What Causes High Blood Sugar in the Morning?

It often puzzles diabetics why their glucose is so high when they awaken, especially because most have not eaten for 8-12 hours. An occasional spike in morning sugar is OK, but consistently elevated glucose is problematic and should be addressed to your doctor.

There are three main causes for high morning glucose …

1. The First is called the “Dawn Phenomenon” which is a result of naturally elevated hormones due to the nocturnal release (4-8 am) of human growth hormone (HGH), and cortisol, among others. HGH stimulates release of extra glucose by the liver. This is usually offset by the pancreas secreting more insulin to offset that increase. However, in diabetics, the pancreatic mechanism is impaired, and it fails to respond properly. For this phenomenon, a different medication may be prescribed by their doctor.

1. Somogy Effect – named for the scientist who first discovered it, this condition is a failure to wake when blood sugar drops to a dangerously low level (called hypoglycemia) during sleep. Under normal circumstances, one wakes when sugar drops too low. Headaches or sweating upon rising the morning is a good sign there’s something wrong. Checking your blood sugar first thing upon arising is a very important habit to get into for all diabetics.

Several causes have been identified:

• Taking too much insulin
• Not eating enough
• Drinking too much alcohol
• Too much natural hormone release

Solutions may include:

• A healthy late-night snack
• Reducing insulin levels at night – check with your doctor first!

1. Waning Insulin, which means your insulin is wearing off too quickly, it may be time for a change in dosage or type of insulin (longer lasting) – check with your doctor and/or pharmacist.

You and your medical team must first discover which of the three above problems is the cause of your elevated blood sugar, or if it is something more complex. The best way to assist is to take and record your sugar levels before bed, at about 3 am and then when you get up for the morning, even if that means setting your alarm to wake you mid-sleep. These numbers will be a great deal of help to your team when formulating a solution.   

• If your numbers are fairly normal at bed time and at 3 am, but high when you wake, you probably have the first type of diagnosis, the Dawn Phenomenon.
• If your 3 am number is low but high when waking you probably have Simogyi effect.
• Lastly if sugar is low at both 3 am and upon waking, you have waning insulin.

Following this guide is just the first step in correction, Do Not Attempt to correct your problem without help from your health care team of doctor and/or pharmacist. There can be many different corrections for your condition and only they know what to do for you.