There are two reasons why glucose numbers swing during sleep or before dawn, these are known as the Dawn Phenomenon and the Somogyi Effect.
The Dawn Phenomenon is:
- the sudden rise in blood sugar in the early morning hours
- the body's response to hormones released in the middle of the night
- experienced by everyone.
Our body produces hormones that negate the effect of insulin. These hormones include glucagon, epinephrine, growth hormone and cortisol, they increase your blood sugar levels by signaling your liver to release more glucose but prevent your body from using it.
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During the night, your body releases more growth hormone. This is followed by a surge in cortisol, which effectively triggers glucose production in your liver. This is a normal response after a period of fasting and the aim is to get your body ready for daytime activity. In non-diabetics the rise in blood sugars is counterbalanced by increased insulin secretion by the pancreas, keeping the blood glucose within normal levels. However, in diabetics such changes in glucose metabolism during the night really affects the early morning glucose level. This is because the pancreas either does not make any or enough insulin, or their liver does not respond to insulin well enough to stop glucose production.
High morning blood sugars may also be caused by your body's recovery from low blood glucose levels at night. This phenomenon is called the Somogyi Effect or rebound hyperglycemia which is your body's natural mechanism against low levels. This can also happen because you have too much insulin in your body from taking an insulin dose in the evening which was too high, or missing out on your bedtime snack.
The way to tell which phenomenon is affecting you is by checking your blood sugar level between 2 and 3am on several consecutive nights. A high blood sugar reading means the Dawn Phenomenon is more likely the cause. If your level is consistently low, the Somogyi Effect is maybe the problem.
How to manage your early morning high blood sugar levels?
Do not hesitate to talk to your health care practitioner as you may need to:
- adjust the dosage of your insulin
- switch to a different medication
- think about using an insulin pump
- avoid high-GI carbohydrate snacks at bedtime. You may need to eat a small snack containing protein or fat and low-GI carbs
- change your exercise schedule to an earlier time during in your day. Exercising late in the evening maybe why your blood sugars drop during your sleep
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Are you looking for effective ways to manage your type 2 diabetes?
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Beverleigh Piepers is a registered nurse who would like to help you understand how to live easily and happily with your type 2 diabetes.
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