Have you ever asked ‘why is blood sugar high in the morning?’ You aren’t alone. This is a common concern for many people with diabetes and there is something you can do about it.
Does this sound familiar: You test your blood sugar before bed and it’s in range. But when you wake up and test, your blood sugar is higher than it was the night before! It can be so frustrating. But elevated morning blood sugar levels are common and when you understand why they happen with type 2 diabetes, you can take a few simple steps to manage them.
Why Blood Sugar Can Run High in The Morning
Elevated morning blood sugar levels can happen for a few reasons. One of the main ones is due to medication you take to manage diabetes. If you take oral medications or insulin, these medications can affect blood sugar levels at different times of day, even long after you’ve taken them.
Some of these medications help your body to produce more insulin, the hormone that helps sugar move out of your bloodstream and into your cells. Depending on the timing of your medication, the impact they have on insulin may be reduced overnight, which can lead to high morning blood sugar readings. In this case, your diabetes care team can work with you to adjust the timing of your medications if needed to improve your morning numbers.
But what if you’re not taking medication? Let’s look at what else could be going on…
The Dawn Phenomenon
The Dawn Phenomenon is the occurrence of high blood sugars in the morning due to hormonal shifts that take place while you sleep. As you sleep, the hormones in your body adjust to a rested state. Your body begins to release counter-regulatory hormones such as growth hormones and glucagon during this time which actually release more sugar into your bloodstream and increase insulin resistance. They do this to protect the body from hypoglycemia (or low blood sugar) as you rest in a fasted state. But for people with diabetes, this hormonal shift can start to cause blood sugar levels to rise above normal levels, generally between 2 am and 8 am, depending on when you go to bed.
Your Liver’s Response To Fasting
Another reason why your blood sugar could be high in the morning is due to your liver’s response to an overnight fast. As you sleep, your body enters into a fasting state, but it knows you will need energy to start your day when you wake up. And that’s where the liver comes in.
Your liver produces its own sugar to help regulate your blood sugar levels so that you have energy even when you’re not eating. Extra sugar production from your liver, in combination with increased insulin resistance (which occurs from those overnight hormonal shifts), can lead to a higher morning blood sugar.
The Symogi Effect
The Symogi effect is more common in people with type 1 diabetes but can occur with people who have type 2 diabetes who take insulin as well.
This effect occurs when you take insulin before bed and your blood sugar drops too low overnight. Your body will release hormones to protect you from hypoglycemia. And when this happens, the body can ‘overcorrect’ which leads to waking up with a blood sugar higher than you’d like.
It’s important to talk with your medical care team if you take insulin in the evening and are routinely waking up with high blood sugars, since many times an adjustment in insulin dosage or a change in your evening meal can help to prevent overnight lows from occurring.
What Can You Do About High Morning Blood Sugars?
If you have a pattern of blood sugars higher in the morning than they are at night, you will want to discuss this with your doctor and dietitian. They may suggest adjustments to medications or snack patterns to help prevent this from occurring. Here are some things you can consider in the meantime.
Eat a Balanced Breakfast
Eat a breakfast that contains complex carbohydrates along with lean protein or healthy fat. This will help slow down how quickly the carbs you eat break down into glucose. A more steady release of sugar into the bloodstream can prevent a rapid rise and fall in your blood sugar levels.
Consider Your Bedtime Snack
For some people, a light bedtime snack of slowly digested carbs with some protein or healthy fat can help balance blood sugar overnight. An example of a good bedtime snack could be Greek yogurt topped with sliced almonds or an apple with peanut butter.
Include Physical activity
In the evenings, consider some light activity, like a walk after dinner. Gentle movement can help to reduce insulin resistance in the body and uses some of the carbohydrates for energy versus it staying in your bloodstream. You may want to avoid more strenuous workouts before bed as this can disrupt your sleep.
To improve morning blood sugar levels, you may need to adjust your evening meal times. For some people, eating dinner a little earlier in the day can help reduce morning blood sugar levels. Do some adjusting and monitoring to see if this makes a difference for you.
Other Factors That Can Make Your Blood Sugars High in the Morning
In addition to what I mentioned above, there are a few other things that may lead to high morning blood sugars.
Eating dinner with excess carbohydrates, snacks with added sugars, or sugary drinks in the evening can lead to elevated blood sugars overnight and in the morning. Eating balanced meals and snacks and avoiding excess added sugars can help to slow the release of glucose into the bloodstream after a meal.
A poor night’s sleep can have a big impact on blood sugar levels as well. Poor sleep can increase the release of stress hormones and insulin resistance in cells. If you have a difficult time falling asleep or find yourself tossing and turning all night, this could be a reason for your high morning readings as well.
What to Do If Your Blood Sugar Is High In The Morning
- Test your blood sugar before bed and in the morning. This helps to identify patterns. You’ll be able to see if your blood sugar is high before bed and higher in the morning, or lower at night and then high in the morning.
- Keep records of your blood sugar readings and the time you took them.
- Record what you eat and when. This helps identify patterns of how your body reacts to certain types or amounts of food.
- The most important step: Call your doctor and your diabetes educator or dietitian. If your blood sugar is elevated more often, it can cause damage to your body. Your diabetes care team can help you to determine the best steps to improve your blood sugar levels.
Can you now identify some of the reasons your blood sugar is high in the morning?