Why do you wake up with high blood sugar? Here's the explanation.

Waking up with high blood glucose levels can be a worrying symptom, especially for those living with diabetes or prediabetes. This condition, commonly known as morning hyperglycemia, can go unnoticed if not properly monitored. Identifying its causes, warning signs, and how to prevent it is essential to maintaining metabolic control and avoiding long-term complications.

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The phenomenon of high blood sugar upon waking is often linked to two possible mechanisms: the dawn effect and the Somogyi effect. Both refer to an unexpected increase in blood sugar levels during the first hours of the day, but they have different origins.

• Dawn effect: This occurs naturally in the body. In the early morning (between 2:00 and 8:00 am), the body releases hormones such as cortisol, adrenaline, and growth hormone, which raise blood glucose levels to prepare the body for the day. In people with diabetes, this increase can be excessive if there isn't enough insulin to compensate.
• Somogyi Effect: This is a rebound response. If a person experiences nocturnal hypoglycemia (low blood sugar levels while sleeping), the body may react by releasing excess glucose, causing a spike in blood sugar upon waking. This is often a result of excess insulin before bed or a very light dinner.

Main warning signs

People with morning hyperglycemia may not have obvious symptoms, but some common signs include:

• Tiredness or weakness upon waking
• Morning headache
• Dry mouth or intense thirst
• Blurred vision
• Frequent need to urinate during the night or upon waking
• Mild nausea
• Irritability or mood swings

These signs can easily be confused with simple morning fatigue, so it's important to monitor your glucose levels regularly, especially if you're living with type 1 or type 2 diabetes.

What to do if you have high blood sugar in the morning?

If you experience frequent high blood sugar at dawn, it's best to consult a healthcare professional to determine the exact cause. Some common recommendations include:

• Check your blood sugar level before going to bed and upon waking up
• Adjust the nighttime insulin dose if indicated by the doctor
• Avoid high-carbohydrate dinners
• Engage in regular physical activity, preferably during the day
• Avoid sugary snacks before bed

In some cases, it may be helpful to take a measurement between 2:00 and 3:00 am to rule out nocturnal hypoglycemia (Somogyi effect).

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Ignoring the rise in glucose levels at dawn can have medium- and long-term consequences. Persistent hyperglycemia can unbalance overall blood sugar levels throughout the day, make diabetes control difficult, and increase the risk of cardiovascular, renal, and visual complications.

Having high blood sugar when you wake up isn't always obvious, but it can be a sign that something isn't working right with your metabolism. Knowing its causes, learning to identify its symptoms, and conducting ongoing monitoring are key steps to preventing complications. If elevated levels persist, it is essential to consult a specialist to adjust treatment and ensure better health.

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