1. Two Main Causes of Morning High Blood Sugar
Many people with diabetes experience high fasting blood sugar in the morning. There are two main causes for this: the ‘dawn phenomenon’ and the ‘Somogyi effect.’ It is important to distinguish between them as their causes are completely different, requiring different approaches.
2. What is the Dawn Phenomenon?
– Cause: Around 3-4 a.m., as our body prepares to wake up, it begins to secrete hormones like growth hormone, cortisol, and glucagon. These hormones cause the liver to release stored glucose into the bloodstream, naturally raising blood sugar levels.
– A Phenomenon in Everyone: This is a normal physiological process that occurs in everyone, not just people with diabetes.
– The Problem for Diabetics: In a healthy person, enough insulin is released to counteract this hormonal effect and keep blood sugar stable. However, a person with diabetes, who has issues with insulin secretion, cannot offset this effect, resulting in high blood sugar in the morning.
3. What is the Somogyi Effect?
– Cause: As described in the question’s premise, this effect occurs when a nighttime dose of insulin or medication is too high, causing ‘hypoglycemia’ in the early morning. In response, the body overcompensates by releasing a surge of stress hormones, which leads to a rebound ‘hyperglycemia’ in the morning.
– How to Differentiate: The most accurate way is to check blood sugar around 3 a.m. If it is low, it’s likely the Somogyi effect. If it is normal or high, it’s likely the dawn phenomenon.
Summary: The ‘dawn phenomenon’ is a natural rise in blood sugar due to hormones secreted in the early morning, independent of nighttime hypoglycemia. In contrast, a rebound high blood sugar in the morning following nighttime hypoglycemia is called the ‘Somogyi effect.’
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