The dawn phenomenon

What’s the daybreak phenomenon?    

The daybreak phenomenon is an early morning rise in blood glucose ranges.  It is because of an evening time improve in sure hormones, which gives vitality that can assist you wake. 

How widespread is it?    

Research present that round half of all individuals residing with kind 1 or kind 2 diabetes expertise it.  

How have you learnt you may have it?    

The principle signal is an elevated glucose degree within the early morning often between 4am and 8am.  You go to mattress, your glucose degree is 5mmol/L.  While you wake, it’s above this. How a lot increased will depend on the person.  You could need to monitor between 2am and 6am, or on waking, to see if there’s a rise.   

Stress hormones, comparable to cortisol, glucagon, and adrenaline, are launched in a single day and your liver releases glucose into the system in response to those hormones.  These hormones also can improve insulin resistance. Making it more durable for insulin to do its job.  

• In an individual with out diabetes there isn’t any rise within the morning. That is because of the physique having the ability to produce extra insulin to counter the results of the stress hormones.    
• These residing with kind 1 diabetes must depend on beforehand injected insulin, which might not be sufficient. If not sufficient, it may result in an increase in fasting blood glucose.   
• These residing with kind 2 diabetes, might not have the ability to produce the correct amount of insulin to manage the in a single day glucose launch and/or their insulin can’t do its job successfully. This may occasionally additionally result in an increase in fasting blood glucose.  

It is very important hold blood glucose in your individualised goal vary to forestall harm to blood vessels and nerves. This reduces your dangers of diabetes-related problems.  The overall fasting blood glucose goal vary, for many who have type1 or kind 2 diabetes, is between 4 and 7mmol/L.  Do notice your physician might set your goal at a special degree. For extra info see the NDSS blood glucose monitoring reality sheet.  

It takes effort to take care of elevated fasting glucose ranges.  Attain out to your diabetes staff to debate a few of the following choices:   

• Reviewing your insulin – want, kind, dose, and timing.  
• When you use an insulin pump, you possibly can contemplate setting the insulin charges to range in a single day, giving extra insulin when glucose is launched. Another choice is utilizing a hybrid closed-loop insulin supply system. That is the place you put on a steady glucose monitor which feeds glucose knowledge to your insulin pump. The pump adjusts your night time time background insulin charges mechanically. It is a superb method to hold your blood glucose in goal vary over night time.  
• Adjusting oral treatment, kind, dosage, and timing.  
• Consuming sufficient carbohydrate on your wants throughout daytime hours and avoiding snacking earlier than bedtime.  
• Sustaining wholesome fats ranges in your physique and decreasing your insulin resistance.   
• Being bodily energetic to extend insulin sensitivity.  
• Strolling, or figuring out, after dinner might scale back your in a single day and fasting glucose ranges.   
• Exercising within the morning, to make use of up the additional glucose.   

For pointers, see the NDSS Bodily exercise factsheet.

Keep in mind when altering your exercise ranges, particularly earlier than bedtime, it’s best to watch your glucose ranges. You might be prone to having low glucose ranges, referred to as hypoglycaemia (hypo).  Focus on how you can stop and deal with hypoglycaemia along with your diabetes care staff.

 If in case you have any normal questions across the daybreak phenomenon or glucose ranges, name the NDSS assist line on 1800 637 700.  You possibly can obtain a name again and communicate with a credentialled diabetes educator, accredited practising dietitian or accredited train physiologist.   

  By Monica McDaniel-Wong, Credentialled Diabetes Educator