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Why Does Blood Sugar Go Up At Night



Low Blood Sugar At Night Is A Common Danger For People With Diabetes It Is Important For Both You And Your Sleep Partner To Know The Warning Signs And Have A Plan For Treatment

Chris Iliades, MD

Untreated hypoglycemia can lead to a seizure and be life-threatening.

You know it is important to have tight control of you blood sugar with diabetes. Tight control is how you prevent diabetes complications. One of the dangers of tight control is letting your blood sugar get too low, called hypoglycemia.

The most dangerous time for hypoglycemia is when you are sleeping, a condition called nocturnal hypoglycemia. Up to 50 percent of diabetics may have episodes of nocturnal hypoglycemia. In fact, almost 50 percent of hypoglycemic episodes occur at night and more than half of dangerous episodes occur at night.

Its Strange That Blood Sugar In A Diabetic Can Rise Despite Not Having Eaten Anything Since Typically Eating Causes Blood Sugar To Go Up

But it’s no uncommon occurrence that in diabetes, glucose or blood sugar levels can actually rise in the absence of eating.

“When we don’t take food into our body for energy, our liver will try to help us by releasing glucose into our blood so we have the energy we need to stay alive,” says Lucille Hughes, RN, CDE, director of diabetes education at South Nassau Communities Hospital in Oceanside, NY.

“For people with diabetes, the liver may release too much glucose, causing blood sugar to go up.”

This is why it’s so important for diabetics to regularly take blood sugar readings, even if they feel fine.

The liver has hundreds of jobs. One of those jobs is to release glucose into the bloodstream for energy — because the body requires energy to function, even when at rest.

Basic bodily functions require energy — and glucose provides that energy.

In diabetes, things are out of whack in the body. The liver in the diabetic may sometimes overestimate how much sugar to release into the bloodstream.

Or, to put it another way, the liver over-corrects the problem.

The only way that a diabetic can stay ahead of this curve is to monitor their glucose levels on a regular basis throughout the day to make sure that the sugar level doesn’t sneak its way into getting into a dangerously high range.

When Combining Keto And 5:2 Intermittent Fasting On Fasting Days Do You Still Follow The Macro Guidelines For Keto

On the two days of fasting, should the 500 calories consumed be of the same macro proportions as followed on the normal keto days? Or can you consume 500 calories of any food without going out of ketosis?

Andrea

I don’t generally recommend people to count calories. Fasting means not eating anything at all, so there is no ‘counting macros’. Dr. Mosley’s 5:2 diet allows 500 calories of whatever you like. But that’s his diet, not mine. I advocate intermittent fasting, with no calories.

Dr. Jason Fung

How Is It Determined If The Dawn Phenomenon Or Somogyi Effect Is Causing The High Blood Sugar Levels

Your doctor will likely ask you to check your blood sugar levels between 2 a.m. and 3 a.m. for several nights in a row. If your blood sugar is consistently low during this time, the Somogyi effect is suspected. If the blood sugar is normal during this time period, the dawn phenomenon is more likely to be the cause.

Some additional clues that the Somogyi effect may be the cause include nightmares, restless sleep and overnight sweating as these are all signs of low blood sugar levels.

How Are You Sweetening Your Coffee What You Add To Your Cup May Affect Your Blood Sugar Levels

Why Does Your Blood Sugar Go Up When You Don T Eat ...

Whether you were recently diagnosed with type 2 diabetes or have been living with the condition for several years, you know how fickle blood sugar levels can be, and how important it is that they stay controlled.

Proper blood sugar control is key for warding off potential diabetes complications, such as kidney disease, nerve damage, vision problems, stroke, and heart disease, according to the National Institutes of Health . Plus, keeping your levels in check on a daily basis can help you stay energized, focused, and in a good mood, explains Lisa McDermott, RD, CDCES, a diabetes specialist with the Pittsburgh-based Allegheny Health Network.

According to the American Diabetes Association , proper medication, effective meal planning, regular exercise, and regular blood sugar checks can all help you keep your levels within a healthy range. The ADA recommends blood glucose stay within 80 to 130 milligrams per deciliter before meals and below 180 mg/dL two hours after the start of a meal. Furthermore, the organization recommends getting an A1C test, which measures your average blood glucose over the past two to three months, at least twice per year if your levels are stable and you are meeting treatment goals.

