The Dawn Phenomenon: What It Is and How to Manage It

The “Daybreak Phenomenon” or “Daybreak Impact” is a time period describing when individuals dwelling with diabetes expertise excessive blood sugar within the morning.

Having your blood sugar rise sharply earlier than you even get up within the morning could make managing your diabetes harder for the remainder of the day, so it’s vital to determine in case you are experiencing Daybreak Phenomenon and make a plan for coping with it. 

This text will define what precisely Daybreak Phenomenon is and easy methods to higher handle it, so its results don’t go on to spoil your day. 

What’s the Daybreak Phenomenon? 

Daybreak Phenomenon is a situation skilled in individuals with both kind 1 or kind 2 diabetes.

It’s excessive blood sugar ranges and insulin resistance individuals expertise within the morning, often between 2 a.m. and eight a.m. 

It often requires extra insulin within the bloodstream throughout these hours to maintain blood sugar ranges regular. 

Some individuals want as much as double the quantity of insulin of their bloodstream in a single day to assist fight the excessive blood sugars attributable to Daybreak Phenomenon. 

Folks with out diabetes expertise the Daybreak Phenomenon as effectively, however their pancreas will increase its insulin secretion to forestall excessive blood sugars. Folks with diabetes don’t have that luxurious. 

It’s estimated that over 50% of individuals with diabetes endure from some extent of Daybreak Phenomenon! 

What causes Daybreak Phenomenon? 

This organic course of dates again to prehistoric instances, when people developed to have greater blood sugars (and thus extra “power”) within the morning to gasoline their searching and gathering to search out meals for the day. 

The causes of Daybreak Phenomenon are principally hormonal: the pure in a single day launch of counter-regulatory hormones, equivalent to development hormone, adrenaline, cortisol, epinephrine, and glucagon will increase insulin resistance, leading to greater blood sugar ranges in a single day and within the morning. 

Moreover, two different processes happen within the liver in a single day that outcome within the launch of glucose into the blood, contributing to greater blood sugars: 

• Glycogenolysis, which is the breakdown and launch of saved glucose 
• Gluconeogenesis, which is the creation of glucose from elements of protein or fats 

Different causes of morning excessive blood sugar can embody inadequate night mealtime insulin, inadequate insulin basal charges in a single day, and even rebound excessive blood sugars from going low in a single day. 

It’s vital that you simply don’t blame your self for experiencing excessive blood sugar ranges from the Daybreak Phenomenon! 

This can be a troubling problem for everybody dwelling with diabetes, and it’s only a matter of determining easy methods to finest handle and forestall it with out blaming your self or feeling responsible. 

What are the signs of Daybreak Phenomenon? 

The signs of Daybreak Phenomenon are the identical as having excessive blood sugar, they usually embody:

• Fatigue
• Thirst
• Must urinate
• Headache
• Physique ache 
• Dry eyes
• Blurry imaginative and prescient

Learn how to take a look at for Daybreak Phenomenon

For those who discover that you simply usually have excessive blood sugar within the morning, you’ll be able to arrange a testing routine for a couple of nights to find out if Daybreak Phenomenon is the trigger.

To do that, take a look at your blood sugar on the following instances:

• earlier than going to mattress
• within the early morning, equivalent to between 2:00 a.m. and 4:00 a.m. (set an alarm clock to wake you up)
• as quickly as you get up

For those who see that your blood sugar is steady from you go to mattress till the early morning after which rises, you might be almost definitely experiencing Daybreak Phenomenon. 

NOTE: In case you have a steady glucose monitor (CGM), you don’t have to do that take a look at as you’ll be able to simply have a look at the in a single day blood sugar graph it gives. 

A blood sugar graph like that is typical for Daybreak Phenomenon:

How excessive a blood sugar is taken into account Daybreak Phenomenon? 

Your diabetes expertise will fluctuate, however something greater than is regular for you is taken into account Daybreak Phenomenon. 

If you’re waking up with higher-than-normal blood sugar ranges a number of mornings every week, it could be time to contact your healthcare supplier about readjusting your insulin settings and/or night routine to assist mitigate the difficulty. 

It’s essential to search assist earlier than you expertise any long-term harm or issues. 

Long run penalties

If left unaddressed, years of experiencing the Daybreak Phenomenon and excessive blood sugars for almost all of the day may end up in diabetes issues equivalent to: 

• Coronary heart Illness
• Stroke
• Neuropathy, particularly within the toes 
• Decrease leg amputations
• Kidney illness 
• Diabetic Retinopathy of the attention
• Untimely dying 

Addressing excessive blood sugars it’s possible you’ll be experiencing when you sleep and into the morning may also help stop and/or delay many (if not most!) of those widespread issues of diabetes. 

How are you going to handle the Daybreak Phenomenon? 

