Diabetes Educator’s Insight in Managing Morning Blood Sugar Spikes
Why Are Morning Blood Sugar Levels So Difficult to Manage?
The primary culprit behind morning blood sugar spikes is something called the dawn phenomenon. This phenomenon occurs in the early morning hours when your body releases a surge of hormones such as growth hormone, epinephrine, and norepinephrine. These hormones help your body prepare for the day ahead by increasing glucose production. However, they can also cause your blood sugar to rise unexpectedly sometimes by 50 to 100 points without you eating anything at all.
In addition to the dawn phenomenon, insulin resistance plays a role in morning blood sugar fluctuations. Insulin resistance occurs when your body’s cells become less responsive to insulin, making it harder for the hormone to do its job of moving glucose from the bloodstream into the cells. This means your body requires more insulin to achieve the same effect. Since insulin resistance tends to be more pronounced in the morning, your blood sugar may rise more significantly when you wake up even if you eat the same meal at breakfast as you would later in the day.
Another factor that contributes to morning blood sugar spikes is cortisol, a hormone that peaks early in the morning. Cortisol has the effect of increasing insulin resistance, meaning that the insulin in your body (whether naturally produced or injected) isn’t as effective at controlling blood sugar. As cortisol levels peak, blood sugar rises, and the insulin you have may not work as efficiently to keep it in check. As the day goes on, cortisol levels decline but the damage may already be done and you might spend the rest of the day chasing high blood sugar.
How to Manage Morning Blood Sugar Spikes
While you can’t eliminate the hormonal effects that cause the dawn phenomenon and cortisol spikes, there are strategies you can implement to minimize their impact on your blood sugar levels:
- Consider a Low-Carb Breakfast
Carbohydrates are the primary driver of blood sugar levels. A lower-carb breakfast will result in a more gradual rise in blood sugar making it easier to manage. If you're on insulin, you may need to reduce your insulin dose slightly for a low-carb meal but this should always be done in consultation with your Type 1 diabetes dietitian. - Adjust Your Insulin-to-Carb Ratio
If you find that your blood sugar spikes are consistently higher in the morning, you might need to adjust your insulin-to-carb ratio. This is especially relevant for people with type 1 diabetes, who may require more insulin in the morning to cover the same number of carbs compared to later in the day. A T1D dietitian can help you determine the appropriate insulin adjustments. - Avoid High-Glycemic Foods
Foods with a high glycemic index such as waffles or sugary cereals cause rapid spikes in blood sugar. Opt for foods with a lower glycemic index, such as eggs, Greek yogurt or a protein smoothie. These foods will provide you with steady energy and a more stable blood sugar response. - Address Foot-to-the-Floor Effect
The "foot-to-the-floor" phenomenon happens when you get out of bed and your liver releases glucose into the bloodstream in response to the increased demand for energy. A small dose of insulin or a small snack may be enough to prevent this spike from becoming a significant problem. Type 1 diabetes patients may benefit from a small dose of insulin upon waking, while type 2 diabetes patients may need just a small snack.
Conclusion
Morning blood sugar spikes can be frustrating and confusing but with the right strategies and the support of a diabetes care team, you can better manage these fluctuations. Whether you're dealing with dawn phenomenon, insulin resistance, or cortisol spikes, there are steps you can take to minimize their impact. Focus on a balanced breakfast, consider adjusting your insulin regimen, and always work with your healthcare provider to find the best approach for your specific needs. By understanding the causes and solutions for morning blood sugar issues, you can regain control of your mornings and start your day with confidence.
If you’re consistently experiencing high blood sugars in the morning, it’s important to consult with your registered dietitian and certified diabetes educator. Together, you can fine-tune your insulin regimen or make lifestyle changes to improve your overall diabetes management.
