There are two reasons why your may be high in the morning в. Your body has little need for between about midnight and about 3:00 a. m. (a time when your body is sleeping most soundly). Any insulin taken in the evening causes blood sugar levels to drop sharply during this time. Then, between 3:00 a. m. and 8:00 a. m. , your body starts churning out stored glucose (sugar) to prepare for the upcoming day as well as releases hormones that reduce the body s sensitivity to insulin. All of these events happen as your bedtime insulin dose is also wearing off. These events, taken together, cause your body s blood sugar levels to rise in the morning (at dawn ). A second cause of high blood sugar levels in the morning might be due to the Somogyi effect (named after the doctor who first wrote about it). This condition is also called rebound hyperglycemia. Although the cascade of events and end result в
in the morning в is the same as in the dawn phenomenon, the cause is more man-made (a result of poor diabetes management) in the Somogyi effect.
There are two potential causes. In one scenario, your blood sugar may drop too low in the middle of the night and then your body releases hormones to raise the sugar levels. This could happen if you took too much insulin earlier or if you did not have enough of a bedtime snack. The other scenario is when your dose of long-acting insulin at bedtime is not enough and you wake up with a high morning blood sugar. How is it determined if the dawn phenomenon or Somogyi effect is causing the high blood sugar levels? Your doctor will likely ask you to check your blood sugar levels between 2:00 a. m. and 3:00 a. m. for several nights in a row. If your blood sugar is consistently low during this time, the Somogyi effect is suspected. If the blood sugar is normal or high during this time period, the dawn phenomenon is more likely to be the cause.
How can this situation be corrected? Once you and your doctor determine how your blood sugar levels are behaving at night, he or she can advise you about the changes you need to make to better control them. Options that your doctor may discuss include: Switching to an, which can be programmed to release additional insulin in the morning Joan Bardsley, RN, CDE, is an assistant vice president at MedStar Health Research Institute. Q. Why does my blood sugar spike in the morning? A. There are many reasons for a high reading. First, look at food. What you ate the night before may be behind the blood sugar spike — for example, if you ate much more than you usually eat, or if the amount of food was more than your medications are made to handle. A second cause could be your medicine. Perhaps the medications you take aren\’t lasting through the night, or the dose isn\’t high enough to keep your blood sugar in check.
P Another possibility is one that happens naturally in the body in response to low blood sugar. When your blood sugar drops, your body releases stored sugar — mainly from the liver — and overcompensates. If your blood sugar level drops in the middle of the night, this overproduction of sugar can cause a high level in the morning. This is called the Somogyi effect. When your blood sugar is low, it\’s best to eat about 15 grams of carbohydrates, and then wait 15 minutes before repeating the process. Or, the spike could be due to the release of hormones between 4 a. m. and 7 a. m. that raise blood sugar. Your body needs to balance these high hormone levels by making more insulin. When it can\’t make enough insulin to compensate, your blood sugar will be high. You may need to manage the timing or amount of your medicine. The risk of having high blood sugar in the morning is that it can raise your average blood sugar levels, as measured on the hemoglobin A1c test.
And starting out high in the morning means you\’ll have to work harder to keep your blood sugar in range for the rest of the day. The first thing to do is find out what caused the blood sugar increase. Talk with your diabetes team ahead of time, so if you wake up and your blood sugar is high, it\’s not a panic situation. Know your target blood-sugar range and exactly what to do when it\’s elevated. Ask your diabetes educator and doctor when to call the office or adjust your medicine dose — for example, if your blood sugar is over a certain level for a predetermined amount of time. Create a diabetes plan with your team, and then be ready to adjust that plan, because diabetes can change over time. Find more articles, browse back issues, and read the current issue of \”. \”P Y 2015 WebMD, LLC. All rights reserved.