Work along with your physician to provide you with some options that may work to raised handle the Daybreak Phenomenon it’s possible you’ll be experiencing, and at all times verify along with your physician first earlier than adjusting any diabetes medicines and/or insulin settings. 

Another methods might embody:

• Keep away from plenty of carbohydrates or snacks with added sugar at bedtime
• Rising your protein-to-carbohydrate ratios of night meals and snacks 
• Get loads of sleep, between 7-8 hours nightly
• Consuming extra water within the night and don’t drink liquids with added sugar 
• Eat dinner earlier within the night  
• Eat a breakfast decrease in carbohydrates, to assist handle any greater blood sugars 
• Alter your doses of insulin and/or diabetic medicines
• Train earlier than bedtime 
• Change from a number of each day injections (MDI) to an insulin pump that may make computerized insulin changes when you sleep 
• Change from a daily insulin pump to a hybrid-closed-loop insulin pump, such because the TSlim Management IQ or Omnipod 5
• Change the time at which you are taking your night medicines  
• Cut up your night dose of long-acting insulin into two doses (verify along with your physician) 
• Change to a distinct remedy that could be extra efficacious for you 

For a really complete and in-depth information to managing Daybreak Phenomenon for those who use insulin, learn the article Managing Daybreak Phenomenon with Basal Insulin 

Different causes for top morning blood sugars

Whereas Daybreak Phenomenon is the commonest motive for top morning blood sugar, it’s not the one one. Two different phenomenons may also trigger your blood glucose to extend within the morning:

Ft on the ground syndrome

Ft on the flor syndrome is what occurs whenever you get up with regular blood sugar ranges, however as quickly as you begin transferring round within the morning, your blood sugar rises, even with out consuming something. 

This is actually because your physique is releasing counterregulatory hormones, like glucagon and epinephrine, when you’ve began transferring round. 

Some easy options for this can be to extend your morning basal insulin fee, or for those who’re not on an insulin pump, to take a small dose of insulin upon waking. 

You possibly can be taught extra about easy methods to handle toes on the ground syndrome in our information Learn how to Keep away from Excessive Morning Blood Sugar

The Samogyi impact

The Samogyi impact additionally ends in excessive blood sugars upon waking, however for just a little little bit of a distinct motive. 

if insulin launched in a single day brings your blood sugars too low, your physique will naturally launch hormones, equivalent to glucagon and epinephrine, spiking your blood sugar in a rebound excessive. 

That is extra widespread in individuals with kind 1 diabetes than kind 2 as a result of everybody with kind 1 diabetes takes exogenous insulin and it’s this insulin that’s bringing your blood sugar too low in a single day. 

To counteract this, it may be useful for those who put on a steady glucose monitor (CGM) and observe your blood sugars in a single day to see for those who’re dipping too low. 

Decreasing your insulin to carbohydrate ratio at dinner, or decreasing your in a single day basal charges may also help alleviate this from taking place. 

You possibly can discover ways to cope with the Samogyi Impact in our information What’s The Samogyi Impact

Different potential causes of excessive morning blood sugars embody however are usually not restricted to:

• any new medicines you’re taking
• hormonal modifications
• being pregnant
• insulin resistance
• a failed insulin pump and/or CGM website
• stress
• lack of sleep
• a miscalculation of a night bolus 

When to hunt care

Excessive morning blood sugars are usually not extra harmful than excessive blood sugars at different instances of the day, so that you don’t want pressing care since you expertise Daybreak Phenomenon.

Nevertheless, as a result of Daybreak Phenomenon could be a persistent problem, it will possibly result in long-term diabetes issues. 

The Nationwide Institute of Diabetes and Digestive and Kidney Illnesses (NIDDK) due to this fact recommends that you simply see your physician or endocrinologist in case your morning blood sugar is excessive greater than 3 times in a 2-week interval.

Your physician may also help you identify in case you are experiencing Daybreak Phenomenon and recommend modifications to your life-style, remedy, and diabetes administration. 

Conclusions

Everybody on this planet experiences the Daybreak Phenomenon, however individuals with insulin-dependent diabetes are most inclined to the insulin resistance and cussed excessive blood sugars that outcome from this pure, hormonal incidence. 

It’s nothing to really feel responsible about, nor be ashamed about, however by taking proactive steps, you’ll be able to assist mitigate, handle, and even stop the Daybreak Phenomenon from ruining your day and diabetes administration. 

The Daybreak Phenomenon could be harmful if skilled long-term, resulting in diabetes issues. 

Make sure to implement prevention methods, equivalent to incorporating night train, limiting carbohydrates at dinner, and rising your protein-to-carbohydrate ratios, for those who’re commonly fighting the Daybreak Phenomenon. 

At all times work along with your physician first earlier than adjusting any basal/bolus insulin settings (for those who’re on an insulin pump), splitting your night dose of long-acting insulin, or rising your insulin doses.