How to Fix High Morning Blood Sugars Dawn Phenomenon and Reactive Hypoglycemia (Somogyi Effect)

How to Fix High Morning Blood Sugars Dawn Phenomenon and Reactive Hypoglycemia (Somogyi Effect)

There are various possible causes of a high blood sugar level in the morning:

1.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.

2.Having high blood sugar from the night before which continue through the night into the morning.

3.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.

Reactive Hypoglycemia (Somogyi Effect)

This is also known as rebound hypoglycemia or the Somogyi Effect. If when you test in the middle of the night you find your blood sugar is going low,

Your body is essentially in panic mode and alerts you by secreting counter regulatory hormones like glucagon and epinephrine (adrenaline) which trigger the liver to change its reserves of glycogen into glucose.

In short, your body senses a low blood sugar and dumps as much sugar as it can into the blood in an attempt to get enough fuel to function.

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 on monitering system (CGM)

Here are some things you could try to reduce this occurrence:

•Eat a carbohydrate snack before bed.

•Reduce blood sugar-lowering medication or insulin in the evening.

•Reduce your long-acting insulin dose.

•Change your exercise schedule from afternoon or evening to first thing in the morning.

Make sure you don’t ignore reactive hypoglycaemia .Over time, your body’s response to low blood sugar levels may change due to hormone changes, leaving your body unable to warn you with low blood sugar symptoms and unable to trigger the liver into dumping sugar into your blood. Also, if other low blood sugar episodes have occurred earlier the same night or excess exercise has taken place, the liver may have already depleted its reserves of glycogen and may not be able to secrete glucose and raise your blood sugar

.This is why being aware of what is happening and solving the likelihood of this event is important. Some people with diabetes periodically check their blood sugar levels around 3 a.m. to stay aware of nighttime blood sugar trends.


The Dawn Phenomenon

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 whether they have diabetes. However, many people with diabetes also experience a rise in blood sugar.

In people without diabetes, the body’s natural insulin response prevents the blood sugars from rising. These hormone surges affect those with type 1 diabetes and according to an ADA published journal, about half of people with type 2 diabetes.

Scientists have suggested that the Dawn Phenomenon experienced by those dependent on insulin is mostly caused by a surge in night time growth hormone secretion. Other hormones secreted in this surge include cortisol, adrenaline and glucagon. These hormones trigger the conversion of the liver’s glycogen stores into glucose which is then dumped into the blood in a process called glycogenolysis.

The Mayo Clinic suggests several things that you can try to combat the effects of the Dawn Phenomenon:

•Avoid carbohydrates at bedtime.

•Adjust your dose of medication or insulin. (If you take a long-acting insulin such as Lantus, be aware it doesn’t last a full 24 hours. This means you may want to try taking it at night or splitting the dose by taking half in the morning and the other half 12 hours later.)

•Switch to a different medication.

•Adjust 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.

Many people get overly concerned about dawn phenomenon. If most of your night is spent with normal blood sugars and you experience a small, temporary increase in the morning, this is likely nothing to worry about. For those that are otherwise in target range, the morning increase is often less than they experience during a typical meal and even more short-lived.

Due to the Dawn Phenomenon, people are more resistant to insulin first thing in the morning. You may want to limit carbohydrates during the hour or two after you wake up. Insulin-users may need to have a higher insulin-to-carb ratio and take more insulin in the morning than during other parts of the day.

If you are experiencing high blood sugar in the morning as a result from elevated blood sugar from the night before, there are several things you could try:

•Eat fewer carbohydrates during the evening hours.

•Add evening exercise like an after-dinner walk.

•In consultation with your doctor, increase blood-sugar lowering medication or insulin.


18 Replies

  • Dear ragivrao ji

    Somogyi effect is a rare thing. Curiously American diabetes association does not accept it's existence.

  • Dear ragivrao ji,

    But if all it is observed,

    What to do is simple :

    a memory aid....

    Do the opposite of what is done in case of dawn effect.

    This last sentence is my composition.


    Kindly scrutinise.

    For eg:

    Dawn... Increase medicine

    Somogyi... Reduce night dose

    Dawn... No food after dinner.

    Somogyi... Take a bed time snack

    Dawn... Back shift dinner and walk before bed.

    Somogyi... Not clear to me... But I think do not do either.

    If any one can find corrections.. Welcome.

    Good luck.

  • India cratus

    Yes.The procedure posted also says same.i am not aware if ADA has not recognised the Somogy phenomenon as existing.I believe it exists in case of insulin dependent Diabetics and it is because of inability to precisely estimating dose of insulin.By trial and error one comes to know it over a period of time.

  • Dear Sir ,

    Some time back one lady was telling that a boiled potato taken before going to bed , stops the dawn phenomenon. POTATO being carb rich food is avoided by all people .So how it is recommended is a big question mark. Have you come across any such idea .

  • it is for diabetes 1 people with inulin and to circumvent somgyi effect. it s not for dawn effect

  • Dear bhaswathy,

    Kindly read in the mayo clinic for dawn and Somogyi effects - - two separate.

    Thelady mentioned by you had a somogyi

    HYPER glycemia.

    A bed time snack is a solution for this.

    My memory is:

    Protein stack is advised . Potato also worked with lesser perfection.

    Good luck

  • ok .

  • There is no universal solution regarding liver dump.

    It Purley depend upon person and his diet and lifestyle and what the medicine prescribed.

    For this until so for no universal theory was not given by scientists or researchers.

