Medical contributions and review by Teri White, BS, RN, CDCES, a Transition Nurse Navigator at UM Charles Regional Medical Center.
Upon waking, it’s natural for the blood sugar (glucose) levels of people with diabetes to be slightly elevated. However, when you have diabetes, these early-morning blood sugar levels can sometimes further rise to an unhealthy level. This is known as the “dawn phenomenon.”
The good news is that you can take proactive steps to manage and prevent these spikes, starting with your actions the night before. Since these fluctuations often originate during the nighttime, improving your evening routine can make all the difference.
Why Does the Dawn Phenomenon Happen?
In people with diabetes, the dawn phenomenon is a natural, early-morning increase in blood sugar levels that typically occurs between 3 and 8 a.m. This increase is due to the body releasing hormones like growth hormone, cortisol, glucagon and adrenaline as it prepares to wake up. Cortisol and growth hormone tell the liver to produce and release more glucose (sugar) into the bloodstream, providing energy to wake up.
In people without diabetes, the pancreas responds by releasing enough insulin to manage this spike in glucose, helping to keep blood glucose levels stable. But if you have Type 1 or Type 2 diabetes, your pancreas may not produce enough insulin. This can lead to elevated blood sugar.
What Triggers the Dawn Phenomenon?
The dawn phenomenon is a natural response to how your body handles hormone surges overnight. It’s not caused by a specific food or activity. However, heavy dinners or snacks before bedtime and even poor sleep may worsen it.
Start the Morning Off Right with a Healthy Night Routine
Because it’s normal for certain hormones to increase in the morning, you shouldn’t aim to stop this natural rise from happening. Instead, the goal is to keep your blood sugar from spiking to unhealthy levels. Here’s what you can do to help keep everything within a healthy range.
Eat Right at Night.
Instead of oversized meals, aim for smaller portions that include a balance of protein, non-starchy vegetables and moderate amounts of complex carbohydrates, such as quinoa, brown rice or sweet potatoes. Complex carbohydrates digest more slowly than simple carbohydrates (like bread or pasta), so they help maintain more stable blood sugar levels. Pairing these complex carbohydrates with protein not only slows digestion but also ensures your blood sugar rises gradually and steadily, rather than spiking.
Move Before Bedtime.
Consider light evening exercise to support stable blood sugar levels. A short walk or gentle stretching after dinner can help your body use glucose better and may help lower your blood sugar before bed.
When you exercise, your muscles need energy, and they use glucose both during the activity and for several hours afterward. Be mindful not to exercise too close to bedtime, as this may interfere with your ability to wind down or could cause prolonged drops in blood sugar overnight.
Adjust Your Medication Time.
If you take medication or insulin, ask your doctor about the best time to take it. They might suggest adjusting the dosage or timing of your evening medication or insulin to help avoid high blood sugar levels in the morning.
Monitor Your Blood Sugar.
Consistent blood sugar monitoring helps you understand patterns that may indicate morning blood sugar spikes. You can use a home blood sugar monitor or a continuous glucose monitor to keep track of your readings. Along with a log of your food and activity, this can reveal hidden triggers.
Release Stress in the Evening.
Stress impacts your blood sugar levels, especially if you have diabetes. When you’re stressed, your body releases hormones like cortisol and adrenaline. These hormones tell your liver to produce more sugar and release it into your bloodstream, causing an increase in blood sugar.
In people without diabetes, the body produces enough insulin to handle this extra sugar, keeping blood sugar levels stable. But if you have diabetes, this means the extra glucose released during periods of stress can build up in your bloodstream and lead to elevated blood sugar levels.
Therefore, chronic stress can lead to blood sugar that’s high on a daily basis. Exercise, especially in the evening, can help manage stress and blood sugar. You may also want to try journaling, deep breathing or mindfulness activities that help calm you and ease stress. If you have difficulty managing stress, you can reach out to a professional for additional support.
Morning Habits to Manage Blood Sugar
These tips won’t prevent an evening blood sugar spike, but they can help you manage healthy blood sugar levels throughout the day.
- Avoid caffeine
- Drink plenty of fluids
- Eat a protein-rich breakfast
Watch a Podcast
Living Well with Diabetes
Learn how to develop healthy habits that support blood sugar control, reduce stress and fit into a busy lifestyle. Teri White, BS, RN, CDCES, a transitional nurse navigator and diabetic educator at UM Charles Regional Medical Center, shares her top strategies for sustainable diabetes care.