What causes the dawn phenomenon ‘early morning spike’ in blood sugar?

Glucometer clock diabetes blood sugar level check

Early morning blood sugar level spike: The Dawn phenomenon that diabetics encounter

Photo : iStock

KEY HIGHLIGHTS

  • Most blood sugar patients are advised to check their blood sugar levels at certain specified times in a day.
  • You may be stunned when the glucometer reading for the early morning check shows higher than normal blood sugar.
  • Let us listen to Mayo Clinic doctors about what could be causing this spike in glucose levels.

If one is diabetic and carries out timely checks of the blood sugar levels, it can be a little disturbing to suddenly see that the blood sugar levels are high in the morning.

Why, you may ask, with an alarm. After all, for the last few hours that you sleep, you ate nothing, so why this jump?

First up, you need to realise that what you ate for dinner counts when it comes to overnight build-up of blood sugar levels. Commonly known reasons why your blood sugar may be high in the morning include high-carb bedtime snacks and not enough diabetes medications, says Cleveland Clinic report.

These causes of high morning blood sugar levels are a result of body changes and reactions that happen while you are sleeping.

High blood sugar in the morning may be caused by either of these two reasons:

  1. the Somogyi effect, a condition also called “rebound hyperglycemia.
  2. the “Dawn phenomenon, is the end result of a combination of natural body changes.

We shall look at the Somogyi effect another time, let us look at the dawn phenomenon here first.

What is the dawn phenomenon?

Your body uses glucose (sugar) for energy and it is important to have enough extra energy to be able to wake up in the morning. So for a period of time in the early morning hours, usually between 3 am and 8 am, your body starts churning out stored glucose to prepare for the upcoming day.

At the same time, your body releases hormones that reduce your sensitivity to insulin. In addition, these events may be happening while your diabetes medication doses taken the day before are wearing off.

These events cause your body’s blood sugar levels to rise in the morning (at “dawn”). Let us hear what an expert from Mayo Clinic says on the same topic.

Readers asked Mayo Clinic diabetologist Dr M Regina Castro (MD) this question:

What is the dawn phenomenon that some people with diabetes experience? Can anything be done about it?

Here’s what Dr M Regina Castro, M.D. replied.

“The dawn phenomenon also called the dawn effect, is the term used to describe an abnormal early-morning increase in blood sugar (glucose) — usually between 2 a.m. and 8 a.m. — in people with diabetes.

“Some researchers believe the natural overnight release of the so-called counter-regulatory hormones — including growth hormone, cortisol, glucagon and epinephrine — increases insulin resistance, causing blood sugar to rise. High morning blood sugar may also be caused by insufficient insulin the night before, insufficient anti-diabetic medication dosages or carbohydrate snack consumption at bedtime.

“If you have persistently elevated blood sugar in the morning, checking your blood sugar once during the night — around 2 am or 3 am — for several nights in a row will help you and your doctor determine if you have the dawn phenomenon or if there’s another reason for an elevated morning blood sugar reading,” Dr Caastro said.

Is there anything one can do to avert this blood sugar level rise in the morning?

Once you and your doctor determine how your blood sugar levels are behaving at night (and having arrived at whether it is the Somogyi effect or Dawn Phenomenon), he or she can advise you about the changes you need to make to better control them. Dr Castro says that your doctor is your best advisor. Ask your doctor and he/she may likely recommend a number of options to help you prevent or correct high blood sugar levels in the morning. They may include instructions for you to follow, such as:

  1. Avoid carbohydrates at bedtime.
  2. Adjust your dose of medication or insulin.
  3. Switch to a different medication.
  4. Change the time when you take your medication or insulin from dinnertime to bedtime.
  5. Use an insulin pump to administer extra insulin during early-morning hours.

The Cleveland Clinic experts offer this advice:

  • Changing the timing or type of your diabetes medications
  • Eating a lighter breakfast
  • Increasing your morning dose of diabetes medication
  • If you take insulin, switch to an insulin pump and programme it to release additional insulin in the morning

https://www.timesnownews.com/health/diabetes-what-causes-the-dawn-phenomenon-early-morning-spike-in-blood-sugar-article-90308683

Aish Barbara

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