If you’ve been diagnosed with diabetes, you’ll know that keeping your blood sugar levels under control can require some very careful management, particularly if you’re someone who experiences the dawn phenomenon. Here we look at the causes of the dawn phenomenon in the context of diabetes management, and explain why taking steps to control your blood sugar at all hours is so important.
What is the Dawn Phenomenon?
The dawn phenomenon refers to the early-morning rise in blood glucose that typically occurs between the hours of 4am and 8am or roughly around 8-10 hours after going to sleep.
This morning blood sugar rise is an entirely natural process that even people without diabetes experience, as the liver is instructed by the body to start making the glucose that’ll be used for energy as the start of a new day approaches. However, the main issue is that in people with diabetes, this morning blood sugar rise causes hyperglycaemia, where their blood sugar levels simply become too high. This is because if you’ve got diabetes, the pancreas doesn’t respond normally and doesn’t release the correct amount of insulin to ensure that your blood sugar levels are properly regulated.
As hyperglycaemia can cause a variety of problems, including damage to your nerves, stroke and heart disease, understanding how to prevent your blood sugar levels from becoming too high overnight is incredibly important.
Symptoms of the Dawn Phenomenon
Monitoring your blood sugar levels at regular intervals is really important, as it can provide a really solid understanding of how well your condition is being managed. If you don’t have a continuous glucose monitoring device, taking your fasting glucose levels when you first wake up will help you to understand whether you’re someone who is actually experiencing the dawn phenomenon.
If your morning blood sugar rise is significant, you may experience a number of symptoms including increased thirst and/or hunger, headaches, blurry vision, irritability, and more frequent urination.
Why Does the Dawn Phenomenon Happen?
It’s not totally clear as to precisely why the dawn phenomenon causes blood sugar levels for some people with diabetes to become too high overnight. That said, there is some research to indicate that some of the hormones that are naturally released by the body as we sleep can cause increased insulin resistance.
When you think about it, the dawn phenomenon isn’t the only reason why your blood sugar might be too high first thing in the morning. Not taking enough medication or insulin the previous night is another all-too-common reason for morning blood sugar spikes, as is consuming a carbohydrate-heavy snack just before going to sleep.
Blood sugar levels can also be impacted by something called the Somogyi effect. This occurs when injected insulin causes your blood sugar to fall too much overnight, prompting the body to release hormones that cause your sugars to increase too much in an attempt to compensate for the deficit.
The Importance of Managing the Dawn Phenomenon
It’s clearly important that you take steps to manage this blood sugar spike, as research has shown that failing to do so can have a negative impact on your overall glycaemic control and can, therefore, increase your risks of developing or worsening any existing complications associated with diabetes.
If your blood glucose gets to very high levels or remains persistently high, it can lead to the development (or worsening) of conditions including peripheral neuropathy, diabetic retinopathy and heart disease. It may even contribute to the development of life-threatening medical conditions, including diabetic ketoacidosis.
How To Manage Morning Blood Sugar Spikes
If you’re here after searching ‘dawn phenomenon diabetes’, you’re likely looking for advice on how to keep your morning blood sugar levels in check. So, firstly, if you think you may be experiencing the dawn phenomenon, it’s really important to have a chat with your medical team.
There are a number of things that may be suggested to help keep your blood sugar levels within a healthy range, including altering your dosage of insulin or diabetes medication. You’ll also be advised to avoid consuming carbohydrates in the evenings and at night.
Other management solutions include switching the time at which you take your medication so that it’s closer to the time you go to sleep, which can be very effective. You may be advised to try a different medication to manage your diabetes, particularly if dosage and/or time changes don’t help.
It’s worth noting that for the dawn phenomenon diabetes management steps that you may be most familiar with often aren’t always effective. If you find that oral medications or long-acting injections aren’t helping, don’t worry too much as this is very common. Instead, you’ll possibly be advised to use an insulin pump, which will provide additional insulin to help regulate your blood sugar levels during the early hours of the morning. This is the most effective treatment for the dawn phenomenon.
FAQs
How many people with diabetes are impacted by the dawn phenomenon?
It’s not known precisely how many people with diabetes experience the dawn phenomenon, however it’s thought to be very common and may even impact more than half of people with Type 1 or Type 2 diabetes. The good news is that there are many steps that can be taken to prevent the dawn phenomenon from causing hyperglycaemia, so it’s important to talk to your diabetes management team if you’re having issues regulating your blood sugars in the early morning hours.
What should normal fasting glucose levels look like?
In most healthy people, normal fasting glucose levels are between 4.0 and 5.4 mmol/L. If you’ve been diagnosed with diabetes, your medical team is likely to give you a pre-meal blood sugar level target of between 4.0 and 7 mmol/L.
