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.