If you have high morning blood sugar that you can't seem to explain, this one is for you.
We all know that diabetes is a balancing act. There's a small blood sugar target we all aim for. In order to hit that bullseye, we have a lot of work to do. When we are awake for the highs and lows it can be much easier to identify and manage the causes. But, when we are sleeping, it is much more difficult to do so. If you are waking up with high blood sugar in the morning, here are three possible reasons why.
According to the American Diabetes Association, everybody experiences dawn phenomenon whether they have diabetes or not. The difference is that, if you have diabetes, your body's ability to deal with it is reduced. Dawn Phenomenon normally occurs between 4 am and 8 am (around dawn). Hormones in your body surge and cause your liver to produce more glucose. This is nature's way of making sure there is enough present when you wake up in the morning since glucose is the body's primary energy source. With little or no insulin being produced during that time glucose levels in your blood increase.
Somogyi effect will manifest as high morning blood sugar but from a very different cause than dawn phenomenon. Also known as the rebound effect, Somogyi effect occurs following a hypoglycemic (low blood sugar) episode when your body releases natural glucagon in an attempt to correct the dangerous low. When this cause and effect occurs at night while you sleep your blood sugar may be high by morning.
There is a third round of possibilities. Examine your evening routine and see if there is something you've overlooked that may need adjusting to avoid morning high blood sugar. Is it something you ate? Unless you measure out exact portions, maybe you ate more of something than you normally do. Or, maybe the food you assumed was low-carb has more than you thought. Take a closer look at labels, or do a quick Google search to find out the nutritional facts about an unlabeled food you normally eat before bed. Is it your medications? Different medications can have different effects on blood sugar. Sometimes adjusting timing or dosage can help. Other times there may be a better option to try:
- If you use Lantus and take it in the morning you may notice a drop in its activity before a full 24 hours has passed, even though it is labeled as a 24-hr insulin. Ask your doctor about taking it at night instead, or switching to a longer-acting basal insulin, like Toujeo or Tresiba.
- Do you use metformin? Regular metformin peaks 4-8 hours after dose. If you take an evening dose there is a chance it is curving off by the time you check your blood sugar in the morning.
- Did you know some supplements can affect blood sugar? For example, according to WebMD, melatonin can have adverse interactions with diabetes medications. It can raise blood sugar, which may interfere with activity of insulin, glimepiride, glipizide, pioglitazone and others. Check side effects and interactions on the labels of supplements you are taking.
Figuring Out the Problem
It is important to seek assistance from your doctor in order to officially identify the problem and possible solutions to manage high morning blood sugar. But you can get a head start. Checking your blood sugar at key times you can collect in advance the data your doctor will need rather than waiting for the doctor to tell you what to do. Reduce the time to resolution with the following steps:
- Check your blood sugar right before bed, noting the time of your last dose of medication along with foods and portions you eat that evening.
- Set an alarm for 4 am. Check your blood sugar and note the result. Is it high, low or in your target range?
- In the morning before breakfast check your blood sugar once more.
- Repeat this process a few nights in a row.
Using the results of the above cycle you can get a very good idea of what is causing high blood sugar in the morning and you will have evidence to share with your doctor. Together you can work to avoid, reduce or treat high morning blood sugar occurrences better. Need extra diabetes testing supplies to figure out diabetes management issues? Pick up our meter and test strips to get the best value out there. Visit our store here.
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