SB2015
Well-Known Member
- Relationship to Diabetes
- Type 1
I didn't want DEusXM's useful info about possible causes of high BGs in the morning and strategies to sort it to be missed as it is in response to another question.
I found this such a useful summary with such practical suggestions for identification and solutions to try. (Tried to copy into here as a quote but did not do the right things. Next time. I will get there in the end)
There's four main reasons why your readings might be significantly higher in the morning than the evening:
Dawn phenomenon
What is it?
Before waking, your body starts pumping out glucose and hormones that increase insulin resistance, which causes your blood sugar to raise.
How do I know if it's this?
Set your alarm to go off a couple of hours before you'd usually wake, and test. If your reading at this time is normal and your morning reading is high, it's probably dawn phenomenon
How do I fix it?
With difficulty. Some options include eating a higher protein meal before bed, which gives your body the fuel it'll need in advance of the morning. You can also try eating a larger breakfast in the morning to train your body to expect a food hit, so it doesn't start dumping sugar. Or you can look at altering your basal timings.
Somogyi effect
What is it?
When you have a hypo in your sleep and don't wake up, it's believed your liver starts pumping out glucose to treat the hypo - which then causes higher blood sugar levels in the morning.
How do I know if it's this?
Set your alarm to wake you at something like 2am or 3am and then test. If your reading is sailing pretty close to hypo territory, it may be this what's happening. Also, those who believe this happens to them also seem wake up with hangover-like symptoms - very tired, headachey etc.
How do I fix it?
Decrease your basal. You shouldn't take preventative action by eating and then go to bed with higher numbers - it'll stop the hypos but it'll just make you fat and then in 10 years time you'll have a foot fall off.
Delayed dinners
What is it?
Protein takes 4-6 hours to start breaking down into glucose but it can be quite significant. A high protein meal can cause your blood sugar to go up quite a lot, but quite late on.
How do I know if it's this?
Test before your evening meal, two hours after, and 4-6 hours after. If your latest reading seems unusually high, it's probably the protein.
How do I fix it?
Either change the proportions of your meal, or increase your basal. Changing the proportions is probably better.
Insufficient basal
What is it?
Your liver will slowly output glucose through the night. If you don't have enough insulin in your system, this will raise your blood sugar.
How do I know if it's this?
Test before going to bed, test again during the night (maybe once or twice) and then test again in the morning. If you see the readings consistently increase throughout the night, you probably don't have enough basal insulin.
How do I fix it?
Adjust your basal insulin until your readings look better.
I found this such a useful summary with such practical suggestions for identification and solutions to try. (Tried to copy into here as a quote but did not do the right things. Next time. I will get there in the end)
There's four main reasons why your readings might be significantly higher in the morning than the evening:
Dawn phenomenon
What is it?
Before waking, your body starts pumping out glucose and hormones that increase insulin resistance, which causes your blood sugar to raise.
How do I know if it's this?
Set your alarm to go off a couple of hours before you'd usually wake, and test. If your reading at this time is normal and your morning reading is high, it's probably dawn phenomenon
How do I fix it?
With difficulty. Some options include eating a higher protein meal before bed, which gives your body the fuel it'll need in advance of the morning. You can also try eating a larger breakfast in the morning to train your body to expect a food hit, so it doesn't start dumping sugar. Or you can look at altering your basal timings.
Somogyi effect
What is it?
When you have a hypo in your sleep and don't wake up, it's believed your liver starts pumping out glucose to treat the hypo - which then causes higher blood sugar levels in the morning.
How do I know if it's this?
Set your alarm to wake you at something like 2am or 3am and then test. If your reading is sailing pretty close to hypo territory, it may be this what's happening. Also, those who believe this happens to them also seem wake up with hangover-like symptoms - very tired, headachey etc.
How do I fix it?
Decrease your basal. You shouldn't take preventative action by eating and then go to bed with higher numbers - it'll stop the hypos but it'll just make you fat and then in 10 years time you'll have a foot fall off.
Delayed dinners
What is it?
Protein takes 4-6 hours to start breaking down into glucose but it can be quite significant. A high protein meal can cause your blood sugar to go up quite a lot, but quite late on.
How do I know if it's this?
Test before your evening meal, two hours after, and 4-6 hours after. If your latest reading seems unusually high, it's probably the protein.
How do I fix it?
Either change the proportions of your meal, or increase your basal. Changing the proportions is probably better.
Insufficient basal
What is it?
Your liver will slowly output glucose through the night. If you don't have enough insulin in your system, this will raise your blood sugar.
How do I know if it's this?
Test before going to bed, test again during the night (maybe once or twice) and then test again in the morning. If you see the readings consistently increase throughout the night, you probably don't have enough basal insulin.
How do I fix it?
Adjust your basal insulin until your readings look better.
