Here is How You Can Avoid Blood Sugar Spikes During the Night

In addition to disrupting your sleep, experiencing high blood sugar during the night can be dangerous. The three primary causes of blood sugar spikes during the night are eating too many carbs or fats at dinner or before bedtime, the dawn effect, and the Somogyi effect.

High-Fat Meal Spikes

Consuming excessive carbs elevates blood sugar, and too much fat can do the same. Fats digest slower than carbohydrates, causing problems for people taking insulin.

Fast-acting insulins like Humalog, Novolog and Apidra work in the body for three to four hours. After enjoying a high-fat meal, these insulins might begin working before a significant amount of glucose reaches the bloodstream – and the insulin may be done working before all the glucose gets there.

This means a glucose reading can be in-range two hours after a high-fat dinner, but the level can elevate above normal five or more hours later.

To avoid carb- or fat-related spikes:

• Stick to the dietary guidelines that generally work for you.
• If you indulge in an occasional high-fat meal – especially one loaded with saturated fat (animal fat) – you may need to alter the dose and timing of your insulin.
• If using oral medications, it can help to do some physical activity (e.g., walking) after consuming a high-fat meal.

The Dawn Effect

Early morning high blood sugar (hyperglycemia) can be owed to insufficient evening medication, carbohydrate bedtime snacks or the “dawn effect.”

The dawn effect occurs when a middle-of-the-night increase in insulin resistance triggers a rise in blood sugar. This phenomenon has been linked to a normal release of hormones about two hours before waking.

In non-diabetics, elevated glucose at dawn helps the body prepare for morning activity, and insulin keeps the glucose level in check. For those with diabetes, there may be insufficient insulin to curb the elevation in blood sugar.

If glucose readings are in target range around 3 a.m. but morning readings are elevated, this might be the dawn effect. Consult with your doctor. He or she might recommend:

• Not eating carbs prior to bedtime.
• Adjusting your insulin or medication dosage.
• Trying a different medication.
• Changing the time you take your evening insulin or medication.
• Using an insulin pump to deliver extra insulin in pre-dawn hours.
• Exercising later in the day.

Somogyi Effect

If there is a rapid drop in glucose during sleep, the body works to elevate blood sugar by releasing glycogen (glucose) from stores in the liver and muscles. The body might release too much glycogen, causing blood sugar to “rebound” into hyperglycemia.

The drop in glucose typically happens around 3 a.m., followed by elevated glucose levels toward morning. It might require some experimentation to stop the Somogyi effect from occurring, and this should be done in cooperation with your doctor:

• Eat a protein snack before going to bed, such as toast with peanut butter, yogurt, nuts, cottage cheese or a small chunk of cheese.
• Turn in at night with your glucose level a bit higher than usual.
• Test your blood glucose between 2 a.m. and 3 a.m. for a week or more and then show your logbook to the doctor. Changes to your insulin or other medication (type/dose) or the use of an insulin pump may be recommended.
• Ask your physician about a three-day continuous glucose monitoring system (CGMS) exam, especially if your body does not detect the symptoms of lows (hypoglycemia unawareness).

Sources: Joslin Center, DLife, Mayo Clinic
Photo: Pixabay