The Dawn Phenomenon: What It Is and How to Manage It

The “Daybreak Phenomenon” or “Daybreak Impact” is a time period describing when folks residing with diabetes expertise excessive blood sugar within the morning.

Having your blood sugar rise sharply earlier than you even get up within the morning could make managing your diabetes harder for the remainder of the day, so it’s essential to establish if you’re experiencing Daybreak Phenomenon and make a plan for coping with it.

This text will define what precisely Daybreak Phenomenon is and methods to higher handle it, so its results don’t go on to break your day.

What’s the Daybreak Phenomenon? 

Daybreak Phenomenon is a situation skilled in folks with both kind 1 or kind 2 diabetes.

It’s excessive blood sugar ranges and insulin resistance folks expertise within the morning, often between 2 a.m. and eight a.m.

It often requires extra insulin within the bloodstream throughout these hours to maintain blood sugar ranges regular.

Some folks want as much as double the quantity of insulin of their bloodstream in a single day to assist fight the excessive blood sugars brought on by Daybreak Phenomenon.

Folks with out diabetes expertise the Daybreak Phenomenon as effectively, however their pancreas will increase its insulin secretion to forestall excessive blood sugars. Folks with diabetes don’t have that luxurious.

It’s estimated that over 50% of individuals with diabetes endure from some extent of Daybreak Phenomenon!

What causes Daybreak Phenomenon? 

This organic course of dates again to prehistoric occasions, when people developed to have greater blood sugars (and thus extra “vitality”) within the morning to gasoline their looking and gathering to seek out meals for the day.

The causes of Daybreak Phenomenon are largely hormonal: the pure in a single day launch of counter-regulatory hormones, similar to progress hormone, adrenaline, cortisol, epinephrine, and glucagon will increase insulin resistance, leading to greater blood sugar ranges in a single day and within the morning.

Moreover, two different processes happen within the liver in a single day that consequence within the launch of glucose into the blood, contributing to greater blood sugars:

• Glycogenolysis, which is the breakdown and launch of saved glucose
• Gluconeogenesis, which is the creation of glucose from elements of protein or fats

Different causes of morning excessive blood sugar can embody inadequate night mealtime insulin, inadequate insulin basal charges in a single day, and even rebound excessive blood sugars from going low in a single day.

It’s essential that you simply don’t blame your self for experiencing excessive blood sugar ranges from the Daybreak Phenomenon!

This can be a troubling challenge for everybody residing with diabetes, and it’s only a matter of determining methods to finest handle and stop it with out blaming your self or feeling responsible.

What are the signs of Daybreak Phenomenon? 

The signs of Daybreak Phenomenon are the identical as having excessive blood sugar, and so they embody:

• Fatigue
• Thirst
• Must urinate
• Headache
• Physique ache
• Dry eyes
• Blurry imaginative and prescient

Tips on how to check for Daybreak Phenomenon

For those who discover that you simply usually have excessive blood sugar within the morning, you possibly can arrange a testing routine for a couple of nights to find out if Daybreak Phenomenon is the trigger.

To do that, check your blood sugar on the following occasions:

• earlier than going to mattress
• within the early morning, similar to between 2:00 a.m. and 4:00 a.m. (set an alarm clock to wake you up)
• as quickly as you get up

For those who see that your blood sugar is steady from you go to mattress till the early morning after which rises, you might be almost certainly experiencing Daybreak Phenomenon.

NOTE: In case you have a steady glucose monitor (CGM), you don’t have to do that check as you possibly can simply take a look at the in a single day blood sugar graph it gives.

A blood sugar graph like that is typical for Daybreak Phenomenon:

How excessive a blood sugar is taken into account Daybreak Phenomenon? 

Your diabetes expertise will differ, however something greater than is regular for you is taken into account Daybreak Phenomenon.

If you’re waking up with higher-than-normal blood sugar ranges a number of mornings per week, it might be time to contact your healthcare supplier about readjusting your insulin settings and/or night routine to assist mitigate the problem.

You must search assist earlier than you expertise any long-term harm or problems.

Long run penalties

If left unaddressed, years of experiencing the Daybreak Phenomenon and excessive blood sugars for almost all of the day may end up in diabetes problems similar to:

• Coronary heart Illness
• Stroke
• Neuropathy, particularly within the toes
• Decrease leg amputations
• Kidney illness
• Diabetic Retinopathy of the attention
• Untimely dying

Addressing excessive blood sugars you might be experiencing whilst you sleep and into the morning will help forestall and/or delay many (if not most!) of those frequent problems of diabetes.

How will you handle the Daybreak Phenomenon? 

