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Why is My Blood Sugar So High In The Morning



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Morning blood sugar readings can sometimes be all over the place. Depending on what you had for dinner or what snacks you had during the evening. What time you took your medicine can play a factor as well. But if you have consistently high blood glucose readings every morning, it could be one of three reasons that we are going to discuss in this video.

DAWN PHENOMENON

Researchers feel the most common reason for high blood glucose levels in the morning is the dawn phenomenon.

The glucose is going up from sources other than digested food. Some of it is produced by the liver from stored starch and fatty acids. Livers that produce too much glucose are one of the main ways diabetes causes high blood glucose levels. Other organs also produce small amounts of glucose. This is called “gluconeogenesis” for those of you who like the technical stuff.

Organs produce glucose to keep blood glucose from going too low at night or other times of not eating. From about 2 AM to 8 AM, most people’s bodies produce hormones, including cortisol, glucagon, and epinephrine. All these hormones increase insulin resistance and tell the liver to make more glucose. The idea is to get you enough glucose to get out of bed and start the day.

Everyone has a dawn phenomenon. Otherwise they’d be too weak to get breakfast. But in people without diabetes, insulin levels also increase to handle the extra glucose. People with diabetes can’t increase insulin levels that much, so their early morning blood glucose levels can rise dramatically.

Experts disagree on how many people have a dawn phenomenon. Estimates range from 3% to 50% of Type 2s and from 25% to 50% of Type 1s.

Is dawn phenomenon a serious problem?

It can be serious. According to the American Diabetes Association, “Some people with dawn phenomenon find that their glucose continues to rise until they eat in the morning. For others, levels will settle down a few hours after waking, regardless of whether or not they eat.”

According to columnist Wil Dubois, the higher your A1C, the more likely you are to have a significant dawn phenomenon. It could be that spending a number of hours each morning out of control is having a significant effect on your overall control.

Some people have high glucose levels in the morning because their medicines wear off overnight. This could be true of medicines like insulin, and metformin. If you are taking any long-acting medicine, consider asking your doctor about changing meds, doses, or times

THE SOMOGYI EFFECT

In some cases, medicine can be too strong. If your glucose goes too low in the night, you could have a rebound high in the morning. This is called the Somogyi effect.

If you are waking up high and are suffering pounding headaches, or find your sheets sweat-soaked, the odds are you are having lows in your sleep…You need to visit with your doctor about taking less meds.
According to Dubois, the new insulins are much less likely to cause a Somogyi reaction. But because of cost, people are going back to NPH insulin. NPH is cheaper, shorter-acting, and more likely to cause a low, leading to a rebound high in the morning.

WANING INSULIN

If you take insulin and have been experiencing high blood sugar in the morning, your insulin may simply be wearing off too soon. If this is the case, your doctor can adjust your dosage or change what time you are taking the insulin to prevent high glucose levels.

Pinpointing the Cause for Effective Treatment

If your blood sugar is fairly even when you go to bed and at 3 a.m. but is higher in the morning, you are probably experiencing dawn phenomenon. If your blood sugar is low at 3 a.m., but high in the morning, you probably suffer from the Somogyi effect. If your blood sugar is elevated at 3 a.m. and then higher still in the morning, you probably have waning insulin.

Even if you’ve identified the reason behind your high morning number, never attempt to correct it on your own. Instead, talk with your doctor. Together, you can find a treatment plan that gets you back on track in the morning.

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.

-Changing the time you take the long-acting insulin in the evening so that its peak action occurs when your blood sugars start rising
-Changing the type of insulin you take in the evening
-Taking extra insulin overnight
-Eating a lighter breakfast
-Increasing your morning dose of insulin
-Switching to an insulin pump, which can be programmed to release additional insulin in the morning

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