Many people with diabetes wonder why their blood sugar levels are higher in the morning, even though they didn’t eat anything overnight. This spike in morning blood sugar can be influenced by various factors, including diet, stress, and changes in the body’s hormonal balance. Two common explanations are the Dawn Phenomenon and the Somogyi Effect. In this post, we’ll explain them, how they are different, and share tips to help keep morning blood sugar in check.
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Why Does Blood Sugar Rise?
When you consume foods containing carbohydrates, your body breaks them into glucose. With the help of insulin, glucose is delivered to your cells for energy or stored in the liver as glycogen.
When blood sugar levels drop, the body releases a hormone called glucagon, which promotes the breakdown of glycogen in the liver to maintain blood sugar levels. Even during sleep, your liver continues breaking down glycogen to provide energy your body needs and keep your blood sugar stable.
What Is the Dawn Phenomenon?
Even in people without diabetes, the body releases hormones during sleep to regulate blood sugar levels. However, for those with diabetes, insufficient insulin production can cause blood sugar to gradually rise in the early morning hours (around 3 – 4 a.m.) due to an imbalance in these hormones. In this case, it’s recommended to consult with health care providers to discuss medication adjustments.
Dawn Phenomenon: Gradual rise in blood sugar levels that occurs in the early morning hours.
Causes of the Dawn Phenomenon
- Hormones: If growth hormone levels rise in the early morning or glucagon is secreted earlier than usual, it can suppress insulin secretion.
- Insulin insufficiency or insensitivity: This may occur if the dosage of long-acting insulin is insufficient to regulate blood sugar levels overnight.
- Excessive intake of food: Consuming too many carbohydrates the night before can increase the body’s insulin needs, leading to higher blood sugar levels in the morning.
- Age: During childhood or puberty, high growth hormone secretion can inhibit insulin’s effectiveness, making it harder to regulate blood sugar levels.
What Is the Somogyi Effect?
In simple terms, imagine your body as a thermostat. When the temperature drops below normal, the thermostat kicks in to restore normal temperature.
Similarly, the body has counter-regulatory hormones that help maintain blood sugar levels. When hypoglycemia occurs between 3–4 a.m., the effects of these hormones’ are amplified. This amplification triggers gluconeogenesis, which leads to a rebound in high blood sugar levels. In such cases, you may try having a small snack before bed or consult with your doctor about adjusting your medication.
Somogyi Effect: Hypoglycemia occurring in the middle of the night triggers the body’s regulatory mechanism, causing blood sugar levels to gradually rise.
Causes of the Somogyi Effect
- Excessive insulin dosage before bedtime: This can increase the risk of hypoglycemia
- Insufficient carbohydrate intake at dinner or prolonged fasting: Eating too few carbohydrates or fasting for too long may raise the risk of nighttime hypoglycemia. Consult with your doctor about adjusting your medication dosage if needed.
- Prolong or intense exercise: Exercise increases insulin sensitivity, which can lower blood sugar levels. To prevent nighttime hypoglycemia, it’s recommended to maintain a slightly higher blood sugar level before bed.
Difference between the Dawn Phenomenon and the Somogyi Effect
The Dawn Phenomenon occurs when blood sugar levels continue to rise from midnight to early morning.
In contrast, the Somogyi Effect involves a drop in blood sugar during the night, followed by a significant increase.
If you notice that your blood sugar levels are abnormally high in the morning, but were normal before bed, try testing your blood sugar at 3 a.m. to determine which you are experiencing.
How to Prevent High Blood Sugar in the Morning
The Dawn Phenomenon occurs due to insufficient insulin secretion in people with diabetes, which leads to rising blood sugar levels in the middle of the night. The following measures can help improve and prevent this:
- Maintain a balanced diet and monitor carbohydrate intake before bed
- Discuss with your doctor whether to adjust your medication and dosage
- Improve sleep quality by establishing a consistent sleep routine
- Reduce stress and anxiety
- Engage in regular, moderate exercise
On the other hand hand, the Somogyi Effect is often caused by low blood sugar during the night, which prompts the body to raise blood sugar levels to prevent hypoglycemia. It’s important to do the following:
- Record health values in detail: When experiencing unusual low blood sugar, this helps the healthcare team better understand your condition.
- Follow medication instructions from your healthcare team: Before adjusting medications, remember to consult with your healthcare team to avoid blood sugar fluctuations.
- Discuss dietary changes with your healthcare team: Changing carbohydrate intake may also increase the risk of hypoglycemia.
Aside from sticking to a healthy daily routine, self-monitoring your health data is also crucial. With the Health2Sync app, you can log your blood sugar, medications, meals, and exercise, allowing you to quickly identify the cause of hypoglycemia. It also helps your healthcare team better understand your condition.
Many hospitals and clinics now also use Continuous Glucose Monitoring (CGM) devices to detect sudden nighttime hypoglycemia as they provide a real-time and more accurate way of monitoring blood sugar levels.
