What is the normal blood sugar at 3 am: Somogyi effect v/s Dawn Phenomenon

What occurs to the level of blood sugar while you are asleep?

Insulin regulates the flow and release of sugar into the bloodstream. While sleeping, the blood sugar level tends to rise; generally, around 3 AM – 8, AM. 2 phenomena can result.

In a non-diabetic person, insulin’s proper functioning can control this overflow of blood sugar by alarming the muscles, liver, and fat cells to absorb glucose from the sugar to maintain and stabilize the situation.

Insulin has the function of transporting the sugar to the cells for production and supply of energy, thus metabolizing the free sugars in the blood.

But when it comes to a diabetic person, the insulin does not succeed in handling this surge, and thus the level of it goes up. He/she can take precautionary steps to avoid any intense hampering in the health system.

Why is a night of good sleep so crucial for a diabetic patient?

Why is a night of good sleep so crucial for a diabetic patient

The hours you sleep, that is, the quantity of sleep you receive each night is a determinant in helping you or harming your diabetic situation. Skimping in the amount of sleep can lead to various problems, among which diabetes, weight gain, and obesity are leading ones.

Staying up late and cutting on your sleep levels is harmful as you spend more time out of exercise and activity as most of these late-night hours are spent laying or sitting.

It also increases the time between your last meal, and you tend to incline towards having a late-night snack. Also, staying up till long at night cuts off the rest that your body requires, and thus you tend to feel tired and less active.

This lessening of activity and more food consumption is directly related to weight gain and, ultimately, diabetes.

Lack of complete sleep also induces stress. This leads to unbalanced amounts of the stress hormone – cortisol, being released, which results in gaining weight.

The release of cortisol is also linked with increasing the level of sugar in the blood at night, and it resists the functioning of insulin required to keep it under control.

Research proves that just a single night of less sleep can have a 30% hike in the increase of fatty acids that are harmful to a diabetic patient and decrease the ability of a person to regulate blood sugar levels by almost a quarter. Nights together can pile it up more and worsen the present conditions.

What happens to blood sugar levels at 3 AM? (The dawn effect and the Somogyi effect)

What happens to blood sugar levels at 3 AM

Glucose is responsible for providing the human body with energy to carry out day-to-day tasks. At night the level of energy tends to be used up as we are asleep.

But to prepare our body for the following morning, our system needs to have glucose and energy. So what goes on during the night is that around the period of 3 AM to 8 AM, our biological systems release hormones and glucose to ready the energy that we will require for the next morning.

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This helps us in waking up feeling energetic and refreshed.Diabetic patients often have trouble sleeping at night due to these fluctuations in the sugar levels to help the body with its energy supplies.

People with no diabetes can regulate the levels of hormones and sugar responsible for energy supply by well-functioning insulin. The rise of sugar around the 3 AM period is balanced to help the body.

On the other hand, a diabetic person has trouble handling this release of sugar, and thus, there is a rise in blood sugar measurements due to improper insulin control.

This leads to unusual and increased levels of blood sugar in diabetic patients during the morning hours.

The two commonly observed phenomena also impact this conclusion in diabetic people that happen overnight. They are as follows:

–  The Dawn Phenomenon:

As the body has to produce energy to prepare itself for the morning activities, it releases hormones like – cortisol, growth hormone, and catecholamines.

These contribute to the increased production of sugar in the blood by the liver to provide energy. The amount of insulin in one’s body helps to keep this rise in sugar levels under control.

The release of those hormones also hampers and resists the production and working of insulin.

A person with diabetes does not have reasonable control over insulin production, regulating the amount of high sugar in the bloodstream.

This leads to an abnormal hike in the blood sugar level during the morning and dawn hours. This is commonly termed as the dawn phenomenon.

–  The Somogyi Effect:

Another grave reason for the increased amounts of blood sugar levels in the morning time is the Somogyi effect. It is also known to be termed as – Rebound Hyperglycemia.

Often, in diabetic patients, the level of blood sugar in the body can drop considerably in the middle of your sleep at night. This can be a harmful effect and can seriously tax the body’s conditions.

To rescue your body from such a situation, hormones like cortisol, catecholamines, glucagon, epinephrine, and growth hormone is released.

They encourage the liver to release amounts of previously-stored glucose in more quantities than usual so that the dangerously low blood sugar can be compensated with.

In a diabetic patient, the liver releases the blood, and it is regulated by the insulin to maintain an average blood sugar level is imperfect.

Therefore, the amount of sugar in the blood flow is more, resulting in a higher blood sugar count in the early hours of the day.

