Why All the Morning Highs?

sunriseSometimes diabetes doesn’t make a lot of sense.

Think of those mornings when you wake up to find your blood glucose looking as if you’ve been up all night eating cookies. What’s up with that? You’d think that not eating for those seven or eight hours would give you lower blood glucose, right?

Such morning highs are common in people with diabetes, but one of the reasons has a particular name: the dawn phenomenon.

The dawn phenomenon is a natural rise in blood glucose between 4 and 8 a.m., which happens because of hormonal changes in the body. All people have the “dawn phenomenon,” whether they have diabetes or not.

People without diabetes would never notice it happening, as a normal body’s insulin response adjusts for this. However, because people with diabetes don’t have normal insulin responses, they may see an increase in their fasting blood glucose.

This is primarily because people with diabetes produce less insulin and more glucagon than they need. The less insulin produced by the pancreas, the more glucagon the pancreas makes as a result. Glucagon, in turn, signals the liver to break down its storage supplies of glycogen into glucose. This is why high fasting blood glucose levels are commonly seen in patients with type 2 diabetes.

The effects of dawn phenomenon vary in each person, and your blood glucose may be higher on some mornings than on others. But not to worry—there are steps you can take to get those numbers down and start your days more comfortably in your target blood glucose range.

Treatment for dawn phenomenon depends on how you treat your diabetes. If you take insulin, you may be able to adjust your dosing so that peak action occurs closer to the morning rise in your blood glucose. If you have type 2, diabetes pills provide options as well, as you can add metformin to reduce the liver’s glucose production.

Eating dinner earlier in the evening and engaging in some light physical activity afterward, like going for a walk, can also help.

If you have diabetes, chances are you’ll experience the occasional high morning blood glucose. That’s not something to fuss about too much. But if it happens regularly, then it’s time to call your doctor.

Have you ever experienced the dawn phenomenon? How did you manage it?

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26 Responses to Why All the Morning Highs?

  1. Nina Paragon says:

    I still have dawn phenomenon. It doesn’t matter what I do. Eat a light snack before bed, don’t eat for hours before bed. Exercise or not. And the doctor never seems worried about it. I don’t have to take any diabetes meds. Just check my sugar a few times a week. My am sugar is always 150-160. Rest of the time my sugar is normal post meals. Last few A1Cs have been 6.0 or less. I’d still like to get these am sugars down.

    • Bob says:

      I am going to start exercising/lifting weight intensely at night instead of the morning because the body is far more insulin sensitive for about 17 hours and the muscles can absorb glucose from the blood effectively while exercising. That should take care of morning highs where I believe I need the most help. During the day I think I have better control but I’m helpless at night. I’m curious why your doctor isn’t concerned with 150-160. A1C 6.0 or below is pretty good and maybe that’s why your doctor doesn’t seem worried but. I’m thinking about leaving my doctor because he doesn’t share with me my passion for getting better and better. Obviously he isn’t type 2/1 or he wouldn’t think that way.

  2. Jay says:

    I’ve been Type 1 for 38 years. Edible cannabis products have lowered my insulin resistance and have negated the dawn effect for me. I consistently tested in the low 200s at wakeup. Since eating small amounts of edibles at bedtime for the past 4 years, my glucose is between 55 and 85 consistently at wakeup. And my A1C has finally dropped to 6.8 after staying in the 7-8 range for over a decade (My worst A1C was 14, 25 years ago).

    • Susan says:

      Edible cannabis products??? What exactly are those??

    • Dan says:

      I am also a medical marijuana patient. MMJ helps lower my BGL significantly. I have been warned by my doctor and many others to watch it when I get the munchies while under the influence. I can eat everything under the sun if i’m not careful. The hard part about MMJ is I never feel satiated (full). I do not use it everyday. I use it when my BGL goes out of whack for whatever reason….which it will from time to time. A few bong hits, and half hour later, i’m back in range.

    • Tom McElheney says:

      That report is remarkable. I am learning that dawn phenomenon varies widely among individuals. Can you tell us what your doctor thinks of this?

  3. Jim says:

    I’ll go to sleep at 110-140 and wake up at 300-400. I figured I was just sleep eating. The worse part is I then bolus my pump and have a huge crash around 9:00am ( I get up at 4:30-5:00). But today my life has changed. I just heard I’ll be beta testing the new artificial pancreas. I’m PUMPED! (Only type 1 ers will get that)

    • Tom McElheney says:

      I get it as a non type 1-er, and I’m smiling! May our medical discoveries heal you as they have healed me! Be well.

  4. Susan says:

    My 14 year old has had type 1 for 7 years and 5 out of 7 mornings wakes up in the mid 200’s after going to bed with a really great number. Don’t know if I would feel comfortable giving her cannabis. LOL

    • Don says:

      You might want to look into using CBD oil made from industrial hemp plant – it contains no THC which it means it is not psycoactive

    • Steve Belcher says:

      Hello, You might want to look at increasing whatever background insulin is taken. Some take it twice a day. If they do increase the night dowse slowly until the AM numbers are lowered. I play with mine by making 4unit adjustments and I wait to see the same result two mornings in a row before making another change. In about a week you might be able to get those morning highs down. If you take one background dose a day you can try the same techneinc , but need to be a little more careful , assuming the rest of the day is ok maybe make smaller changes or maybe change the time of the shot, from AM to PM or something.

