Unexplained high blood sugar in the morning: how to prevent?
Blood sugar in the morning can be an unfathomable mystery. We woke up with normal glycemia, were engaged in morning preparations, did not eat anything, but a repeated measurement before breakfast suddenly shows an off-scale figure. How so? … We tell why this happens and what to do about it.
It’s NOT ALWAYS a dawn phenomenon
The first thing that many might think of is the dawn phenomenon. Yes, this phenomenon has a similar result, but a different mechanism. High morning blood sugar in the phenomenon of dawn is the result of the release of contrainsular hormones in the body in the early morning. It is predominantly a mixture of growth hormones, cortisol, adrenaline and glucagon – which in turn increase insulin resistance.
This hormonal surge usually occurs between 2 am and 6 am. It is most often observed at night.
Let’s say you woke up at 7:30 AM and are no longer in the dawn time frame. Then what is this jump?
Wake-up Signals: Glycogen and Cortisol Levels
The moment you get out of bed, you are signaling to your body that you need energy. The body understand, has not eaten for many hours. At the same time, if food is not supplied, the “lazy” body finds the most readily available source of energy – glycogen.
The liver is a huge supermarket for stored energy. Energy is stored in the form of glycogen, which can be easily broken down during prolonged fasting.
In the morning, when you have already started to be active, but have not yet eaten, several factors can together lead to an increase in blood sugar levels:
- the body can break down glycogen to glucose for energy;
- after sleep, we are less sensitive to insulin due to an increase in the contrainsular hormone cortisol, the concentration of which occurs at 7-8 o’clock in the morning.
- if you sleep poorly or little, cortisol will be higher than usual.
If you are using a continuous glucose monitoring system, you can track this process.
Such an increase in blood sugar will be different from both the dawn phenomenon and rebound hyperglycemia – the Somogyi effect .
How to prevent an increase in the level of glycemia in the morning?
Changing Insulin Therapy: Basal or Bolus?
Discuss with your endocrinologist the possibility of adding an additional morning correction injection if you are prone to such an increase in blood sugar in the morning. There is a possibility that not everything is in order with basal insulin, and perhaps you need to compensate for the contrasular hormone with a bolus – any of these versions need to be checked.
You need to monitor to determine what insulin, how much and at what time you need. For several days, record your morning blood sugar readings in your diary at 30- and 60-minute intervals. Analyze CGM data if using this system.
Then one day try to check how much your basal insulin dose is enough for you. If the long insulin version fails – your dosage is as needed and the rise in sugar in the morning is due to an unknown reason – adjust the dose for your bolus insulin injection according to your insulin sensitivity ratio.
Changing Eating Habits: Don’t Skip Breakfast
Not all people like to eat breakfast. And today we know that there is no direct evidence that breakfast is a necessary meal. And yet, when it comes to maintaining normal sugars, breakfast can be a great help. It can be a simple and easy meal, incl. not containing many carbohydrates.
If you observe a strange increase in glycemia in the morning, not associated with the Somogyi effect and the dawn – try NOT TO SKIP BREAKFAST.
As paradoxical as it may sound, energizing the body can prevent high blood sugar levels.
Just add water
Another good additional strategy is to replenish the water balance in the morning. You wake up in a state of shifted water balance, so the blood may be thicker, and sugars correspondingly higher. A glass of water upon waking up can improve your general condition and your blood glucose meter . Although, of course, this is only an additional measure to insulin therapy and nutrition.
These strategies should help you start the day with better compensation. And the joke about the inexplicable rise in blood sugar from the air will remain just a joke!