Getting high blood sugars after a period of fasting is often puzzling to those not familiar with the Dawn Phenomenon.
The Somogyi effect is also called reactive hyperglycaemia and happens in type 2 diabetic patients. The Dawn Effect, sometimes also called the Dawn Phenomenon (DP) was first described about 30 years ago. Just before awakening (around 4am), the body secretes higher levels of Growth Hormone, cortisol, glucagon and adrenalin. Since these hormones all tend to raise blood sugars, we might expect that our sugars would go through the roof in the early morning.
So, in the normal, non-diabetic situation, blood sugars are not stable throughout 24 hours. The underlying cause of insulin resistance is the fact that the liver is overstuffed with fat and sugar, like 10 pounds of sausage meat in a 5 pound skin. In the Dawn Phenomenon, the body is under orders to release some of the stored sugar into the bloodstream. Insulin moves the sugar from the blood where they see it, and into the tissues (liver) where they cannot. In the IDM program, we typically use medications to keep blood sugars in a reasonable, but not low range during fasting.
The Dawn Phenomenon, or higher blood sugars during fasting does not mean you are doing anything wrong.
3Regina RichardsJune 15I've been doing 5-10 days fasts once a month along with LCHF since January. 4RyanJune 15This is a great read and one of the biggest reasons I switched to a pump was to have more control over my basal to cover my pretty dynamic dawn phenomenon (I am type 1). This post was sponsored by Libbey as part of an Influencer Activation for Influence Central. The Diabetes Forum - find support, ask questions and share your experiences with 209,001 people. Fasting, as the name suggests, means refraining from eating of drinking any liquids other than water for eight hours. After fasting, a carbohydrate metabolism test is conducted which measures blood glucose levels. When fasting the hormone glucagon is stimulated and this increases plasma glucose levels in the body.
If a patient doesn’t have diabetes, their body will produce insulin to rebalance the increased glucose levels.
However people with diabetes either dona€™t produce enough insulin to rebalance their blood sugar (typically in type 1 diabetes) or their body is not able to use the insulin effectively enough (typical of type 2 diabetes). Consequently when blood glucose levels are tested, people with diabetes will have blood sugar levels significantly higher than people who do not have diabetes.
The fasting blood sugar test is also used to test the effectiveness of different medication or dietary changes on people already diagnosed as diabetic. Fasting blood sugar levels are measured by taking a blood test after a period of fasting, usually of 8 hours without food.
A fasting blood glucose test can be useful to see how well the body is able to manage blood sugar levels in the absence of food. The target for fasting blood glucose levels are the same as the targets for before meal readings.
However,  some people may be set individual targets, by their doctor, that differ to the above levels. Fasting blood glucose tests for people with type 2 diabetes are useful for showing how well your body’s insulin responds to periods without food, such as overnight.
In type 1 diabetes, fasting blood glucose levels help to show whether your long term insulin, also known as background insulin, is set at the right dose.
The fasting test should be conducted on two separate occasions to ensure consistent results and in order to avoid a false diagnosis. This is the case as increased blood glucose levels may be as a result of Cushing’s syndrome liver or kidney disease, eclampsia and pancreatitis. Find support, ask questions and share your experiences with 209,001 members of the diabetes community.

