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 >>
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 >>
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 >>
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 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 >>
Help! High Blood Sugars In The Morning, Fine The Rest Of The Day!
Diabetes Forum The Global Diabetes Community Find support, ask questions and share your experiences. Join the community Help! High Blood Sugars in the morning, fine the rest of the day! I am hoping some people might be able to offer some advice. I am 27 and have had diabetes for 25 years. I am usually well controlled (especially in the past 5 years) however for the past few months I have been waking up with high blood sugars each morning. And I mean high- this morning I was 17.2. I take Glargine (split dose am and pm) and then carb count with Humalog during the day. The rest of the day I am absolutely fine, running at between 4 and 6 most of the time. And there seems to be no pattern to the highs. Most mornings I am around 12-15 but sometime I am normal at 5. I tried cutting out desserts, eating earlier, eating later but nothing seems to change. My doctor suggested increasing my Glargine, which I did for a couple of weeks but I was hypoing all over the place so I have gone back to the original dose. Has anyone ever had anything similar? Or does anyone have any advice? I am pretty much up for trying anything right now as I feel so awful when I wake up Yes, I have done the thing where you test every 2 hours through the night - and it seems to be in the last few hours before waking up (I usually get up at 7am). To me this suggests I am running out of insulin in those last few hours, but is there a way to combat that? I am pretty good at rotating my injection sites. I have to admit I am not sleeping great, but I havnt for a number of years and its only in the last few months that this has become an issue! Thanks for your response, I will try rotating my sites abit more to see if it helps I had the same issue for the longest time and my doctor got me one of those devices (c 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 >>
Why All The Morning Highs?
Sometimes diabetes doesn’t make a lot of sense. Think of those mornings when you wake up to find your blood glucose looking as if you’ve been up all night eating cookies. What’s up with that? You’d think that not eating for those seven or eight hours would give you lower blood glucose, right? Such morning highs are common in people with diabetes, but one of the reasons has a particular name: the dawn phenomenon. The dawn phenomenon is a natural rise in blood glucose between 4 and 8 a.m., which happens because of hormonal changes in the body. All people have the “dawn phenomenon,” whether they have diabetes or not. People without diabetes would never notice it happening, as a normal body’s insulin response adjusts for this. However, because people with diabetes don’t have normal insulin responses, they may see an increase in their fasting blood glucose. This is primarily because people with diabetes produce less insulin and more glucagon than they need. The less insulin produced by the pancreas, the more glucagon the pancreas makes as a result. Glucagon, in turn, signals the liver to break down its storage supplies of glycogen into glucose. This is why high fasting blood glucose levels are commonly seen in patients with type 2 diabetes. The effects of dawn phenomenon vary in each person, and your blood glucose may be higher on some mornings than on others. But not to worry—there are steps you can take to get those numbers down and start your days more comfortably in your target blood glucose range. Treatment for dawn phenomenon depends on how you treat your diabetes. If you take insulin, you may be able to adjust your dosing so that peak action occurs closer to the morning rise in your blood glucose. If you have type 2, diabetes pills provide options as 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 >>
The Dawn Phenomenon – Why Are Blood Sugars High In The Morning?
Getting 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 to start p 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 >>
Blood Glucose Levels High In Morning & Low After Eating
You may be puzzled by a high blood glucose reading in the morning despite going to bed with a good reading the night before. Or your postmeal blood glucose may be lower than the reading before you ate. Unusual blood glucose fluctuation can be frustrating for diabetics and is affected by many factors. Keeping a good record of your diet, medication and blood glucose can often help you solve the mystery. Video of the Day If you consistently wake up with higher blood glucose levels despite being compliant with your meal plan, this could be a condition known as the dawn phenomenon, states the American Diabetes Association. Dawn phenomenon is a a sudden rise of blood glucose levels 10 to 20 milligrams per deciliter in the early morning between 2:00 and 8:00 a.m. It is caused by an increased release of hormones such as cortisol, glucagon and epinephrine while your body is preparing to wake up. These hormones increase insulin resistance and stimulate your liver to release glucose, causing blood glucose levels to rise. Insufficient insulin or medication, excessive carbohydrate snacks at bedtime or high-fat meals at dinner may also cause blood glucose to be elevated in the morning. To rule out if your high blood glucose is due to dawn phenomenon, your endocrinologist may ask you to eat a low-fat, carbohydrate-controlled dinner, maintain your usual physical activities and check your blood glucose around 2 or 3 a.m. for several days. Your doctor will help you determine if you have dawn phenomenon and adjust your medications accordingly. If the fluctuation is due to food, your dietitian may alter your meal plan and may suggest that you skip a bedtime snack or change the type of snack to a lean protein, modify your dinner or add some light exercise after dinner. When you wake up with 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 >>
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 >>
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 >>