How To Differentiate Between The Two Effects If You Suspect High Fasting Blood Sugar

If your sugar level shoots up every morning after you wake up, then always check your 3:00 am sugar.

If sugar at that time comes low then this is a Somogyi effect. You should always consult your doctor as root cause analysis of hypoglycemia is required. There may be a need for drug dose reduction but it all depends on clinical judgment.

But if your 3:00 am sugar comes out to be normal or on the higher side, then it’s a dawn effect. It requires clinical judgment, your dose may need to be increased or changed.

Hypoglycemia or low blood sugar levels should be managed at priority since low sugar causes our body to get deprived of energy and causes symptoms such as tiredness, weakness, fatigue, lethargy, shivering, and extreme hunger.

If sugar levels are not managed at this stage, it can further lead to unconsciousness or coma. Unawareness of hypoglycemia phases could be dangerous due to the same reason and hence must be looked for!

On the other hand, hyperglycemia or high blood sugar levels are also important to be managed as it can further lead to complications. Constant high blood sugar levels can impact kidneys, eyes, nerves, heart and brain.

You must work on managing your blood sugar levels within the normal range in order to live a healthy and happy life. Do improve your lifestyle by eating timely, exercising daily, going for doctor follow-ups and taking insulin or medicines on time. For more information, read this blog.

The Somogyi Effect Causing Blood Sugar Level To Go Up During The Night:

There is another possible reason behind the high blood sugar levels in the morning or blood sugar levels that go up through the night and that is, the Somogyi Effect. When a person has too low blood sugar levels, which is possible for hypoglycaemia patients, the body sends signals to the liver through the hormones to release more glucose into the blood for performing the bodily functions. It is the body’s own way of ‘rescuing’ itself from the adverse effects of low blood sugar, which is usually the inability to produce energy and perform the physiological tasks. When this release is extremely high, more than what is needed or more than usual, it is called the Somogyi Effect. It is named after Dr. Michael Somogyi, who first discovered this condition and the reason behind this. It results into high blood sugar levels in the morning.

Why Would You Have High Blood Sugar If You Have Not Eaten In 12 Hours

When humans eat carbohydrates, the body converts them to sugar. The sugar fuels every cell in the human body, but it’s important that sugar levels be neither too high nor too low. Low blood sugar, called hypoglycemia, can cause brain damage and even shock. High blood sugar, known as hyperglycemia, is another matter.

What Are Some Tips To Prevent Nighttime Blood Sugar Level Dips

  • Check your level before bed. According to Sulay Shah, M.D., a board certified endocrinologist, the only way to know if you are at risk is to monitor your blood glucose levels—as there aren’t always telltale signs.“If you check and you notice that your levels are close to 70 mg/dL at bedtime, then you know you might be at risk,” Dr. Shah says. In this case, he recommends eating some complex carbohydrates, like a peanut butter sandwich, an apple with peanut butter or one slice of multigrain toast with some avocado.
  • Don’t skip dinner. If you aren’t eating dinner, Dr. Shah advises skipping your rapid-acting insulin or medicine, like glipizide or glimepiride, that can decrease your blood sugar levels. “The goal here is to match your meal and medication,” he says.
  • Monitor your alcohol intake. If you notice that your blood sugar is dropping after having a few beers or vodka sodas, then Dr. Shah warns that you may need to try to eat complex carbohydrates with the alcohol. Dr. Shah notes that blood sugar tends to drop 3 to 4 hours after drinking alcohol. “When you regularly drink alcohol, you are decreasing the amount of stored glucose in the liver which helps to maintain a blood sugar in normal range,” he explains.
  • How Can High Blood Sugar Levels In The Morning Be Controlled

    Once you and your doctor determine how your blood sugar levels are behaving at night, he or she can advise you about the changes you need to make to better control them. Options that your doctor may discuss depend on the cause of the morning high blood sugars.

