The body automatically goes through a series of hormonal changes while you sleep. In people who are not challenged by diabetes, the body makes more insulin to balance everything out on its own. If you have Type 1 Diabetes, your body cannot respond to these hormonal changes by simply making insulin, so your blood sugar rises. Basically, your body is starting the engine, releasing some fuel, and prepping to go for the day. The effects of the dawn phenomenon can vary from person to person, even from day to day.

 

There are a few potential causes of high morning blood sugars:

1. dawn phenomenon

2. continued high blood sugar from the night before

3. reactive hyperglycemia (high BG), also called the Somogyi Effect

 

There are steps you can take to figure out the source of your unexplained morning blood sugars. The most straightforward strategy is to test your blood sugar before bed, test again in the middle of the night and then test first thing in the morning. This extra effort upfront will help you get to the bottom of things pretty quickly.

 

Don't become overly concerned about dawn phenomenon. If most of your night is spent with normal blood sugars and you experience a small, temporary increase in the morning, this is likely nothing to worry about. To proactively combat dawn phenomenon, you can: 

• avoid carbohydrates at bedtime

• go for an after-dinner walk or exercise for 10-30 minutes before bed

• adjust your insulin dose - note: if you take a long-acting insulin such as Lantus, be aware it doesn’t last a full 24 hours

• change the insulin delivery amount or timing from dinner to bedtime

• use an insulin pump to administer extra insulin during early-morning hours
  note:  be sure to discuss any changes in pump settings with your doctor and/or specialist team before doing so

 

In some cases, because of the dawn phenomenon, people can become more resistant to insulin first thing in the morning. Limiting carbohydrates during the hour or two after you wake up or adjusting to a higher insulin-to-carb ratio for a brief period in the morning will also help to get blood sugar levels back in range.

CONTRIBUTING SOURCE: dLife | Diabetes Canada