How Can I Prevent High Blood Glucose in the Mornings?
Erin Palinski-Wade, RD, CDE, responds:
If you have morning blood glucose levels that are inexplicably higher than they were the night before, you are not alone.
What to Know
The most common cause of elevated morning glucose is simply eating too many carbohydrates before bed. If your evening meal or bedtime snack is carbohydrate rich, try adjusting your intake to see if this helps lower both your before-bed and morning glucose levels.
Nothing is more frustrating than finding your blood glucose has increased while you were sleeping, even though it was in an ideal range when you went to bed. In that case, your morning highs may be the result of an increase in hormones, what’s known as the “dawn phenomenon.” As you progress through the sleep cycle, your body releases hormones that can reduce your sensitivity to insulin. At the same time, you begin releasing stored glucose as your body prepares itself for the upcoming day. This combination of reduced insulin sensitivity and the release of glucose can result in an elevated blood glucose level upon awakening.
A condition known as the Somogyi effect, or rebound hyperglycemia, can also lead to an elevation in morning glucose levels. If too much insulin is taken before bed, your blood glucose may drop too low overnight. When this occurs, your body begins to release stored glucose to protect you from hypoglycemia, therefore elevating blood glucose levels. Your blood glucose levels may also rise if the long-acting insulin you take in the evening or your insulin pump basal rate is not enough for your needs.
Find Out More
To determine the cause of your elevated morning glucose readings, your doctor or diabetes educator may suggest checking your blood glucose in the middle of your sleep cycle.
Together with your health care provider, you may be able to correct elevated morning glucose levels by:
- Adjusting the timing of your long-acting nighttime insulin so that the peak action correlates with the rise in blood glucose levels.
- Monitoring and adjusting your evening carbohydrate intake.
- Changing the type or dose of your medication or evening insulin, or altering your overnight basal rate.
Elevated morning blood glucose levels can be frustrating, but they can also be corrected. Working together with your diabetes management team can help you discover the best approach to adjusting both what you eat (particularly any nighttime snacks) and medications for healthy blood glucose management throughout the day.
Erin Palinski-Wade, RD, CDE, is the author of Walking the Weight Off for Dummies, among other books. Find her at mommyhoodbytes.com.