For people with diabetes, both the Somogyi effect and the dawn phenomenon can lead to high blood glucose levels in the early morning. The dawn phenomenon occurs naturally, whereas the Somogyi effect is usually associated with daily diabetes management.
Insulin, blood glucose, and sleep
The main source of energy in the human body is a type of sugar called glucose. The hormone insulin, secreted by the body’s pancreas, helps transport glucose from the blood to the cells.
When you are asleep, your body needs less energy. And when it’s about to wake up, the body is ready to expend more capacity. This alerts the liver to start releasing more glucose into the bloodstream, which in turn triggers the body to release more insulin in response to the increased blood sugar.
And for people with diabetes, the body is unable to produce enough insulin, resulting in high levels of sugar in the blood, a problem known as hyperglycemia.
High blood sugar can lead to serious health problems, so people with diabetes need to lower their blood sugar levels. Blood sugar can be controlled through diet and exercise, or you can receive medications such as insulin.
Dawn phenomenon
People with diabetes do not produce enough insulin to respond to early morning blood sugar spikes. This usually happens between 3 a.m. and 8 a.m., hence the name dawn phenomenon.
Almost everyone with diabetes will experience dawn. However, it can be prevented in a number of ways, including:
- Don’t consume carbohydrates before bed.
- Inject insulin before bedtime rather than early in the morning or at night.
- Ask your doctor to adjust the dose of insulin or other diabetes medications.
- Use an insulin pump at night.
The Somogyi effect
The Somogyi effect can also cause early morning hyperglycemia, but this usually occurs when too much or too little insulin is injected before bedtime, or when no snacks are eaten at night.
In these cases, the patient’s blood sugar drops dramatically during the night. In response, the body releases hormones that block insulin production, which eventually leads to high blood sugar in the body in the early morning. This is also called reactive hyperglycemia.
How can you tell?
Before deciding how to treat it, the doctor will try to find out why the blood sugar is high in the early morning, usually by asking the patient to take blood glucose measurements at night (around 2 or 3 am) for several nights in a row.
If blood glucose levels are consistently low at this time of day, it may be a Somogyi effect, otherwise it may be a dawn phenomenon. Once the symptoms are identified, the doctor can help the patient find a solution to address the symptoms.