    For dawn phenomenon:

    • Changing the timing or type of your diabetes medications
    • Eating a lighter breakfast
    • Increasing your morning dose of diabetes medication
    • If you take insulin, switching to an insulin pump and programming it to release additional insulin in the morning

    For Somogyi effect:

    What Should Blood Sugar Be At 3:00 Am And How To Maintain It

    It is important to maintain a 3:00 am blood sugar level between 100–180 mg/ dL and prevent it from dropping. Make sure that you are following these guidelines:

  • Correct your eating pattern: Instead of having 3 heavy meals eat a small portion of meals every 2–3 hours throughout the day.
  • Balanced dinner: Include chapatis / rice with dal/ curd and sabzi in your dinner.
  • Bedtime meal: Before sleeping, drink 1 glass of milk with a pinch of turmeric and black pepper. This will help in managing sugar levels while you’re sleeping.
  • Monitor your blood sugar levels: Keep a check on the low blood sugar trend. This will help you and your doctor in planning future actions.
  • Keep your Doctor in the loop: Low blood sugar levels must not be taken lightly so always consult your doctor for insulin and medicines changes.
  • Be ready: Always keep multiple glucose powder sachets and water on your bedside. This will help in preventing any delay to treat low blood sugar.
  • Avoid alcohol intake: Alcohol is known to cause low blood sugar episodes at night. Start by limiting alcohol and then gradually stop it for a healthier lifestyle.
  • How to manage low blood sugar? Know it all from our expert Dr Arpit.

    Now that you know why you are waking up in the middle of the night with low blood sugar, let’s discuss another phenomenon that diabetics experiences, called high fasting blood sugar.

    Are There Any Newer Technologies To Prevent Hypoglycemia

    “We are lucky that in this day and age, we can predict hypoglycemia and prevent it through technology like continuous glucose monitors,” explains Dr. Shah. Additionally, he notes that there are newer insulins available to help decrease episodes of hypoglycemia.

    “One of our roles as your doctor is to educate every patient about the self-management of diabetes and to create a personalized care plan,” explains Dr. Shah. “By self-managing your condition you will really feel empowered enough to take control of your health.”

    Dr. Shah is located at the Hackensack Meridian Health Medical Group Diabetes Center, part of Hackensack Meridian Health Medical Group. Call to schedule an appointment at the office in Old Bridge.

    Our care network can help you better manage your health. Visit HMHMedicalGroup.org to find a practice near you.

    The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.

    Resources

    What Are The Warning Signs Of Early Morning Hypoglycemia

    Your Health: Why Are My Hands and Feet Tingling?

    Whenever you experience low blood sugar levels at 3:00 am, your body will show symptoms that are not always the same for everyone. These symptoms include:

  • Feeling uneasy during early morning hours
  • Unable to fall asleep after waking
  • Feeling weak or excessive sweating while asleep
  • Increased heartbeat or shaking of hands and legs on waking
  • High fasting blood sugar level
  • Shades Of Chia Pudding: A Diabetes Breakfast Revolution

    What we’ve learned from over 75,000 people about making awesome chia pudding for breakfast: new recipes, new flavors, and how to overcome common stumbling blocks

    Chia pudding has struck a resounding chord with diaTribe readers: over 40,000 people have viewed the original column, “The Three-Minute Diabetes Breakfast That Changes Lives,” and more than 30,000 people have now viewed our original how-to video on YouTube and Facebook.

    As I shared in Bright Spots & Landmines, chia pudding is an awesome diabetes breakfast: little impact on blood sugar, super filling, three minutes to make without cooking, under $0.60 per meal, infinitely customizable, tasty , and yes – even “life changing.” Simplifying breakfast – which is almost certainly the hardest meal of the day for blood sugars – can be transformative.

    Over the past year, we’ve learned how diaTribe readers make chia pudding in their own clever ways. This article organizes more than 50 tips and tricks into a single, choose-your-own adventure guide to making chia pudding with new “bases” and “toppings.” It’s like the Chipotle approach, but re-applied to my favorite breakfast: Chia-potle?

    Replies On Why Is My Blood Glucose Increasing Overnight

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    The increase in blood sugar may be due to either the Dawn effect or the Somogyi Effect.

    The dawn effect is caused by not having enough insulin in your body at night. While we sleep, glucose is released into our body as a response to hormone stimuli. The release of these hormones to repair and maintain your body causes an increase in blood glucose levels during the first hours of the morning. If you take insulin, you should increase your insulin dosage at night or take it later in the evening.

