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This has been documented to occur in the early morning hours; typically between 4-8 am. Most literature states that this is the body’s way to start prepping itself for the day. It’s gearing up so to speak.
There are hormones at play here. They are:
All of these have the ability to cause an increase in glucose production by the liver. That is exactly what is happening. The liver is producing glucose to get our bodies ready to start another day.
For a long time, I believed this was exclusive to diabetics. But when I delved into this deeper, I learned that both diabetics and nondiabetics alike experience the same biological activity while sleeping that causes us diabetics to wake up with higher blood sugar.
The key difference is the nondiabetic’s pancreas increases its insulin secretion to compensate for the extra glucose. This has the effect of maintaining normal blood sugar levels in these people upon waking. In diabetics however, as you know, our whole blood glucose regulatory system is impaired. What this means in the context of the dawn phenomenon, is that we’re unable to properly generate the insulin needed to normalize our blood sugars by the time we wake up in the morning.
This particular 1984 (abstract) published in Diabetes Care tied the dawn phenomenon to our body’s circadian rhythm. Makes sense as it does seemingly occur on a schedule during the night, as noted above.
In this , a group of type 2 diabetics were monitored overnight and provided a constant stream of insulin to counteract dawn phenomenon. They noted that even with this constant insulin flow, they could not curtail the spike. It wasn’t until they increased the insulin levels at 5:00 am that they were able to meet that objective.
This confirms that an increase in insulin secretion is required. The study noted that in nondiabetics they were able to note a fluctuation of insulin levels during the night. This fluctuation is characterized by a:
It’s the rise in insulin in the morning that normalizes blood sugar. As diabetics, we lack that ability. However, there are things that can be done which, I will get into shortly. Ultimately, it is the liver producing the extra glucose. How does that actually happen? It is through two biological processes that it does this: glycogenolysis and gluconeogenesis.
Glycogenolysis is the process by which glucose is created from glycogen (stored sugar in liver and muscle tissue) and converted into glucose under certain conditions. Gluconeogenesis on the other hand, makes glucose from protein and fats. I won’t bore you with more detail than that but I wanted to give you the big picture.
Before I provide some of my tips for getting morning sugars down, I want to provide some more facts that will lead into that. The study also states these early morning sugar highs are better controlled when your A1c is less than 7%. The opposite is true at an A1c greater than 7%.
Additionally, according to the same study, oral medications will not suffice; insulin is needed to better control the dawn phenomenon effect. Also, it’s worse when morning meals include carbohydrates. Now I can certainly attest to that.
Finally, they documented a 3-step progression to the dawn phenomenon effect:
If you study those steps closely, you may realize that a feedback loop is created. In other words, it’s a catch-22 or vicious cycle. It all feeds itself and round and round we go.
In this , at the end of their experiments the researchers concluded that no matter what treatment protocol a type 2 diabetic was on, they experienced dawn phenomenon. The conclusion was made that dawn phenomenon worsens with time in relation to pancreatic impairment, which makes complete sense.
Not only that, it was stated that oral medications make it worse. But a shot of basal (longer acting) insulin does improve it. In fact, I believe this is how doctors help their patients manage it, through a long-acting insulin shot before bed.
Also, they noted that glucose levels were at their highest after breakfast. Make a mental note of that one. Additionally, the way to treat dawn phenomenon, according to the study, is to treat it with the objective of lowering daily average blood glucose levels. This in turn will give you lower HbA1c readings.
I concur that does help lower early morning sugars; keeping your daily average blood glucose levels down.
The more you are persistent with these steps below, you will experience success. I can guarantee that. It doesn’t mean you should try to be perfect so don’t beat yourself up. Just get back on track. I do every time.
Those tips done repeatedly will drastically reduce dawn phenomenon because you’re attacking high blood sugar day in and day out. You go to bed with lower numbers, so you wake up with lower numbers. I see that in my case all the time. I know that some of the tips are hard to fathom because I’ve been there. But you’ll never realize they do work until you try them.
You may find it hard to accept that fruit is a no no. I know I did, for years. At least initially, if you want to have a piece of fruit with your lunch go ahead but not for breakfast or dinner.
Try it. You won’t regret it.
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