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.
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