can work with your healthcare team to change your basal rate prior to the spike so that you can smooth out your overnight glucose control. If you don’t use a personal CGM system, you can still follow your overnight glucose levels using your blood glucose (BG) meter and an alarm clock. You will have to wake yourself up a couple times during the night to check your BG using your meter. Ask your healthcare team for some guidance, but generally you will have to check a fingerstick BG at bedtime where it should be greater than 100 mg/dL, again during mid-sleep, and then when you wake up to see if your overnight basal rates are correct. Rather than writing down all of your readings, you can upload data from your blood glucose meter 2 into CareLink® Personal Software, along with your insulin pump so that you have all your information in one place. Review your findings with your healthcare provider to pinpoint when you are experiencing dawn phenomenon. Your insulin pump can handle m Continue reading >>

The Overnight Blood Sugar Conundrum

How do I stay in range while sleeping? In the past week, I’ve seen these two 24-hour CGM traces: It’s amazing that the same overnight insulin dose produced those two markedly different midnight-to-9am glucose outcomes (left side of each graph). The example on the right, I believe, was caused by: (i) a big late-night dinner after barely eating all day, and (ii) changing my pump’s infusion set and reservoir right before bed, without confirming a few hours later that it was working properly. Whatever the cause, I woke up at 7:50 am on Tuesday at 262 mg/dl – exhausted, frustrated, and late for a team event. I changed my pump site quickly, took a huge six-unit insulin bolus, and decided at the last minute to ride my bike 4.5 miles to the event. Halfway down the steep hill from my house, I had that sinking feeling: “Gah! I should go back home and get glucose tabs, just in case.” I cycled back, grabbed the tabs, and then my prediction turned out to be correct 15 minutes later – halfway to the event, my glucose was dropping faster than I’d ever seen in my life. I ate three tabs as a buffer and luckily avoided going low. By 9:05 am, I had arrived for our team photo event covered in embarrassing business-casual sweat, but back in range. And from there, the workday could actually begin. I tell this story to illustrate a larger point – overnight blood sugar has a major impact on the next day. Unfortunately, keeping glucose in range every single night is very difficult without an automated system. This article shares some of my Bright Spots for beating this nighttime conundrum, gleaned from those nights like the example above on the left. Enjoy, and get all my Bright Spots & Landmines here (free PDF) or at Amazon. Overnight BGs in a tight, safe range (80-140 mg/dl) 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 >>

Avoiding Blood Sugar Spikes During The Night

In addition to disrupting your sleep, experiencing high blood sugar during the night can be dangerous. The three primary causes of blood sugar spikes during the night are eating too many carbs or fats at dinner or before bedtime, the dawn effect, and the Somogyi effect. High-Fat Meal Spikes Consuming excessive carbs elevates blood sugar, and too much fat can do the same. Fats digest slower than carbohydrates, causing problems for people taking insulin. Fast-acting insulins like Humalog, Novolog and Apidra work in the body for three to four hours. After enjoying a high-fat meal, these insulins might begin working before a significant amount of glucose reaches the bloodstream – and the insulin may be done working before all the glucose gets there. This means a glucose reading can be in-range two hours after a high-fat dinner, but the level can elevate above normal five or more hours later. To avoid carb- or fat-related spikes: Stick to the dietary guidelines that generally work for you. If you indulge in an occasional high-fat meal – especially one loaded with saturated fat (animal fat) – you may need to alter the dose and timing of your insulin. If using oral medications, it can help to do some physical activity (e.g., walking) after consuming a high-fat meal. The Dawn Effect Early morning high blood sugar (hyperglycemia) can be owed to insufficient evening medication, carbohydrate bedtime snacks or the “dawn effect.” The dawn effect occurs when a middle-of-the-night increase in insulin resistance triggers a rise in blood sugar. This phenomenon has been linked to a normal release of hormones about two hours before waking. In non-diabetics, elevated glucose at dawn helps the body prepare for morning activity, and insulin keeps the glucose level in check. For tho Continue reading >>

Blood Sugar And Sleep Problems: How Blood Sugar Levels Impact Sleep

November is National Diabetes Month and Alaska Sleep Clinic is dedicating this month’s blog posts to raising awareness for diabetic complications and how they correlate with sleep disorders and overall tiredness. SLEEP PROBLEMS AND SNORING MAY PREDICT DIABETES Studies have shown that individuals who consistently have a bad night's sleep are more likely to develop conditions linked to diabetes and heart disease. Loud snoring sleepers (many of whom may have sleep apnea), compared to quiet sleepers, double (2x) their risks of developing certain types of metabolic syndrome(s); including diabetes, obesity, and high blood pressure. This likelihood also increased dramatically to 80% in those who found it difficult to fall asleep and to 70% for those who woke up feeling not as refreshed. Blood Sugar and Sleep Problems Sleep can affect your blood sugar levels, and your blood glucose control can also affect your sleep. It’s a vicious cycle. As the amount of sleep decreases, blood sugar increases, escalating the issue. Lack of sleep has been shown to increase blood sugar levels and the risk of diabetic issues. Higher blood sugar means less long-lasting fat metabolism in the night and even less sleep. Researchers at Boston University School of Medicine found that people who slept less than 6 hours a night had more blood sugar complications compared to those who received 8 hours of sleep. HIGH BLOOD SUGAR - HYPERGLYCEMIA Sleepless and restless nights hurt more than your mood and energy; it is a form of chronic stress on the body. When there is added stress on your body this results in having higher blood sugar levels. When researchers restricted people with type-1 diabetes to just 4 hours of sleep, their sensitivity to insulin was reduced by 20% compared to that after a full nig 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 >>

4 December 2012why Is My Blood Glucose So High When I Wake Up?

It doesn't seem fair, does it? You haven't eaten anything all night and you still wake up with high blood glucose! What is going on and how can you lower it? For those of you with diabetes, this post is for you! Basics Your body strives to keep blood glucose (BG) within a safe range, but with diabetes the balance is disturbed. The insulin your pancreas produces might not be sufficient to cover your BG lowering needs. As well, the insulin it does produce might not be handled properly by target body cells. And to make matters worse, your liver might be on glucose production overdrive. All of this results in your body's failure to control BG overnight as well as after meals or snacks. For more basic information about diabetes, please be sure to read my article, Diabetes Basics at MyNetDiary's library. Dawn Phenomenon Due to normal daily changes in our body's release of hormones during sleep and wake cycles, BG typically starts to rise in the very early morning – starting about 3 AM - and continues to rise as the morning progresses. For folks without diabetes, insulin production simply increases and takes care of the rising BG. However, for folks with diabetes, unless there is medication on board to cover this early morning rise, BG will eventually rise out of target range by the time they wake up. The classic pattern is to see BG within target range at both bedtime and during the middle of the night, and then see a high fasting BG. If you have noticed that your fasting BG is creeping up over time and is no longer within target range despite sticking to a carb controlled eating plan and taking your diabetes medication as prescribed, then it might be time to talk with your doctor about your diabetes medication. The type, dose, and/or timing might need to be adjusted to bet Continue reading >>