Table of ContentsView AllTable of ContentsCausesTreatmentSomogyi Effect
Table of ContentsView All
View All
Table of Contents
Causes
Treatment
Somogyi Effect
The dawn phenomenon is a surge in hormones that causes blood sugar levels to be elevated in the morning—even before you’ve eaten anything. Anyone can experience this type of hormonally generatedhyperglycemia, even people who don’t have diabetes, but no matter your health status, the dawn phenomenon can be prevented.
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Again, the dawn phenomenon can affect anyone. However, according to research from the American Diabetes Association, it may be particularly problematic for people who have diabetes. This is because their bodies are not able to respond normally to the blood sugar increase, which may in turn allow their glucose to reach especially high levels.
At night the body naturally produces less insulin. But during the last hours of sleep, from around 4 a.m. to 8 a.m., hormones tied to the circadian rhythm start to trigger the circulation of glucose throughout the body to provide energy for cells to use for the day ahead. Hormones such as cortisol, adrenaline, glucagon, and growth hormone each trigger the body to pump out more glucose from the liver and muscles, but this, combined with the lack of insulin in circulation, results in a natural blood sugar rise in the morning.
While the dawn phenomenon is normal for most people, it can be amplified in those with diabetes who have greater insulin resistance. If you suddenly realize your fasting morning glucose is soaring, it could be related to not taking an adequate dose ofinsulinat night, missing your evening diabetes medication, or overeating carbohydrates at dinner or bedtime.
The hormones causing glucose to increase can make morning glucose tougher to treat in people with diabetes, but you cantake steps to counteract the dawn phenomenon, such as:
Check your eligibility for acontinuous glucose monitor(CGM)—a small device that measures real-time glucose 24 hours a day. Alarms can sound off when your blood sugar is trending high or low, even at night.
The Somogyi Effect
It can also happen if you take insulin and your bedtime blood sugar was on the lower side and you didn’t eat a snack before bed. In either case, your blood sugar drops during the night and your body releases hormones to counteract the drop. The result? You wake up with a higher than normal blood glucose level.
If you have type 1 diabetes and are experiencing this effect, let your healthcare provider know. They may need to change your medication or insulin dosages.
If you are taking insulin, monitor your blood sugar before you go to bed. If your levels are too low—for example, less than 100 mg/dL (though this can vary for each person)—you may need to have a snack before bed consisting of some protein, fat, and a small number of carbohydrates. For example, a handful of berries and plain Greek yogurt or half a nut butter sandwich on whole-grain bread.
How to Tell the Difference
The best way to know for sure whether you’re experiencing the dawn phenomenon or the Somogyi effect is to test your blood sugar in the middle of the night. Wake up sometime between 2 a.m. and 3 a.m. for several nights in a row and check your blood sugar. If you are low at that time (less than 70 mg/dL), it could be the Somogyi effect. If you are normal or high, then the dawn phenomenon may be the culprit. You’d need to do this a few nights in a row to determine whether or not this has become a pattern warranting a change or if it was just a fluke episode.
7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Diabetes Association.Hyperglycemia (high blood glucose).Porcellati F, Lucidi P, Bolli GB, Fanelli CG.Thirty years of research on the dawn phenomenon: Lessons to optimize blood glucose control in diabetes.Diabetes Care. 2013;36(12):3860–3862. doi:10.2337/dc13-2088Monnier L, Colette C, Dejager S, Owens D.Magnitude of the dawn phenomenon and its impact on the overall glucose exposure in type 2 diabetes: Is this of concern?Diabetes Care. 2013;36(12):4057–4062. doi:10.2337/dc12-2127U.S. National Library of Medicine, StatPearls.Dawn phenomenon. November 10, 2019.National Sleep Foundation.Excessive sleepiness: Sleep longer to lower blood glucose levels.Rybicka M, Krysiak R, Okopień B.The dawn phenomenon and the Somogyi effect - two phenomena of morning hyperglycaemia.Endokrynol Pol. 2011;62(3):276–284.Cleveland Clinic.Blood sugar: Hidden causes of high blood sugar levels in the morning. Reviewed May 25, 2018.Additional ReadingAmerican Diabetes Association.Insulin routines.Choudhary P, Davies C, Emery CJ, Heller SR.Do high fasting glucose levels suggest nocturnal hypoglycaemia? The Somogyi effect-more fiction than fact?Diabet Med. 2013;30(8):914–917. doi:10.1111/dme.12175
