Dawn Phenomenon: When Your Day Starts With High Blood Sugar

There are many reasons you may experience an increase in blood sugar levels. If you have diabetes, even sleeping can raise your blood sugar levels. This spike in the early morning hours is known as the dawn phenomenon. According to the American Diabetes Association, it affects nearly half of all people with Type 1 and Type 2 diabetes.

“Waking up with high blood sugar levels starts your day off on the wrong foot,” says Kim Edwards, RD, CDE, a registered dietitian and certified diabetes educator at Beaufort Memorial. “You feel super thirsty, need to urinate a lot and have other symptoms. Managing the dawn phenomenon helps protect your health and quality of life.”

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What Is the Dawn Phenomenon?

While you sleep, your body and brain work to repair damage and remove toxins. Hormones and chemicals surge through your body, helping to achieve or restore good health. 

In the hours before you wake up, things get really busy. This is when you may experience an increase in blood glucose. Here’s how it happens:

• Hormone release — Your body releases growth hormone and cortisol, a hormone that helps you wake up.
• Pancreas activation — These hormones encourage your pancreas to send insulin into the body, so you can maintain healthy blood glucose levels.
• Weak response — Because of diabetes, your body either doesn’t make enough insulin or is resistant to insulin’s effects. This insulin resistance or inadequate insulin production causes high blood sugar levels in the morning, also known as the dawn phenomenon.

Why the Dawn Phenomenon Matters to You

With diabetes, your blood glucose levels fluctuate throughout the day and night. The goal is to keep those levels within your personal target range. The dawn phenomenon can make this difficult.

“Having your blood sugar surge while you’re asleep can sabotage your daytime management efforts,” Edwards says. “In severe cases, the dawn phenomenon puts your health and life at risk.”

An early-morning rise in blood sugar may contribute to diabetes complications that include: 

• Cardiovascular disease, such as heart failure or arrhythmia (irregular heartbeat)
• Chronic kidney disease
• Eye diseases, including glaucoma and retinal damage
• Foot issues, ranging from poor circulation to amputation
• Neuropathy (nerve damage)
• Skin problems, such as fungal or bacterial infection
• Stroke

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Improving Morning Blood Sugar Levels on Your Own

Managing the dawn phenomenon starts at home. Lifestyle modifications can help keep your blood sugar from spiking early in the morning. 

These include:

• Exercising at night or in the morning — Walking and other exercises are great tools for managing high blood sugar levels. The trick is finding the right time for your body, so your exercise routine doesn’t lead to low blood sugar first thing in the morning or any other time of the day.
• Timing your meals — If you go to bed with high blood sugar, you may maintain that high all night long. You can help lower your levels by timing your meals more effectively. If you’re used to eating late, eat dinner earlier, well before you head to bed. Still having problems? Change what you eat.

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How Your Care Team Helps Manage the Dawn Phenomenon

For optimal control over diabetes and the dawn phenomenon, consult your healthcare provider.

“Diabetes management takes a team,” Edwards says, “and the best teams know how to pivot when necessary.”

Your care provider can help you adjust your lifestyle, including finding the best time to exercise and what and when to eat. Additionally, your care provider can recommend changes to the following:

• Medication — Your healthcare provider may adjust the dosage of long-acting insulin or other diabetes medications you take. If you continue to experience blood sugar spikes while sleeping, your healthcare provider may recommend an insulin pump. This provides an insulin boost whenever you need it, helping to prevent the dawn phenomenon.
• Monitoring — A continuous glucose monitor shows how your blood sugar levels rise and fall throughout the day and night. This gives your care team helpful information to better control your condition. It can also determine if you have the dawn phenomenon or a similar condition, such as the Somogyi effect.

“Dealing with high blood sugar in the morning is frustrating and annoying,” Edwards says, “but your care team is here to brainstorm solutions so you can reach your goals, day and night.”

How the Dawn Phenomenon Affects You

The dawn phenomenon causes an excessive rise in blood glucose when you wake up. Understanding the condition can help you avoid its complications and maintain control over diabetes. 

1. Your body releases insulin before you wake up. However, diabetes results in insulin resistance or poor insulin production. This can result in high blood sugar first thing in the morning.
2. You can take steps at home to reduce the risk of high blood sugar in the morning. Get regular exercise and avoid eating too close to bedtime.
3. Changing your medication or getting an insulin pump can help you maintain healthy blood sugar levels throughout the day. A continuous glucose monitor shows how your blood sugar rises and falls throughout the day, so your care team can make adjustments as needed.

The Beaufort Memorial Diabetes Care Center is located at the LifeFit Wellness Center, located on the first floor of the Beaufort Memorial Medical and Administrative Center at 990 Ribaut Road in Beaufort, as well as at the Okatie Medical Pavilion, 122 Okatie Center Blvd. in Okatie. 

As a part of the Diabetes Self-Management Program, patients meet with diabetes educators who help them develop the skills needed to manage diabetes, including how to monitor blood sugar, take medications as directed, get active and avoid complications.

If you have diabetes, enroll in our nationally recognized Diabetes Self-Management Program by calling 843-522-5635.