What Causes High Blood Sugar Levels in Morning?

Dawn Effect

The rise in blood glucose levels in early hours of the morning is known as the dawn effect. This effect is observed between 3 AM and 6 AM in people with normal sleeping patterns. The reason for this surge in blood glucose level is due to the increased levels of human growth hormone. This hormone triggers the release of glucagon from the liver which increases blood glucose levels. In normal people, insulin counters the effects of glucagon and the blood glucose levels do not get too high, but in diabetics there is not enough insulin and this can lead to high blood sugar in the morning.

Waning Insulin

A low insulin level can be responsible for high blood glucose level in the morning. If the insulin dose after an evening meal or dinner is not sufficient, the blood sugar levels can be high in the morning. The morning blood glucose level can also creep up when the effect of long acting insulin starts to wane. With waning insulin, the rise in blood glucose is more gradual than with the dawn effect.

Somogyi Effect

The Somogyi effect or rebound hyperglycemia is said to lead to high blood glucose level in the morning. This is usually observed in patients with poorly controlled diabetes. The explanation is that if a person with diabetes suffers Somogyi effect during the night, which may be caused by drinking alcohol, eating too little, or taking too much medicine, the body will release more anti-insulin hormones to bring blood sugar level back up. However, the excess anti-insulin hormones will lead to high blood glucose in the morning.

Whatever the cause of morning high blood glucose is, the main source of excess glucose is the liver, which is responsible to store and produce glucose. Hormones give the liver signal to fuel the body by producing glucose between meals and overnight. Hormone imbalance in diabetes caused by different reasons, such as low level of insulin and too much medication, can give the liver wrong signal to release excess glucose than it should.

It is extremely important to figure out the reason of morning hyperglycemia. To pinpoint the exact cause, you need to check your blood glucose levels before you go to bed, at 3 AM and then again when you wake up. It seems a bit tough to wake up at 3 AM and check the blood glucose levels, but doing this for a few nights will help to ascertain the reason why you have high blood glucose levels in the morning and once the cause is identified, it can be treated with better results.

• If your bed time glucose level and 3 AM level is nearly the same and the morning levels are high, you are most probably experiencing the dawn effect.

• If your 3 AM level is lower than the bed time level and the morning levels are high, this is most likely due to the Somogyi effect.

• If your 3 AM blood glucose level is higher than the bed time level and the morning levels are even higher than that, the reason is waning insulin.

Take Basal Insulin

Discuss with your treating physician about taking basal insulin dose at bed time. They can prescribe the correct dosage or if you are already taking it, they can readjust the dose according to your blood glucose levels.

Adjust Medications

If your high blood glucose is caused by low blood sugar level while you are sleeping, it indicates that you should adjust the dose of any medication you are taking in the evening. For other conditions, taking an evening dose of metformin can be helpful to control high blood sugar in the morning. Talk with your doctor about whether you need to adjust your medications or not.

Have a Healthy Pre-Bed Snack

If you are having the Somogyi effect, the best thing you can do is to take a healthy snack at bed time. The snack should be high in protein and complex carbohydrates to keep the blood glucose levels steady during the night. Your dietician can give you the right advice regarding your diet.

Increase Physical Activity

If you are physically active, your blood glucose level will stay within the limits. This will help you control your blood sugar levels and you will need less medication. Do talk to your doctor if you are on insulin and check with them how much physical activity is ok for you without getting hypoglycemic.

Weight Loss

One of the best ways to control blood glucose level is to lose the extra weight. When you shed the extra kilos, your body will respond better to the treatment. A healthy lifestyle can prevent many complications and make the management of diabetes easier.