10 week (free) low-carb education program developed with the help of 20,000 people with T2D and based on the latest research. The first comprehensive, free and open to all online step-by-step guide to improving hypo awareness. The Somogyi phenomenon (also known as post-hypoglycemic hyperglycemia, chronic Somogyi rebound) describes a rebound high blood glucose level in response to low blood glucose. Amongst those people with diabetes who manage their blood glucose using insulin injections, this may take the form of high blood sugar in the morning due to an excess amount of insulin during the night.
He prepared the first insulin treatment given to a child with diabetes in the USA, and also showed that too much insulin would make diabetes management unstable and more difficult. The Dawn Effect (or Dawn Phenomenon) is a morning rise in blood sugar which occurs as a response to waning levels of insulin and a surge in growth hormones. Somogyi theorised that prolonged levels of untreated hypoglycemia could lead to stress (due to low blood sugar) and a high blood sugar levels rebound. This is a defensive response by the body as it released endocrine hormone glucagon, backed up by the stress hormones cortisol and epinephrine.
This means an instant increase in blood glucose, and stress hormones cause insulin resistance for several hours, and this in turn leads to elevated blood sugar. Testing blood sugar regularly using a traditional blood glucose meter helps to catch low blood sugar levels before any rebound occurs. Night testing of blood glucose levels is also important, and adjusting insulin in response may also be appropriate. Practical ways to avoid Somogyi effect include regular blood glucose monitoring, logging blood glucose values, conservatively increasing insulin, being aware of hypoglycemia and how your insulin influences it, and using the most suitable insulin for your circumstances.
The evidence indicates that most people with type 1 diabetes who experience nocturnal Somogyi effect do not usually wake up. At this stage, although the Somogyi Effect is widely reported and well-known amongst healthcare professionals, there is little scientific evidence to prove its existence.
Clinical studies indicate that high fasting glucose is down to insulin running out during the night. The A1C test is a blood test that reflects the average blood-glucose level over the last two to three months. Unknowingly, you may have a lot of blood-glucose highs and lows, thus end up with an unrelated hba1c as compared with meter reading. Additionally, if you are self-monitoring your glucose level today and treat accordingly will help to achieve optimal A1C months later. If you have A1C percentage, it is meaningless unless it has converted into an equivalent blood-glucose level, here you can find A1C chart & calculator.
Research studies show improving both blood-glucose levels, and A1C is important for diabetes patients to avoid both micros and macro-vascular diabetes complications. Insulin secretion also increases in the early morning to counteract the counter regulatory hormones.
Like the overinflated balloon, the liver puts forth prodigious amounts of sugar in order to relieve itself of this toxic sugar burden.
Remember, there are hormonal changes during fasting that include increases in growth hormone, adrenalin, glucagon and cortisol.
They are medication that don’t actually help the patient in any way, but make the doctors feel better about themselves.
I'm feeling better and better and losing weight but I was also seeing this phenomenon and was worried by it.
They are medication that don't actually help the patient in any way, but make the doctors feel better about themselves. We are joining the Black White Sunday blog hop hosted by our friends, Sugar at GoldenWoofs Nola the Dachshund! Typically, fasting blood glucose levels are taken in the morning before any breakfast is eaten. When we do not eat for several hours, the body will release glucose into the blood via the liver and, following this, the body’s insulin should help to stabilise blood glucose levels. If you are in any doubt, Your healthcare team can help you to understand the levels you are getting and suggest any dosage changes.
Firstly, intense blood glucose testing allows the individual experiencing Somogyi effect to detect and then prevent the circumstances leading to it.

The need to keep blood sugar levels stable whilst still adjusting insulin to take account of a complex lifestyle involving stress and exercise can be really difficult.
On the other hand, some more people may ask what it means if I have healthy A1C and elevated fasting glucose. A good A1C means, your diabetes control was well past one or two months that appeared in you A1C result.
Your HbA1c is conflicting with home glucose monitoring; for example, the self-monitoring blood-glucose levels have been between 300 to 400s and an HbA1c of 6% the two do not reconcile and there may be a medical condition affecting the test results. You should consult with your healthcare professional; confirm whether you are doing the finger-prick glucose measurement correctly and accurately. Additionally, you need regular glucose test, because this helps to assess the glucose level at that instant. That is, they counter the blood sugar lowering effects of insulin, meaning that they raise blood sugars. Around 4 am, counter regulatory hormones surge and insulin is also released to counter this. When our liver gets the ‘go’ signal to release sugar, it does so in huge amounts, overwhelming the pitiful attempts of the insulin to keep it bottled up inside.
If we stop insulin, there is a risk that it comes out much too quickly (like the overinflated ballon releasing all at once). When our liver gets the 'go' signal to release sugar, it does so in huge amounts, overwhelming the pitiful attempts of the insulin to keep it bottled up inside.
When having your fasting blood glucose levels taken, you should not have any drinks apart from water during the period of fasting. However, if you look closely at the blood sugar readings, there is a slight increase in the morning time. However, in T2D, the body has high insulin resistance, meaning that the insulin has minimal effect at lowering the blood sugars. This results in the clinical diagnosis of T2D, when doctors are able to see the high blood sugars. Lots of doctors consider it bad, because they are only concerned about the sugar that they see (in the blood). So we want to use less insulin, but enough to release the stored sugars at a reasonable measured pace. If your body stores are filled to bursting, then you will expel as much of that sugar as possible. Fung for explaining what this is and that it is my body doing exactly what it is supposed to do, healing.
He’s a world-leading expert on intermittent fasting and LCHF, especially for treating people with type 2 diabetes.
Around 4am or so, knowing that you will soon be waking up, your body prepares you for the upcoming day.
Since the counter regulatory hormones (mostly growth hormone) still are working, blood sugars rise unopposed, and therefore much higher than the normal non diabetic situation.
A physician needs to adjust the medications to properly control the flow of sugar out of the liver. Your body then tries to increase the glucose in the blood by encouraging the liver to release some of its stored sugar and fat.
In order to prevent the sugars from rising too much, insulin increases to act as a ‘brake’ on the system. In order to prevent the sugars from rising too much, insulin increases to act as a 'brake' on the system. However when you have T2D, there is too much sugar released from the liver which shows up in the blood like an uninvited guest.'This is a 'placebo' line.
Hormones are secreted in a pulsatile manner peaking in the early morning hours then falling to low levels during the day.

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