The Dawn Phenomenon

How often have you gone to bed with a perfectly acceptable blood sugar level, only to wake up with a high one? You know you did not raid the fridge in the middle of the night, so what causes it?

This is called the Dawn Phenomenom (DP), so-named because of the timing of the high blood sugar, and this is normal response in human beings. It becomes a problem for the diabetic person because the fluctuations in blood sugar contribute to other side effects and increase the risk for serious complications.

It is normal for our body to release glucose, while we sleep, and this occurs in response to several hormones, including cortisol, epinephrine, growth hormone and glucagon. They are released to help your body heal and repair during your sleep, and have the effect of countering anti-diabetic medications.

The best to determine if you have DP is to wake up in the middle of the night and check your blood sugar. If the value is high, and then your morning value is also high, you may have DP.

How can you prevent DP?

1. Limit your carbs in the evening. Make your bedtime snack one of fats and
proteins.
2. Exercise in the evening to bring your sugars down a bit before you go to bed. Remember to monitor your blood sugars when you exercise so that you do not
drop too low.
3. Talk to your doctor about adjusting your medications. You may need to increase your evening oral agent or long acting insulin to "cover" the morning sugar.
4. Don't skip meals or your medications. Your body becomes accustomed to receiving calories and medications at regular times, and omitting them can put your system out of sync, worsening the problem.

Mild elevations are not abnormal, and should not be cause for concern unless they are above your diabetic plan range. As always, talk with your doctor about the best way to manage your blood sugar fluctuations to decrease the risk for complications.