Work along with your physician to provide you with some options that may work to higher handle the Daybreak Phenomenon you might be experiencing, and all the time examine along with your physician first earlier than adjusting any diabetes drugs and/or insulin settings.

Another methods could embody:

• Keep away from plenty of carbohydrates or snacks with added sugar at bedtime
• Growing your protein-to-carbohydrate ratios of night meals and snacks
• Get loads of sleep, between 7-8 hours nightly
• Consuming extra water within the night and don’t drink liquids with added sugar
• Eat dinner earlier within the night
• Eat a breakfast decrease in carbohydrates, to assist handle any greater blood sugars
• Modify your doses of insulin and/or diabetic drugs
• Train earlier than bedtime
• Change from a number of every day injections (MDI) to an insulin pump that may make automated insulin changes whilst you sleep
• Change from an everyday insulin pump to a hybrid-closed-loop insulin pump, such because the TSlim Management IQ or Omnipod 5
• Change the time at which you are taking your night drugs
• Cut up your night dose of long-acting insulin into two doses (examine along with your physician)
• Change to a distinct treatment that could be extra efficacious for you

For a really complete and in-depth information to managing Daybreak Phenomenon in the event you use insulin, learn the article Managing Daybreak Phenomenon with Basal Insulin 

Different causes for top morning blood sugars

Whereas Daybreak Phenomenon is the most typical cause for top morning blood sugar, it’s not the one one. Two different phenomenons also can trigger your blood glucose to extend within the morning:

Toes on the ground syndrome

Toes on the flor syndrome is what occurs if you get up with regular blood sugar ranges, however as quickly as you begin shifting round within the morning, your blood sugar rises, even with out consuming something.

This is actually because your physique is releasing counterregulatory hormones, like glucagon and epinephrine, when you’ve began shifting round.

Some easy options for this can be to extend your morning basal insulin price, or in the event you’re not on an insulin pump, to take a small dose of insulin upon waking.

You possibly can study extra about methods to handle toes on the ground syndrome in our information Tips on how to Keep away from Excessive Morning Blood Sugar

The Samogyi impact

The Samogyi impact additionally leads to excessive blood sugars upon waking, however for a bit little bit of a distinct cause.

if insulin launched in a single day brings your blood sugars too low, your physique will naturally launch hormones, similar to glucagon and epinephrine, spiking your blood sugar in a rebound excessive.

That is extra frequent in folks with kind 1 diabetes than kind 2 as a result of everybody with kind 1 diabetes takes exogenous insulin and it’s this insulin that’s bringing your blood sugar too low in a single day.

To counteract this, it may be useful in the event you put on a steady glucose monitor (CGM) and observe your blood sugars in a single day to see in the event you’re dipping too low.

Lowering your insulin to carbohydrate ratio at dinner, or decreasing your in a single day basal charges will help alleviate this from occurring.

You possibly can learn to cope with the Samogyi Impact in our information What’s The Samogyi Impact

Different potential causes of excessive morning blood sugars embody however usually are not restricted to:

• any new drugs you’re taking
• hormonal modifications
• being pregnant
• insulin resistance
• a failed insulin pump and/or CGM website
• stress
• lack of sleep
• a miscalculation of a night bolus

When to hunt care

Excessive morning blood sugars usually are not extra harmful than excessive blood sugars at different occasions of the day, so that you don’t want pressing care since you expertise Daybreak Phenomenon.

Nonetheless, as a result of Daybreak Phenomenon generally is a persistent challenge, it may result in long-term diabetes problems.

The Nationwide Institute of Diabetes and Digestive and Kidney Ailments (NIDDK) subsequently recommends that you simply see your physician or endocrinologist in case your morning blood sugar is excessive greater than thrice in a 2-week interval.

Your physician will help you identify if you’re experiencing Daybreak Phenomenon and counsel modifications to your way of life, treatment, and diabetes administration.

Conclusions

Everybody on the earth experiences the Daybreak Phenomenon, however folks with insulin-dependent diabetes are most vulnerable to the insulin resistance and cussed excessive blood sugars that consequence from this pure, hormonal incidence.

It’s nothing to really feel responsible about, nor be ashamed about, however by taking proactive steps, you possibly can assist mitigate, handle, and even forestall the Daybreak Phenomenon from ruining your day and diabetes administration.

The Daybreak Phenomenon could be harmful if skilled long-term, resulting in diabetes problems.

You’ll want to implement prevention methods, similar to incorporating night train, limiting carbohydrates at dinner, and rising your protein-to-carbohydrate ratios, in the event you’re often combating the Daybreak Phenomenon.

All the time work along with your physician first earlier than adjusting any basal/bolus insulin settings (in the event you’re on an insulin pump), splitting your night dose of long-acting insulin, or rising your insulin doses.