Practical Tips to Manage Overnight High Blood Sugar Levels

You’ve just crawled into bed, glanced at your continuous glucose monitor (CGM), and feel confident about where you’re ending your day. Cut to the next morning, you do a quick check and find that you have a high glucose. Unfortunately, many people with diabetes experience this. Although there are a variety of causes for a high glucose level in the morning, it’s most likely the dawn phenomenon. 

Understanding the Dawn Phenomenon

To get ready for the day, our bodies release certain hormones to help wake us up as soon as the sun starts to rise. These hormones tell our liver to release sugar into the blood for energy.

If you have diabetes, your body has trouble handling this extra sugar, which can make your blood sugar go higher than normal in the early morning.

The dawn phenomenon is different from the Somogyi effect. The Somogyi effect is a rebound spike in glucose (due to the liver’s production of glucagon) after having low glucose during the night. 

Both the dawn phenomenon and Somogyi effect can cause high glucose in the morning. To identify the actual cause of an early morning glucose rise, monitoring and evaluating your body’s glucose trends is key. 

Using a CGM to Track and Identify Patterns

CGMs provide glucose readings every one to five minutes. In real time, CGMs track how your glucose is moving, up or down, by way of trend arrows. CGMs also provide glucose graphs looking back over the last one to 24 hours. With so much data, CGMs are a great tool in determining if you are experiencing the dawn phenomenon.

Start by reviewing overnight CGM data on mornings when you wake up with a high glucose. Make sure to:

• Check your graph from three to four hours after your last meal or snack through to the time you woke up 
• Rule out other causes of early morning spikes like sickness, an unaccounted for bedtime snack, high stress or anaerobic exercise the evening prior, like weight lifting

Practical Tips + Strategies for Managing Dawn Phenomenon

Research has shown that using an insulin pump is more effective than multiple daily injections (a combination of long acting and rapid acting insulin) at keeping glucose levels in range and decreasing early morning spikes. Other ways to manage the dawn phenomenon are:

• Eating dinner earlier. This gives your body more time to process the glucose before going to sleep. 
• Light aerobic exercise after dinner. This can help drive blood sugar into your cells. Even going for a walk can make a big difference!
• Time your medications. Be sure to follow your doctor’s directions on when to take your diabetes medications. Talk to your healthcare provider (HCP); you may need an adjustment to your insulin regimen. 

The Takeaway

The dawn phenomenon can have a big impact on glucose levels. Luckily, CGMs are a great tool to understand when and why you may experience the dawn phenomenon. Work with your HCP. Share your CGM data, your insights and don’t give up on finding the right solution. 

This content was made possible by Abbott Diabetes Care, an active partner of Beyond Type 1. Beyond Type 1 maintains editorial control over its content.