Dawn phenomenon: Ways to control high morning blood sugars

Dawn phenomenon is a normal rise in blood sugar released by the liver. The release happens as the person's body is preparing to wake for the day. The rise in blood sugar is normally handled with insulin. But, so is not the case in diabetics

Dawn phenomenon: Ways to control high morning blood sugars
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The normal, natural rise in blood sugar that occurs in early morning hours, between roughly 4 and 8 am is called as the dawn phenomenon. Blood sugar levels change as a result of hormonal changes in the body.

All people experience this phenomenon to one level or another and it can vary day by day. People without diabetes may never notice it happening, as a normal body’s insulin response adjusts for rise without intervention.

A person with diabetes is more likely to experience symptoms from the rise in blood sugar levels, however.

How does it affect people with diabetes?

Dawn phenomenon is a normal rise in blood sugar released by the liver. The release happens as the person’s body is preparing to wake for the day.

The rise in blood sugar is normally handled with insulin. For people with diabetes, insulin is not produced in high enough quantities, or the body is unable to use the insulin properly.

As a result, a person with diabetes will feel the effects of having high sugar levels in the blood.

These effects can include:

  • faintness
  • nausea
  • vomiting
  • weakness
  • disorientation
  • feeling tired
  • extreme thirst

Managing the dawn phenomenon

Managing blood sugar levels is nothing new to most people with diabetes. A combination of diet, exercise, and medication often help keep the symptoms and problems under control.

In the case of dawn phenomenon, there are some additional changes that may help prevent issues caused by the spike in blood sugar.

Some steps people with diabetes can take to manage the dawn phenomenon include:

  • changing medication entirely or making adjustments with a doctor on existing medication
  • avoiding skipping meals or medication doses
  • avoiding carbohydrates around bedtime
  • taking medication closer to bedtime and not at dinner time

Other steps include eating dinner earlier in the evening. After dinner, some light physical activity, such as going for a walk, jogging, or yoga, is encouraged.

It is likely that a person with diabetes will experience high morning blood sugar levels from time to time. Occasional, mild issues from dawn phenomenon are not too worrisome. However, if the frequency becomes much more regular, then it’s time to call a doctor.

Complications

If blood sugar levels spike too high as a result of dawn phenomenon, the effects can range from mild to a life-threatening medical emergency.

Some complications that a person with diabetes may experience as a result of dawn phenomenon include:

  • nerve damage
  • damage to blood vessels
  • organ damage
  • ketoacidosis, an extremely dangerous buildup of acid in the bloodstream

People who experience repeated high blood sugar levels due to dawn phenomenon should see a doctor to prevent these consequences.

Do options differ between type 1 and type 2 diabetes?

Differences in dealing with dawn phenomenon depends more on the individual person than what type of diabetes they have or what their treatment plan is.

A person with type 1 diabetes may adjust the dosage or type of insulin to account for any changes overnight. In other cases where the person wears an insulin pump, they may adjust the pump to deliver extra insulin in the morning.

What is the Somogyi effect?

Unlike in the dawn phenomenon, the Somogyi effect occurs when blood sugar levels drop too low. This causes the growth hormones, cortisol, and catecholamines, to release into the blood.

For example, if a person who takes insulin or medication to lower blood sugar levels does not eat a regular bedtime snack, their blood sugar levels may drop during the night.

This person’s body then responds to the low blood sugar levels by releasing hormones that trigger sugar levels to go back up. This may cause blood sugar levels to be higher than normal in the morning.

How can you tell the difference?

The major difference between dawn phenomenon and the Somogyi effect is that the latter can occur any time there is extra insulin in the body.

The easiest way to rule out the Somogyi effect is to check blood sugar levels at bedtime, around 2 to 3 a.m., and after waking up for several nights and mornings.

Some people may choose to wear a continuous glucose monitor, which can record the sugar levels throughout the day and night, allowing the user to track the trends.

Here are two possible results and what they might mean:

If the blood sugar level is low at or between 2 to 3 a.m., there is a good likelihood the Somogyi effect is the cause.

If the blood sugar level is normal or high at or between 2 to 3 a.m., it is more likely that the cause is the dawn phenomenon.

Treatments, home remedies, and prevention

The best treatment is prevention. Treatment for the dawn phenomenon is likely to be the same type that they would use to treat a spike in blood sugar.

Some people may have to inject insulin while others might have specific medication to target increases in blood sugar.

Each person with diabetes should discuss with their doctor what to do when their blood sugar levels spike, regardless of whether it is the dawn phenomenon or not.

Source: Medical News Today