Managing blood sugar levels is a key aspect of Diabetes and an essential strategy in effective diabetes management. However, controlling blood sugar levels can be a complex process.
The unpredictable nature of the regulation of glucose is a key reason for this. Take the morning for example. Blood sugar levels can be higher than anticipated, which may be a result of varying reasons like consuming high-carb bedtime snacks and not taking enough diabetes medications.
There are two other lesser-known reasons that may explain higher blood sugar levels in the morning, which are known as the Dawn Phenomenon and the Somogyi effect.
What exactly is the Dawn Phenomenon and the Somogyi effect?
The Dawn Phenomenon refers to the time of day when the sun begins to rise and your body biologically responds by releasing hormones, such as cortisol and epinephrine, to help get you ready for the day ahead. What happens with the secreting of these hormones are a subsequent rise in blood sugar. So, while the body is releasing hormones that reduce sensitivity to insulin (may be happening while your diabetes medication from the day before are wearing off), your body is also beginning to utilize stored glucose to prepare for the day ahead. This usually happens between 3am and 8am and is what causes your bodies blood sugar levels to increase in the morning (aka dawn). This process is harder for the body to compensate for when you have diabetes.
The second possible cause for high blood sugar levels in the morning is known as the Somogyi effect (also known as rebound hyperglycemia). The Somogyi effect happens when blood sugar drops low during the night while you are sleeping. The occurrence of low blood sugar may be due to too much exercise or basal insulin. However, when this occurs, the body secretes hormones like the ones previously mentioned above and attempt to correct the dangerously low blood sugar by prompting the liver to release stored glucose in large amounts. This results in a rise in blood sugar. This response is the body’s way of trying to raise blood sugars back to safe levels, however, for people with diabetes, the liver often releases more sugar than is needed which leads to high blood sugar levels in the morning.
How do you know if the Dawn phenomenon or Somogyi effect are contributing to your high blood sugar levels?
Checking blood sugar levels between 2am and 3am for several nights in a row could help to determine which of the two effects is occurring.
If your blood sugar is low during this time, the Somogyi effect is likely.
If blood sugar levels are normal during this time, then the Dawn phenomenon is likely.
So now that we covered what the Dawn and Somogyi effects are, there are a few tips that can help to manage high blood sugar levels in the morning…
For the Dawn Phenomenon:
- Take medications consistently
- Alter the time you take your diabetes medications and increase your morning dose (discuss with your healthcare team first)
- Eat a lighter breakfast
- Have a bedtime snack (change the amounts of fat, carbs, protein in your snack to see if it makes a difference)
- Eat regularly (do not go more than 6 hours without eating)
For the Somogyi Effect:
- Count carbs and eat consistent amounts of carbs in the evenings
- Have a bedtime snack that includes carbs
- Eat regularly (do not skip meals)
- Decrease the dose of diabetes mediations causing overnight lows (discuss with your healthcare team first)
- Exercise earlier in the day or early evening
Looking to learn more about diabetes? Learn more about the basics of diabetes as well as diabetes management.
If you’re looking for support and guidance in managing your diabetes, feel free to reach out to our team of experienced Registered Dietitians to help guide you to the right path and take control of your diabetes.
* Note that this information is for educational purposes only and is not intended as medical advice or individualized nutrition. *
Sources:
https://www.diabeteseducator.org/docs/default-source/living-with-diabetes/tip-sheets/blood-glucose-monitoring/morning-highs-tip-sheet.pdf
https://my.clevelandclinic.org/health/articles/11443-blood-sugar-hidden-causes-of-high-blood-sugar-levels-in-the-morning
https://myhealth.alberta.ca/Health/pages/conditions.aspx?hwid=zx3495