    The Somogyi effect differs from the dawn effect because it is caused by too much insulin at night, and there is a dramatic decrease in blood glucose between 2-4 am. Because of this drop, the body compensates by increasing glucose in the body, thus causing the high blood suger upon awakening. The only way to differentiate between the two is to check your blood sugar between 2-4 am. If you do not currently take insulin, then this probably is not the problem because it is caused by too much insulin at night.

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    I wish mine only spiked that much!

    My blood sugar is around 90-120 when I go to sleep and when I wake up its between 260-300!! It is so frustrating!!!!I have tried everything! I just don’t know what to do anymore. I spend all day trying to get my blood levels back in check only to have it ruined at night!

    at at

    People With Diabetes Generally Take 2 Types Of Insulin:

    • Short-acting insulin and
    • Long-acting insulin.

    Short-acting insulin such as APIDRA or NOVORAPID or HUMALOG reaches the bloodstream within 30 minutes after injection and peaks anywhere from 2–3 hours.

    However, long-acting insulin such as LANTUS is peakless insulin that works in the background and lasts more than 24 hours.

    The effect of these two insulins gets combined and the peak of short-acting insulin shifts to early morning hours. This increases the risk of hypoglycemia around 3:00 am.

    How To Monitor Your Blood Sugar Levels For Better Sleep

    The only way to get the full picture of what is going on with your glucose levels overnight is to use a Continuous Glucose Monitor . A CGM can track your glucose levels while you are sleeping, helping you identify the highs and lows that are disrupting your sleep. You can then use this information to make adjustments to your evening and sleep hygiene routine to improve your overnight glucose levels. It also brings awareness of how your current sleep patterns are affecting your overall glucose levels. Best of all, it’s actionable data that can drive positive change. 

    The NutriSense Continuous Glucose Health Program makes monitoring your glucose levels simple. It demystifies the science behind metabolic health by combining CGM technology with clinical support. 

    Great Bedtime Snacks For People Living With Diabetes

    For some people, a healthy bedtime snack helps to prevent glucose swings during the night. By eating a small snack that is full of protein and healthy fats , your body may be better able to avoid an overnight high – but if you take insulin, be sure to cover the carbohydrates in your snack even if it only requires a small dose of insulin.

    Here are some snack ideas:  

    • Plain nuts or seeds – try eating a small handful

    • Raw vegetables, such as carrots, celery, cucumbers, or tomatoes, with a small amount of hummus or peanut butter

    • Plain yogurt, and you can add berries or cinnamon

    Remember, a bedtime snack is only helpful for some people. To see if it works for you, you’ll have to carefully monitor your glucose before bed, during the night, and when you wake up.

    How Diabetes And High Blood Sugar Affects Your Sleep

    To make matters worse? Having diabetes usually makes quality sleep even more elusive. Here’s how:

    • Sleep Apnea: Many people who have type 2 diabetes also suffer from sleep apnea. When untreated, pauses in breathing can cause people to wake up hundreds of times throughout the night.
    • Peripheral Neuropathy: Nerve damage in the legs or feet is common among people with diabetes, and can lead to tingling, numbness, burning, or pain that can make it tougher to doze off.
    • Restless Leg Syndrome: Another condition common among those with diabetes, RLS can cause feelings of needing to move your legs while sitting or lying down, which can make it harder to fall or stay asleep.
    • High or Low Blood Sugar: Both can make it difficult to achieve restful sleep. Too-high blood sugar can leave you feeling hot, irritable, or unsettled. Blood sugar that’s too low could result in nightmares, or cause you to wake up feeling sweaty or clammy.
    • Nocturia: Nocturia, or nighttime urination, is a common problem among diabetics that’s usually the result of uncontrolled blood sugar. Having higher amounts of sugar in your urine may cause you to wake up and have to go more frequently during the night.

    What To Eat To Maintain Blood Sugar Levels At Night

    If you’re hungry at night, eat a low-carb snack to keep your blood sugar from spiking. If you’re managing the Somogyi effect, you’ll likely need to include some carbohydrates to prevent low blood sugar and the resulting rebound hyperglycemia. Rizzotto says an evening snack should be eaten about two hours before bed.

    Protein

    Protein does not spike blood sugar or insulin levels, making it an ideal bedtime food choice. Protein also slows the body’s ability to metabolize carbohydrates, according to a June 2015 systematic review published in Diabetes Care. The slower the body absorbs carbs, the less your blood sugar levels will rise. Smart high-protein options include a hard-boiled egg, tofu, low-fat yogurt or a few slices of low-fat deli meat, such as turkey.

