When your morning blood sugar level is high it is probably due to Dawn Phenomenon. Dawn Phenomenon is common in people with Type 2 Diabetes.
Are you eating eat a well-balanced dinner and you don’t snack in the evening, but you still wake up with high blood sugars? You may be asking “Why is my morning sugar level high?”. It can be frustrating if your morning blood sugar level is higher than when you went to bed?
If you are having high blood sugars in the morning you could be experiencing the Dawn Phenomenon. Dawn Phenomenon is common in people with Type 2 Diabetes. It affects up to 50% of people with diabetes. For Type 2 Diabetes, your fasting or morning blood sugar should be between 70 -130 mg/dL or 4-7 mmol/l.
What is Dawn Phenomenon?
Everyone has Dawn Phenomenon, even people WITHOUT diabetes. In the early morning hours between 2 am and 8 am, there is a surge of epinephrine, cortisol, and glucagon. These hormones peak right before we wake up and cause our livers to make sugar. This increases our blood sugars and signals our body that it’s time to wake up.
What Causes Your High Morning Blood Sugars?
The morning high blood sugar occurs when your body makes less insulin and more glucagon. Glucagon is a hormone that increases blood sugar. When the pancreas makes less insulin, it makes more glucagon. Glucagon signals the liver to break down stored sugar into blood sugar. This results in the high morning blood sugar that is common with people with Type 2 diabetes. This is sometimes called a “liver dump” of sugar or a “leaky liver”.
In someone without diabetes, the body releases insulin to lower the blood sugars. If you have diabetes, your body doesn’t produce enough insulin to deal with the blood sugar spike. The impact of the dawn phenomenon can vary from day to day as hormones and other circumstances vary.
What Can Prevent Dawn Phenomenon?
If you think you have dawn phenomenon, there are a few things you can try to lower your morning sugars:
- Eat your dinner earlier in the evening
- Do some physical activity in the evening, like a walk
- Eat a bedtime snack of complex carbs (15-30 grams) and protein. This will last into the night and “shuts off” the body’s response to no food. Try a ½ meat or cheese sandwich, crackers and cheese, a high protein Greek yogurt, or peanut butter on toast.
- Eat breakfast – it signals your body to shut off the early morning blood sugar elevating hormones
Is Your High Morning Blood Sugar Level a Concern?
A high morning blood sugar level is likely not a concern if:
- It is only slightly elevated
- It is only elevated once in a while. An occasional high morning sugar may due to other factors such as forgetting to take a medication
- It comes down after eating in the morning
- Your HA1C is in the target range (under 7 for most people)
You should discuss your morning blood sugar level with your healthcare provider if:
- Your morning blood sugar levels are significantly elevated
- You have tried the prevention tips outlined above and morning blood sugars remain elevated
- Your high morning sugar is impacting the rest of the day’s blood sugars
- Your HA1C is higher than the target range (under 7% for most people)
It's important that the fasting blood sugar is within the target range. Morning blood sugar levels set the tone for the day with the rest of your sugars. If you start with high blood sugars in the morning, it can be hard to get sugars in the target range later in the day. Most doctors will “fix the fasting blood sugar first”. This is because it's difficult to make other adjustments when fasting blood sugar is high.
Sometimes your doctor may ask you to test your sugars for a few nights at 2-3 am. This will rule out a less likely problem called the Somogyi effect. This can happen if your sugars go too low at 2-3 am and your body is over-producing sugar in response to the low.
Have your blood sugars been unexplainably high in the morning?