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Diabetes Association.Hyperglycemia (high blood glucose).Porcellati F, Lucidi P, Bolli GB, Fanelli CG.Thirty years of research on the dawn phenomenon: Lessons to optimize blood glucose control in diabetes.Diabetes Care. 2013;36(12):3860–3862. doi:10.2337/dc13-2088Monnier L, Colette C, Dejager S, Owens D.Magnitude of the dawn phenomenon and its impact on the overall glucose exposure in type 2 diabetes: Is this of concern?Diabetes Care. 2013;36(12):4057–4062. doi:10.2337/dc12-2127U.S. National Library of Medicine, StatPearls.Dawn phenomenon. November 10, 2019.National Sleep Foundation.Excessive sleepiness: Sleep longer to lower blood glucose levels.Rybicka M, Krysiak R, Okopień B.The dawn phenomenon and the Somogyi effect - two phenomena of morning hyperglycaemia.Endokrynol Pol. 2011;62(3):276–284.Cleveland Clinic.Blood sugar: Hidden causes of high blood sugar levels in the morning. Reviewed May 25, 2018.Additional ReadingAmerican Diabetes Association.Insulin routines.Choudhary P, Davies C, Emery CJ, Heller SR.Do high fasting glucose levels suggest nocturnal hypoglycaemia? The Somogyi effect-more fiction than fact?Diabet Med. 2013;30(8):914–917. doi:10.1111/dme.12175
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Diabetes Association.Hyperglycemia (high blood glucose).Porcellati F, Lucidi P, Bolli GB, Fanelli CG.Thirty years of research on the dawn phenomenon: Lessons to optimize blood glucose control in diabetes.Diabetes Care. 2013;36(12):3860–3862. doi:10.2337/dc13-2088Monnier L, Colette C, Dejager S, Owens D.Magnitude of the dawn phenomenon and its impact on the overall glucose exposure in type 2 diabetes: Is this of concern?Diabetes Care. 2013;36(12):4057–4062. doi:10.2337/dc12-2127U.S. National Library of Medicine, StatPearls.Dawn phenomenon. November 10, 2019.National Sleep Foundation.Excessive sleepiness: Sleep longer to lower blood glucose levels.Rybicka M, Krysiak R, Okopień B.The dawn phenomenon and the Somogyi effect - two phenomena of morning hyperglycaemia.Endokrynol Pol. 2011;62(3):276–284.Cleveland Clinic.Blood sugar: Hidden causes of high blood sugar levels in the morning. Reviewed May 25, 2018.
American Diabetes Association.Hyperglycemia (high blood glucose).
Porcellati F, Lucidi P, Bolli GB, Fanelli CG.Thirty years of research on the dawn phenomenon: Lessons to optimize blood glucose control in diabetes.Diabetes Care. 2013;36(12):3860–3862. doi:10.2337/dc13-2088
Monnier L, Colette C, Dejager S, Owens D.Magnitude of the dawn phenomenon and its impact on the overall glucose exposure in type 2 diabetes: Is this of concern?Diabetes Care. 2013;36(12):4057–4062. doi:10.2337/dc12-2127
U.S. National Library of Medicine, StatPearls.Dawn phenomenon. November 10, 2019.
National Sleep Foundation.Excessive sleepiness: Sleep longer to lower blood glucose levels.
Rybicka M, Krysiak R, Okopień B.The dawn phenomenon and the Somogyi effect - two phenomena of morning hyperglycaemia.Endokrynol Pol. 2011;62(3):276–284.
Cleveland Clinic.Blood sugar: Hidden causes of high blood sugar levels in the morning. Reviewed May 25, 2018.
American Diabetes Association.Insulin routines.Choudhary P, Davies C, Emery CJ, Heller SR.Do high fasting glucose levels suggest nocturnal hypoglycaemia? The Somogyi effect-more fiction than fact?Diabet Med. 2013;30(8):914–917. doi:10.1111/dme.12175
American Diabetes Association.Insulin routines.
Choudhary P, Davies C, Emery CJ, Heller SR.Do high fasting glucose levels suggest nocturnal hypoglycaemia? The Somogyi effect-more fiction than fact?Diabet Med. 2013;30(8):914–917. doi:10.1111/dme.12175
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