    Fats

    Fats also play an important role in controlling blood sugar levels. According to the National Institute on Aging, they give the body energy without raising blood sugars. They also help the body absorb essential vitamins. Therefore, it’s wise to include a small amount of healthy fat in your evening snack.

    Healthy fats are found in low-fat cheeses, seeds, nuts, avocados and olive oil. But though these fat sources are nutritious, it’s important that you enjoy them in moderation so as to avoid consuming too many calories and gaining weight. A healthy serving size for nuts, seeds and cheese is about an ounce, or 1 to 2 tablespoons.

    Read more:How Long Does It Take for Blood Sugar Levels to Peak After Eating?

    Carbs

    What Causes High Blood Sugar Levels In The Morning

    why does my blood glucose go up after exercise?

    Commonly known reasons why your blood sugar may be high in the morning include high-carb bedtime snacks and not enough diabetes medications.

    Yet two lesser-known reasons may be causing your morning blood sugar woes: the dawn phenomenon and the Somogyi effect. These causes of high morning blood sugar levels are a result of body changes and reactions that happen while you are sleeping.

    Tips To Prevent Blood Sugar From Dropping At Night

      Sulay Shah, M.D. contributes to topics such as Diabetes.

      Hypoglycemia, also known as low blood sugar or low blood glucose, occurs when blood glucose levels drop below normal—which is typically below a level of 70 milligrams per deciliter . With levels more commonly ‘dipping’ at nighttime, otherwise referred to as nighttime hypoglycemia, this condition affects mostly patients with diabetes.

      Easy Before Bed Routines For People With Diabetes

      Natalie Olsen, R.D., L.D., ACSM EP-CStephanie Watson

      Managing diabetes — whether you have type 1 or type 2 — is a full-time job. Your condition doesn’t clock out at 5 p.m. when you’re ready to take a break. You have to maintain your blood sugar checks, medication, exercise, and eating habits all day to keep your disease under control.

      In fact, you should be mindful of your diabetes all the way until bedtime. Before you set the alarm and settle in under the covers each night, here are a few bedtime to-do’s that will help you get more control over your diabetes and sleep more soundly.

      Surprising Things That Can Spike Your Blood Sugar

      Minus

      When you first found out you had diabetes, you tested your blood sugar often to understand how food, activity, stress, and illness could affect your blood sugar levels. By now, you’ve got it figured out for the most part. But then—bam! Something makes your blood sugar zoom up. You try to adjust it with food or activity or insulin, and it dips really low. You’re on a rollercoaster no one with diabetes wants to ride.

      Do you know all of these blood sugar triggers?

      Knowledge is power! Look out for these surprising triggers that can send your blood sugar soaring:

    • Sunburn—the pain causes stress, and stress increases blood sugar levels.
    • Artificial sweeteners—more research needs to be done, but some studiesexternal icon show they can raise blood sugar.
    • Coffee—even without sweetener. Some people’s blood sugar is extra-sensitive to caffeine.
    • Losing sleep—even just one night of too little sleep can make your body use insulin less efficiently.
    • Skipping breakfast—going without that morning meal can increase blood sugar after both lunch and dinner.
    • Time of day—blood sugar can be harder to control the later it gets.
    • Dawn phenomenon—people have a surge in hormones early in the morning whether they have diabetes or not. For people with diabetes, blood sugar can spike.
    • Dehydration—less water in your body means a higher blood sugar concentration.
    • Nose spray—some have chemicals that trigger your liver to make more blood sugar.
    • Sleep Impacts Sympathetic Nervous System Activity

      Sleep deprivation, or broken sleep, can lead to an increase in sympathetic nervous system activity. In stressful or dangerous situations, the sympathetic nervous system is what controls your “fight or flight� response. Lack of sleep can cause your “fight or flight� mode to kick in during the day and night, releasing stress hormones like cortisol. 

      When your sympathetic nervous system is overly active, it can reduce insulin secretion and promote insulin resistance. Both of these can lead to chronically raised blood sugar levels. 

      When blood sugar levels become raised, it can cause lifelong chronic conditions such as pre-diabetes, diabetes, or metabolic syndrome. 


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