Dawn Phenomenon or Somogyi Effect – Why is Your Morning Blood Sugar High?

One cussed factor a couple of life with diabetes is that you simply’re extra seemingly than to not expertise morning excessive blood sugar ranges. 

It may be irritating to get up with excessive blood sugar while you really feel as in the event you’ve carried out nothing unsuitable (to not point out that you simply haven’t even eaten something but for the day!). 

What might be the reason for these hyperglycemic episodes? Is it Daybreak Phenomenon? The Somogyi Impact? A bent insulin pump cannula or consuming whereas sleepwalking? 

This text will describe the completely different the explanation why your morning blood sugar could also be excessive and what you are able to do about it. 

What is taken into account excessive blood sugar within the morning? 

At all times speak along with your physician about your particular person blood sugar targets, as a result of they will fluctuate throughout one’s lifespan (and differ relying on whether or not or not you’re pregnant, sick, or going by a hormonal or life change). 

Usually, nevertheless, fasting blood sugar ranges for somebody with diabetes ought to be someplace between 70-130 mg/dL. 

Excessive blood sugar ranges routinely above which might be thought-about hyperglycemic. Something above 180 mg/dL after your preliminary meal of the day is the benchmark for hyperglycemic blood sugars when not fasting. 

What’s the Daybreak Phenomenon? 

The Daybreak Phenomenon is a organic course of that dates again to prehistoric occasions. It developed to happen so people have extra vitality within the morning (and thus extra sugar within the blood) to gasoline their days..  

The Daybreak Phenomenon is a hormonal shift within the physique of the in a single day launch of counter-regulatory hormones, like development hormone, adrenaline, cortisol, epinephrine, and glucagon. 

This ends in morning insulin resistance that can lead to greater blood sugar ranges between 2 a.m. and eight a.m., however it may possibly offset your total day, and depart you annoyed, hungry, and affected by extended excessive blood sugar ranges that aren’t wholesome over the long-term. 

Folks with out diabetes have Daybreak Phenomenon as effectively, however their pancreases improve insulin secretion to forestall excessive blood sugar ranges. 

It’s estimated that over 50% of individuals with diabetes undergo from Daybreak Phenomenon. Nonetheless, it’s extra widespread in folks with sort 1 diabetes than folks with sort 2 diabetes, and most noticeable in people who find themselves on insulin remedy. 

What’s the Somogyi Impact? 

The Somogyi Impact, then again, is the physique’s response to a low blood sugar skilled in a single day, the place the liver releases glucagon to deliver the blood sugar again up in an emergency scenario, often leading to extraordinarily excessive blood sugar ranges. 

This will also be referred to as Rebound Hypoglycemia. 

This is quite common in folks with insulin-dependent diabetes, as a result of manually dosing insulin to handle blood sugar ranges will not be an ideal science, and experiencing low blood sugar ranges when you sleep is attribute of a life lived with diabetes. 

The Somogyi Impact is commonest in folks with sort 1 diabetes and insulin-treated sort 2 diabetes. 

How will you inform the distinction between the 2 circumstances?

Telling the distinction between the 2 circumstances might be key to serving to forestall the ensuing excessive blood sugar ranges from harming you within the first place. 

In the event you put on a steady glucose monitor (CGM) machine, scan by the hours throughout which you had been asleep. 

In the event you see a gentle rise of blood sugar between the hours of two a.m. and eight a.m. over a number of days or even weeks, whereas having regular blood sugar ranges of between 70-130 mg/dL earlier than you went to mattress, you’re more than likely experiencing the Daybreak Phenomenon. 

In the event you scan by your blood sugar ranges and see a pointy drop in blood sugar in a single day after which a sudden spike (with out treating your hypoglycemia), indicators result in the Somogyi Impact.

This occurs when your liver dumps glucose into the bloodstream to forestall a chronic and harmful low blood sugar. 

In the event you don’t have a CGM, you’ll have to get up in the course of the night time between 2 a.m. and eight a.m. and take a look at a number of occasions to see the place your blood sugars are trending. 

You could wish to set some alarms to get up hourly to see whether or not you’re going low throughout these hours or inching greater to find out whether or not you’re experiencing the Daybreak Phenomenon or the Somogyi Impact. 

How will you forestall these circumstances from occurring? 

Since these two circumstances have completely different causes, they’ll require completely different interventions to unravel. 

Some methods to assist forestall the onset of the Daybreak Phenomenon embody:

• Don’t eat a carbohydrate-rich snack or meal earlier than mattress
• Train earlier than mattress as a substitute of within the morning or in the course of the day 
• In the event you’re on a number of day by day injections, change your long-acting insulin to a night dose as a substitute of a morning dose, so it’s not truly fizzling out all through the night time (or cut up your dose in two – morning and night)
• Discuss to your physician about growing your insulin-to-carbohydrate ratio and correction issue (CF) to be extra aggressive in your bolusing
• Use an insulin pump and set extra aggressive basal charges all through the night time 

Some methods to forestall the onset of the Somogyi Impact embody: 

• Train within the morning as a substitute of within the afternoon or night
• Have a decrease carbohydrate snack or meal within the night, so that you’ll have much less insulin on board at bedtime 
• Pair a excessive fats, excessive protein snack at bedtime, to assist keep blood sugar ranges (assume peanut butter with celery)
• Use an insulin pump and reap the benefits of quickly decreasing your basal charges in a single day to keep away from low blood sugar ranges 
• Discuss along with your physician about adjusting your insulin-to-carbohydrate and correction issue (CF) ratios to be much less aggressive within the night to keep away from low blood sugar ranges 

You’ll be able to study extra about methods for avoiding excessive morning blood sugars in our information: Easy methods to Keep away from Excessive Morning Blood Sugar

Conclusions

Each the Daybreak Phenomenon and the Somogyi Impact are widespread circumstances skilled by individuals who have diabetes, particularly insulin-dependent diabetes. 

Though the circumstances lead to the identical final result, excessive blood sugar ranges within the morning, they’ve vastly completely different causes. 

The Daybreak Phenomenon is a pure organic launch of hormones between the hours of two a.m. and eight a.m. that will increase insulin resistance and means greater blood sugar ranges upon waking.

The Somogyi Impact, then again, is a rebound excessive blood sugar, ensuing from the liver dumping glucose into the bloodstream to deal with a extreme low blood sugar skilled in a single day. 

These points might be irritating, and over time, could contribute to diabetes problems, which ought to be prevented in any respect prices. Whereas not fully preventable, their severity might be mitigated with some strategic ways. 

Taking preventive measures earlier than going to mattress, equivalent to both growing or lowering your basal and bolus settings and the time at which they’re taken, adjusting your bedtime snack and night meals, and determining what time in the course of the day is greatest for train may help you mitigate these widespread however cussed morning excessive blood sugar ranges. 

Discuss along with your physician earlier than adjusting your insulin doses to determine essentially the most acceptable settings for you and your well being targets.