Lesson 6 - Early Morning Hyperglycemia

The Dawn Phenomenon refers to an increase in blood glucose levels sometime during the early morning (usually between 3 a.m. and about 8 a.m.) due to increased glucose production and insulin resistance.

The dawn phenomenon is mostly influenced by such factors as:

• how long you've had diabetes, and how severe your present condition is
• insulin sensitivity
• the counterregulatory system
• quality of glycemic control

This condition stems from the body's release of counterregulatory hormones to compensate for falling blood glucose levels.

The Dawn Phenomenon occurs in the early morning, and can be treated in three ways:

• dividing your insulin doses between dinner and bedtime
• increasing the basal infusion rate if you are using a pump
• increasing your evening insulin dose

The Somogyi effect, on the other hand, progresses gradually throughout the night and is treated by lowering insulin doses before bedtime, or by increasing food intake at bedtime.

Since these two conditions are very similar, it is necessary to check your blood glucose levels a few times during the night for several nights in a row, usually between 2 a.m. and 3 a.m., to determine when the fluctuations begin to occur. If your blood glucose level rises during most of the night, it may be caused by the Somogyi effect. If your glucose levels are stable until the early morning, you may be experiencing the dawn phenomenon.

Now that you've immersed yourself in all this knowledge, how about another crack at that quiz?

We hope you scored higher this time! If not, why not browse back through the lesson again on your spare time? If you do, you deserve a pat on the back, partner!

Check your blood glucose level several times a day for a week, and calculate any substantial fluctuations in glucose levels. Is it higher after soccer practice? Eating a large meal? See if you can account for all fluctuations; if fluctuations appear for no understandable reason, check with your physician.

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