How To Prevent Dawn Phenomenon – The dawn phenomenon and the Somogyi effect are two possible reasons why diabetics wake up with elevated blood sugar levels. In this article, we explain the differences between the two and the available treatment and prevention methods.
The dawn phenomenon is an unexpected early morning spike in blood sugar levels. The American Diabetes Association (ADA) defines morning sickness as an increase in stress hormones — such as cortisol, glucagon, or epinephrine — that the body naturally produces around 4 a.m. to 5 a.m. These hormones are the body’s way of signaling that it’s time to get up, and they can cause the liver to release glucose which can affect morning blood sugar and A1C levels.
According to Diabetes.co.uk, some researchers believe that the release of these hormones can cause a short period of insulin resistance, which leads to an increase in blood sugar levels.
People with type 1 and type 2 diabetes may experience morning sickness, because their bodies cannot produce insulin (type 1 diabetes) or cannot use it properly (type 2 diabetes) to stabilize blood sugar levels. However, people with type 2 diabetes have a higher chance of experiencing a morning shift. Metformin, a common oral diabetes medication prescribed for people with type 2 diabetes, can help slow the release of glucose from the liver and prevent morning sickness.
Also called rebound hyperglycemia, the Somogyi (suh-MOH-jee) effect occurs when the body reacts to a state of hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar).
The Somogyi effect was described by Dr. Michael Somogyi, who believed that prolonged periods of untreated hypoglycemia could cause stress that could lead to high blood sugar levels. The National Center for Biotechnology Information (NCBI) explains that if blood glucose levels drop in the evening, the body can respond by producing hormones that trigger an increase in glucose production.
The Somogyi effect is more common among people with type 1 diabetes than with type 2 diabetes. People who manage their diabetes with insulin injections may experience the Somogyi effect because insulin levels are higher at night. If you have type 2 diabetes and take metformin, there is no risk of a Somogyi effect.
The dawn event and the Somogyi effect may seem very similar, as they both involve the production of hormones in the body that promote the production and release of glucose. However, there is a big difference. According to the NCBI, Somogyi’s effect is based on a nocturnal hypoglycemic episode in which the response is a morning increase in blood glucose levels. The morning event can occur without the body having a hypoglycemic episode.
Health professionals will use continuous glucose monitoring (CGM) data to assess overnight blood sugar levels and determine cause and effect. For people with diabetes who do not have CGM, there are specific CGM systems that many healthcare professionals can use to collect necessary data. The patient uses these regimens for a few days and the information gathered can be used to make necessary changes in treatment.
Monitoring your blood glucose patterns overnight can provide valuable information about your body’s glucose management. If a person doesn’t have a CGM, they can set an alarm to test their blood glucose levels between midnight and 3 a.m. (these are common times but can be adjusted based on sleep schedule) to see which way their numbers are going.
The symptoms associated with the dawn phenomenon and the Somogyi effect will vary greatly and will depend on how long a person has had diabetes.
A person with long-term type 1 diabetes may experience hypoglycemia unawareness, which means they don’t have symptoms when their blood sugar goes too low. For some people, low blood sugar can cause them to wake up in the middle of the night sweating because the body is trying to control the low. Some people may have no symptoms when they have high blood sugar, but others may have symptoms of high blood sugar, such as extreme thirst or fatigue.
Treatment and prevention of both the cause and effect of Somogyi begins under the supervision of a healthcare provider. They will ask you to measure and record your glucose levels several times a night, between midnight and 3 a.m. Recommended times may vary based on your treatment regimen, so check with your healthcare team to determine the best times to test if you have a good morning. Blood sugar. Continuous diabetes monitoring will record this information, but you can also set overnight alarms and test your blood sugar with a blood glucose meter.
Bring a record of your glucose levels to every appointment with your healthcare provider. They will assess your history and recommend appropriate treatment to help prevent these incidents from occurring. If you suffer from frequent morning sickness, your medication or insulin may need adjusting. For example, some people may need to add a dose of metformin at dinner time if they take it in the morning, or they may need to split their basal insulin dose into morning and evening. An insulin pump can also help better control your blood sugar.
If you wake up with high blood glucose, be sure to check your blood sugar throughout the day. Your health care team will use this data to determine if changes to your medications are necessary.
NCBI notes that the dawn phenomenon has been found more frequently than the Somogyi effect. A health professional may recommend some of these common remedies for morning sickness:
It is important to stick to your meal plan and not to skip meals unless otherwise advised by your healthcare team. Diet plan recommendations are made by individuals and are based on factors such as:
If you take insulin, your healthcare team may advise you to adjust your insulin dose to correct your blood sugar. If you are using an insulin pump, they may advise you to give yourself a correction dose and the timing of your bolus meal to adjust.
As we noted, the dawn event is found more frequently than the Somogyi effect. Diabetes.co.uk reports that although the Somogyi effect is well known throughout the health industry, there is no scientific evidence to prove its existence.
Some clinical studies have suggested that lowering insulin at night is often the cause of the body’s failure to prevent hyperglycemia. One study in people with type 1 diabetes found that nocturnal hypoglycemia is often associated with morning hypoglycemia, not hyperglycemia. In clinical practice, it has been reported that patients who experience hypoglycemic episodes at night do not wake up due to hyperglycemia, which contradicts the effect of Somogyi.
Whether this is due to morning sickness or the Somogyi effect, waking up with high blood glucose requires further investigation. You should tell your healthcare team, and they may recommend measuring and recording your blood sugar levels overnight, with either a blood glucose monitor or blood glucose meter. Using the data you collect, they will be able to recommend the best treatment options to help you better manage your diabetes.
Download this free chart for glucose guidelines and helpful information about high and low blood sugar levels.
Melissa Herrmann Dierks RDN, LDN, CDCES is a registered dietitian nutritionist, diabetes care and education specialist, and licensed registered dietitian in Huntersville, NC with over twenty-five years of professional experience in nutrition and diabetes education. In addition to providing nutrition solutions for adults and children, he provides nutrition communications services to the food and beverage industry and is the owner of Supermarket Savvy. Melissa has held various sales and marketing positions for leading diabetes companies including insulin pump, blood glucose monitor and diabetes distribution companies. daily blood ketone levels. But instead of having high blood ketone levels, your ketone levels are surprisingly low, even though you stayed on the keto diet the night before, went to bed in ketosis, and have been “fasting” ever since. why?
Do not worry. It has nothing to do with what you did or didn’t do. What you may hear is called the “dawn effect” or “dawn effect.”
The dawning phenomenon of hyperglycemia is a natural, early-morning rise in blood sugar (glucose) levels that occurs in all people, even without excessive carbohydrate consumption or a ketogenic diet; It has nothing to do with food consumption, but rather has to do with biological processes called gluconeogenesis and glycolysis. It is thought that the release of other hormones, such as cortisol, during the morning may play a role.
For some people, it is important to raise blood glucose levels in the morning. For others, it is not immediately apparent.
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