Thursday, July 10, 2014

Why All the Morning Highs?

sunriseSometimes diabetes doesn’t make a lot of sense.
Think of those mornings when you wake up to find your blood glucose looking as if you’ve been up all night eating cookies. What’s up with that? You’d think that not eating for those seven or eight hours would give you lower blood glucose, right?
Such morning highs are common in people with diabetes, but one of the reasons has a particular name: the dawn phenomenon.
The dawn phenomenon is a natural rise in blood glucose between 4 and 8 a.m., which happens because of hormonal changes in the body. All people have the “dawn phenomenon,” whether they have diabetes or not.
People without diabetes would never notice it happening, as a normal body’s insulin response adjusts for this. However, because people with diabetes don’t have normal insulin responses, they may see an increase in their fasting blood glucose.
This is primarily because people with diabetes produce less insulin and more glucagon than they need. The less insulin produced by the pancreas, the more glucagon the pancreas makes as a result. Glucagon, in turn, signals the liver to break down its storage supplies of glycogen into glucose. This is why high fasting blood glucose levels are commonly seen in patients with type 2 diabetes.
The effects of dawn phenomenon vary in each person, and your blood glucose may be higher on some mornings than on others. But not to worry—there are steps you can take to get those numbers down and start your days more comfortably in your target blood glucose range.
Treatment for dawn phenomenon depends on how you treat your diabetes. If you take insulin, you may be able to adjust your dosing so that peak action occurs closer to the morning rise in your blood glucose. If you have type 2, diabetes pills provide options as well, as you can add metformin to reduce the liver’s glucose production.
Eating dinner earlier in the evening and engaging in some light physical activity afterward, like going for a walk, can also help.
If you have diabetes, chances are you’ll experience the occasional high morning blood glucose. That’s not something to fuss about too much. But if it happens regularly, then it’s time to call your doctor.
Have you ever experienced the dawn phenomenon? How did you manage it?