The day to day of managing diabetes is tough to understand why your blood sugar levels don't always make sense. Sometimes 2+2 doesn't = 4 and when you begin your day with high blood sugar the mystery feels frustrating.
The dawn phenomenon may be the cause.
You CAN control how much food and insulin you take in, but factors outside of your control like dawn phenomenon creates another obstacle. The holidays, traveling, added stress are all factors that affect your blood sugar control. Whenever your routine is off, morning highs caused by the dawn phenomenon are even more common.
Many people experience some kind of dawn phenomenon throughout their life, diabetes or not and it occurs in people with type 1 or type 2 diabetes. These high blood sugar readings in the early morning especially after what we ate the night before may be related to hormonal changes while you sleep.
So, what is dawn phenomenon?
In people with diabetes, it refers to a period of high blood sugar right after waking up from nighttime sleep. This period usually starts around 4 AM and lasts until around 8:00 AM.
When your body is starting to wake up in the morning, it goes through changes. Hormones like cortisol and growth hormone send a message to your body to start producing sugar in order to help wake you up.
Those of us with diabetes, these sugars cannot be broken down by insulin, so they stay in our bloodstream and cause a period of high glucose immediately after we wake up.
There is also an extended version that can last until mid-morning and if you add in some morning coffee, increases cortisol even more which pushes your glucose even higher.
Here's a few tips to help prevent or correct high blood sugar in the morning:
Tip #1 Recognize what high blood sugar in the morning may be caused by:
Not getting enough insulin the night before.
Not getting the right dose of diabetes medicine the night before.
Eating a snack with carbohydrates in it at bedtime.
Track your food and lifestyle habits to learn how and why you are trending higher in the morning. If you wear a CGM (continuous glucose monitor) notice your graph levels throughout the night and when you wake up. This information helps you and your health care provider confirm if you have the dawn phenomenon or if there could be another reason for high morning blood sugar.
Tip #2 - If you and your doctor can confirm you are experiencing the dawn phenomenon you can then come up with a plan
Adjusting your insulin therapy, is an effective treatment for the dawn phenomenon and especially the extended dawn phenomenon. Trying an earlier and/or larger dose of insulin as you start your day may head off a morning spike.
"Since even small increases in blood sugar levels can impact your health, managing the dawn phenomenon can be an important step in reducing your risk of diabetes complications." By Jill Seladi-Schulman, Ph.D. on April 15, 2021
Tip #3 - Drinking water as soon as you wake up and do some light exercise, like a morning walk
Both of these habits when added to your morning routine will help keep glucose in check. Whenever I am consistent with these simple to do's my mindset and confidence in managing blood sugar for the rest of the day is impacted. Starting your day in range will keep you closer to time in range all day and evening, this trend determines your fasting blood sugar and how you start a new day. Like a snowball effect, small steps lead to even bigger gains.
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Tip #4 Have patience and give yourself grace
Diabetes is like trying to hit a moving target, sometimes you nail a bullseye but the rest of the time you're learning, adjusting and doing the best you can.
While figuring out if dawn phenomenon is the underlying cause and the best ways to avoid morning high blood sugars, remember how hard you are working and celebrate your wins.
Whatever you and your doctor decide, avoiding consistent blood sugar highs is crucial for both type 1 and type 2 diabetes management.
Managing blood sugar doesn't always make sense and feels overwhelming when all your efforts don't add up. But with support, encouragement and sound advice from someone like me who understands...you can make thriving with diabetes attainable.
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Have you experienced dawn phenomenon; trend higher in the morning than makes sense? Leave a comment and share.