High blood sugar in the morning is a common occurrence for diabetic patients. Due to an inadequate quantity of NPH/Lente insulin that you may take before dinnertime or at bedtime, blood sugar levels are highly likely to be elevated in the morning. This is a normal alteration of the hormones known as the dawn phenomenon and the Somogyi effect.
The Dawn Phenomenon
The dawn phenomenon is simply part of the natural process of the sleep cycle and the body waking up and preparing itself for the long day ahead by secreting quite a few different hormones. The body secretes counter-regulatory hormones such as cortisol, norepinephrin, epinephrine and somatropin between 3am to 8am to give you the energy to wake up and get moving. These hormones give you a boost of energy by releasing the glucose stored in your liver. In a person without diabetes, the process of glucose rise is complemented with insulin rise to help transform the plasma glucose into morning energy. On the contrary, people with diabetes, due to the lack of insulin production, do not transform glucose into energy and get a dose of energy in the morning. Instead they may simply wind up with high blood sugar.
Researchers have found out the hormone that triggers dawn phenomenon by infusing different hormones into experimental subjects. Among the hormones secreted during the early hours in the morning, the culprit is the Somatropin or what is known as the growth hormone. They found out that if they block the somatropin in the body, the blood sugar level stays flat. This may be the reason why older people do not experience a surge in blood sugar in the morning – because they no longer produce considerable quantity of growth hormone.
The somogyi effect is also known as the counter regulatory response or rebound hyperglycemia. This response occurs when the body is too low on blood sugar and the body thinks that it is in danger of going hypoglycemic. To remedy this situation, the body then goes to work to release stress hormones to get the glucose level back into a safe zone. As we all know, even if diabetes type II can still produce insulin, they can never produce enough insulin to counter the glucose produced, thus resulting in hyperglycemia in the morning.
Taking in too much insulin or not eating enough at dinner or before bedtime often causes the somogyi effect. When asleep, the body continues to convert glucose into energy and when the glucose level drops at a dangerous range, usually around 2am to 3am, the body normally responds to correct it. Although the flow of events and the result is similar to the dawn phenomenon, this is more “man-made”, a consequence to poor diabetic diet management.
How to Manage High Blood Sugar in the Morning
Discuss with your doctor how you can manage the dawn phenomenon and the somogyi effect. Often they will advise you to change some of your nighttime routines to counteract the high blood sugar in the morning.
Experiment with eating a light snack before bedtime to prevent your glucose level on dropping too low during your sleep. Try a protein snack, as it will gradually release carbohydrates into your body over a period of seven hours.
Change the time of your insulin intake so that its greatest action occurs as your glucose starts rising. You can also use a programmable insulin pump to pump additional insulin in the morning before waking up.
Eat a lighter snack in the morning so you will not add to the high glucose level.
Diabetic management is not easy, but it can be done. Earnestly watch your diet, take your insulin shots religiously and keep yourself active as much as you can.
This is not medical advice and is not meant to treat, diagnose, prescribe or cure any ailment. Check with your physician first before following any advice you have read on BrightHub.com. Consult your physician before you start, stop or change anything that has been previously prescribed to you.
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