  5. Amanda Anderson says:

    I’m waking up with my meter reading levels over 600 please wash hands and test again. That’s every morning.. I have the continuous glucose monitor and when it goes off saying high..I adjust my insulin accordingly all through the night. Doesn’t help. I eat so well. I don’t know how this happens. My meter keeps me up like a Hungry newborn every single night but nothing i do helps. I’m rarely ever in the 100s.. this is a terrible disease.

  6. Berdj J. Rassam says:

    It’s a tough situation for those living with diabetes (and their loved ones); good to get additional info like this. Info is power.

  7. Jim says:

    I work for RKF Medical and have been in the medical industry for many years but it wasn’t until I was diagnosed with Diabetes two years ago that I now understand all of the struggles. Great article.

  8. Rama says:

    I was taking medicine for Diabetes for some time. I felt a good excercise,diet control would help. with good excercise and proper food intake my blood sugar levels stabilized. I stopped medicine, though I keep checking the blood sugar levels. I always get reading a between 140 & 150 in the morning at about 7AM. After an hour or so it gets reduced to about 120. My one/two hour after meal reading is once again between 140 & 160. In the evening times my average blood sugar levels are between 110 to 125. I am close to 50 years, but I am more stronger and fitter than when I was at 25 years. I am in search of a natural way (without medicines. I believe medicines would have the side effects) to reduce this morning bounce of blood sugar levels. I am going to try vinegar intake through food at bed time. Will update you guys on the results after a month. Hope it helps.

  9. Maria says:

    I have type 2 and have had good success with drops under the tongue at bedtime, of cannabis tincture. This lowers the morning blood sugars to below 110 (from 150 + without the drops.) Cannibas (weed) is legal in my state, but for those living in the “dark age” states, you can get hemp paste, which has literally no psychotropic effects, and IS legal in all states. It has also been documented to help cancer victims. Please research the NON toxic amazing uses for medical marijuana and the actual reasons it was demonized in the first place. No more living in the dark, with all of the evidence and research on the magnitude of beneficial effects of cannibas, it’s time to really take a stand on our own health and live well. Nature has provided us with amazing healing, life giving plants.

    • Don says:

      I am interested in learning more.
      Does the Cannabis tincture you use contain THC ?
      What dosage are you using ?
      Tell me more about Hemp paste ? Is it THC free ?

      Thank you.

  10. Don says:

    I now realize that like so many others with type 2 diabetes that I am experiencing the ” dawn phenomena”which has helped me to stop blaming myself thinking that my diet was inadequate. I live in Ontario Canada and have a medical marijuana card. I would like to hear from others who have used CBD oil without THC as I want to avoid getting high.

  11. Rama says:

    I started taking bigger salads and reduced the carb intake at the dinner time. This certainly helped in reducing my morning blood sugar level to less than 120. I have changed back and forth and noticed that heavy salad at the dinner table really helps in reducing the blood sugar levels the next day. I believe in taking medicine only when I have no alternative. I have been avoiding medication for controlling A1C levels.

  12. bob says:

    Hello everyone, my name is bob 21 years old with type 1 for over 10 years. I play soccer regularly and eat bread most of the time and vegetables, half apple, small orange. I am taking 3 shots of insulin( morning, lunch time, evening) I EAT NO SWEETS. my readings 2hours after breakfast are between 50-180 and the same goes to lunch+dinner. before i go to bed i am at 42 mg/dl but when i wake up i find always 300-500. could you please help me understand what is going on? by the way my A1C is 11.5

    • Rose Bronson says:

      Hi Bob,
      It is your diet. The bread, regardless of whole wheat, will do it. And apples & oranges are on the “higher” carb index as well. I was just diagnosed with type 2. It runs in my family and I was expecting it. I have been an avid exerciser and one who eats well except for a rare “treat”. I don’t take any meds for my diabetes. When you consume any of the carbs in bread, pasta, potatoes, etc., they will turn into sugar and it would be the same as eating a sugary snack. The body will utilize them the same way. Keep track of your carbs. I am in the 70’s in the evening and wake up with it being from 105 to 117. Not sure if I have the dawn phenomenon. I have taken it 2 hrs after a bad meal at my dad’s and it is in the 90’s. I do keep track of my total carbs. I also will substitute a food carb for a snack carb once in a while.
      I broke my back and went off of my healthy eating habits, got depressed and gained some weight. That all changed when I was diagnosed. Now I am back and feel great. Your A1C will drop when you morning numbers go back down. If not, I would call your doctor asap and see what he says. Good luck and hope this helps.

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