    1 How much insulin produced in the body of every person

    .2 Liver will dump the insulin when the body needs only. How much insulin will produce at the moment. if it produces required quantity of insulin then there is no problem of diabetes.

    3 liver will stored 120 - 150 gms of carb to produce insulin. If insulin storage may chances complete and liver storage may be nil in storage.

  • Difficult to understand your response.

    Can you explain where you got these ideas.

    Good luck

  • Ragivrao / Indiacratus, Thanks for respond.

    As liver is the main organ in human body it will store some portions of what we consume the carbs for converting emergency time as glycogen and this is natural process

    Further the body has produced the insulin whenever necessary only ? that means if we consume the food then insulin will produce the body to convert the food to be digestive process.

    Al;so all food will convert glucose after digestion. But here also so many different types.

    1 Carb will digestive immediately started at a time of consume with mouth itself and it will completely digested within 1 hour but if w consume too much food when it is not possible to digest ( Insulin quantity may not possible to digest completely ) then non digested portion became stored as fat and it may convert4ed triglyceride and etc If excess of these will stored then liver has excess of glycogen stored capacity. that is the reason FBS or PPBS mainly noticed in higher way.

    To avoid this

    2 We must found out how much of insulin required for the persons daily activity. and how much of insulin will produced in the body generally and how much quantity will b stored in liver always These points is main synopsis when I have study something for liver and diabetes subject.

    but no suitable answer may not obtained.

    3 Protein will also spikes blood sugar but it was only 55% of what we consumed it also later hours of 4 or5 hours after consuming food Excess of protein consuming is causes kidney problems and also high blood pressure.

    4 Fat may not problem for spiking blood sugar it willspike only 10 % of consuming after period of 6 -10 hours.

    I think now you have clear picture of insulin and liver.

    Are you have any source of insulin details in the human body how it works.

    For diabetic insulin is main problems as if it may be defficienct or resistance. and liver willdump the glycogen without control due to diabetic problem.

    This is DAWN PHENOMENON for diabetics.

    and one simple question if FBs under range 100-135/140 are you considered it as higher blood sugar spikes or etc insulin produced in the body ?

    Pleasae clarifies all Thanking you

  • Dear agrhar,

    There are many mistakes in your understanding of diabetes... Physiology.

    That is why I asked you...

    Where you got these ideas.

    Please do not learn from the forum.. When it comes to basics.

    The best website is

    Mayo clinic and NIH.. national institute of health.

    Good luck

  • indiacratus please answer what I am pointed out. WEB MD Mayo clnic NIH are not given clear idea

    If FBS is 130-145 Is it liver dump the insulin excess ? or Blood sugar is raise itself ?

    If liver dump excess of insulin what is the solution how to avoid. whether excess of SU drug taken or less diet in night or at bed time 9-10 Pm taking some additional food

    or Metformin additional dose may be taken .

    Your expereince is great please clarify. It is better towrite a discvussion for this which include

    How much insulin liver will dump at night time for diabetes person .

    Thanks for respond and early reply..

  • agrahar

    1 some where i had read that a non diabetic is capable of producing half gallon in 24 hours

    2 liver does not dump dumps glycogen

    3 please is not clear?does liver store carbs?it does not produce insulin.

  • ragivrao

    If liver producing half gallon ( please share with gms) what is the insulin ratio in the body. Mostly as lab report insulin normal value in person 2.6-24.9 is it sufficient to maintain human body in healthy without diabetic.

    2 liver does not dump insulin but dumps glycogen as you told but this glucagon will dump under emergence condition of the body. which converts insulin.

    3 If excess of insulin produce what the problem ? Hypo or hyper ?

    4 For diabetic persons liver may not able to accurate glycogen as in the case of non diabetic is it O K ?

    3 if liver may not stored carb how it dump the glucogon.

    In my opinion excess of carb with other food consumption is the main reason. If this consumption may not digested it becomes fat and triglyceride. and this may also stored in the liver as glycogon and it dumps.

    The liver dumps glycogon then body produces insulin but if excess of glucogn dumps then FBS is higher chances ?

    This is my opinion. but no gogle searches or any available searches has its own merit and not possible to apply uniformly all the person.

    Can you please share any mistakes in this posting. .

  • Agrhar

    1) it is equivalent to 0.32 units of insulin every 10/15 minutes in bouts released by pancreas depending upon your physical activity which needs energy conversion from your body cells case of diabetics who do not produce their own insulin but inject insulin from outside in to the blood ,the blood sugar may drop to dangerously low level. due to inappropriate quantity injected As the body senses this it releases glycogen stored in the lever to increase its availability for use as body continues to require energy for all the 24 hours even in while you are resting/sleeping.

    3 hypo

    4 No .liver releases the stored glycogen to offset hypo. In case of non diabetics release of insulin and release of stored glycogen is automatically regulated by the body so as to maintain normal blood sugar level as required. In case of diabetics it may not depending on quantity of external injection of insulin. such a case hypo can be avoided by midnight eating or taking sugar to maintain balance of normal bl sugar

    I hope I have answered all doubts. as i have understood

  • From the master himself -- Somogyi effect is a MYTH

  • @Ragivrao

    "Make sure you don’t ignore reactive hypoglycaemia .Over time, your body’s response to low blood sugar levels may change due to hormone changes, leaving your body unable to warn you with low blood sugar symptoms and unable to trigger the liver into dumping sugar into your blood. "

    There is no such adaptation.

  • Could it be deficiencies in glucagon secretion?

    Reactive Hypo is normally applied to non diabetics and occurs ~4 hrs after a High Carb meal. One way to detect is extend OGTT to 5 hrs.

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