Improper bedtime snacking and an incorrect dosage of diabetes medicine or insulin can cause such rising levels of blood sugar at the dawn and morning hours. These need to be identified and corrected to prevent any significant casualties.

How to identify and differentiate between the Dawn Phenomenon and the Somogyi Effect?

The effects and results of the two phenomena observed are quite the same. But to tell the difference and identify what is causing your higher levels of blood sugar in the morning is crucial.

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To find out which among the two you are going through when you see a rise in your blood sugar count in the morning, you will have to take a sugar level test in the middle of the night at around 2 AM – 3 AM, as this is the time when the alterations usually take place.

If the count shows a high reading at that time, it means that your body is preparing you for the morning’s energy needs, and hence the measure is higher. This would indicate the dawn phenomenon taking place.

After testing your blood sugar level from 2 AM – 3 AM, if the reading comes up to below, it determines that your sugar levels in the blood have faced downfall.

It represents the Somogyi effect, to overcome which the liver will release more sugar into the blood flow. You will end up with unusually higher levels of blood sugar by the morning.

Having determined which one of the two is taking place, you must discuss your diabetes doctor‘s results. They will help you plan your meals, insulin, medications, sleeping habits, and testing times accordingly.

Effects of the Dawn Phenomena:

The dawn phenomenon takes place in all individuals and is instead natural. Usually, people with good insulin circulation do not notice any discomfort or danger as insulin can control sugar levels.

When it comes to a diabetic person, insulin functioning inefficiency can lead to misbalance of sugar levels leading to the following effects and symptoms:

–         Nausea

–         Blurred vision

–         Weakness

–         Extreme thirst

–         Fainting

–         Disorientation and improper sense of balance

–         Feeling tiresome

Etc.

How to control the high blood sugar levels caused by the Dawn phenomena?

Once it is determined that the higher levels of blood sugar in the body in the morning result from the dawn phenomena, then it can be corrected, and habits to improve this can be induced.

With regularly combining efforts at maintaining your sugar levels and a healthy lifestyle, including – proper diet, exercise, meditating, timely consumption of medicines, etc. a diabetic person can also make some other additional changes to handle the spike in amounts of blood sugar caused in the mornings. They include:

–         Referring to a doctor for any necessary changes in medication or insulin intake.

–         Eating regularly and on time.

–         Correctly taking all medication as prescribed with the dosage.

–         Avoiding a carbohydrate-rich snack before bedtime.

–         Having a light breakfast in the morning.

–         Shifting the intake of medicines before its time to sleep instead of before dinner time.

–         Having an active light session after dinner, preferably walking or yoga.

–         Keeping a record of blood sugar level during the night hours from 3 AM – 8 AM.

A regular hike in blood sugar levels around the morning time caused by the dawn phenomenon must not be neglected and must be reported to a doctor for the right treatment.

Effects and symptoms of the Somogyi effect:

The Somogyi effect is mainly caused by over-exercising, not taking a good bedtime snack, or at times due to increased amounts of insulin intake. All these factors are contributors to the impaired functioning of insulin.

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At night, when the glucose levels in the human body fall low (hypoglycemia) and the other hormones act to encourage the release of extra sugar by the liver to balance this loss, the insulin does not effectively work to control the sugar released. This results in an overall hike in sugar levels.

The symptoms of this effect can be noticed as:

–         Low sugar count at 2 AM – 3 AM

–         Hyperglycemia in the morning

–         Sweating while sleeping

–         Dizziness

–         Blurry vision

–         Waking up due to headaches

–         Fatigue

–         Increased appetite and thirst

Etc.

How to control the spiking blood sugar levels caused as a result of the Somogyi effect?

To check and find out about this effect taking place, you must test and record blood sugar levels before you go to bed, during the 2 AM – 3 AM time, and after waking up in the morning.

It is necessary to have a stable blood sugar and glucose level to avoid the Somogyi effect. It must be reported to an expert and assisted with proper medicines and treatment.

Some of the management options include:

–         Adjusting the insulin taking routine as per the requirements.

–         Having a lower dose of insulin at night.

–         Altering the type and dosage of medicine as well as insulin administered.

–         Having a good bedtime snack to resist the fall of glucose beyond limits during the night.

–         Inducing lifestyle changes such as – better diet, stress-relief, meditation, exercise, etc.

Along with all the necessary medication changes as per the Dawn phenomenon or Somogyi effect, it is also essential to have a good sleeping routine with enough hours of sleep.

This will complete the rest cycle and prevent building up of stress and strain that ultimately lead to lifestyle-related problems like diabetes, obesity, weight gain, etc.

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Dr Sharon Baisil MD

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