Many people with diabetes deal with high blood sugar levels in the morning, a condition commonly known as the dawn phenomenon (although other factors like the Somogyi effect can also cause morning highs).
This occurs due to a natural hormonal change that coincides with waking up. Unfortunately, for those with diabetes, this phenomenon often results in stubbornly high blood sugar levels.
We sat down with Anna Faith Adair from northern Georgia, who has been managing her type 1 diabetes since 2016, to learn more about her experiences with morning highs and the strategies she employs to lessen them.
Key facts
- To help manage the dawn phenomenon, Anna Faith Adair transitioned from multiple daily insulin injections (MDI) to an automated insulin delivery system, significantly improving her morning blood sugar levels and overall diabetes management.
- She emphasizes the importance of timely and appropriate evening meals and managing dietary fats to decrease overnight and morning blood sugar spikes.
- Adair also highlights the benefits of continuous glucose monitoring and insulin pump technologies in managing fluctuating blood sugar levels, particularly during the morning.
Table of Contents
- What factors do you find contribute most to your high morning blood sugar levels?
- How do you manage your insulin regimen to deal with fluctuations in morning blood sugar?
- Are there specific dietary choices or bedtime routines you follow to stabilize your levels?
- What challenges have you faced with morning blood sugar control, and how have you addressed them?
- Have you found any particular strategies or technologies especially effective in managing these levels?
- Do high morning blood sugar levels affect your mood, energy, and daily activities?
- What adjustments have you had to make in your daily life to accommodate these levels?
- Over time, what have you learned about your body’s response to insulin and food intake?
- How have your management strategies evolved as you have learned more about your diabetes?
- What advice would you give to someone else dealing with high morning blood sugar levels?
- Are there any resources or tools you would recommend for managing these issues?
- What do you wish more people understood about the variability of blood sugar levels in type 1 diabetes?
- Do you want to address common misconceptions about managing morning highs?
What factors do you find contribute most to your high morning blood sugar levels?
Everyone experiences high morning blood sugar for different reasons. For Adair, it comes down to a variety of things.
She says,
“My high sugars in the morning are caused by a combination of dehydration, late-night eating, poor sleep, and hormonal fluctuations.”
How do you manage your insulin regimen to deal with fluctuations in morning blood sugar?
Like many people who are just diagnosed, Adair started with multiple daily injections to manage her type 1 diabetes. She reflects,
“I was on MDI from 2016-2021. My doctor told me that my sugars during the day were great, but if we couldn’t get my overnight sugars handled, we would never reach my A1c goals. We started discussing automatic insulin delivery systems.”
Automatic insulin delivery (AID) systems combine an insulin pump with a continuous glucose monitor (CGM) to adjust insulin delivery automatically based on real-time glucose readings. These systems are particularly effective for managing persistent high blood sugar levels, such as those caused by the dawn phenomenon.
Adair describes the impact of switching to an AID system:
“This was a game changer for me in terms of managing morning sugars. Before getting on a pump, I was waking up several times a night to eat or give a correction. Getting put on an automated system saved my sleep. Now diabetes wakes me up maybe once a week and my morning sugars are much more manageable.”
Are there specific dietary choices or bedtime routines you follow to stabilize your levels?
Adair is cautious about her meal timing and composition to prevent overnight blood sugar spikes.
She explains,
“From giving insulin, to post-dinner [blood sugar] spike, to leveling back out — it can all take between 2 and 3 hours. I try to eat dinner early enough that a potential spike could be leveled out by the time I go to sleep. I also try to eat less fatty foods in the evening, since fat content can delay a blood sugar spike.”
What challenges have you faced with morning blood sugar control, and how have you addressed them?
Managing morning blood sugar levels is a significant challenge in diabetes, often complicating the start of the day. Adair shares,
“The challenge with high blood sugars in the morning is its associated fatigue. My temporary solution is caffeine, but even a black coffee with Splenda can spike my sugar.”
Additionally, Adair deals with multiple chronic illnesses that can exacerbate her condition.
“I have several chronic illnesses, and if I am flaring from a different disease, my sugars often run higher. If I am battling a sinus infection or Hashimoto’s flare, I will often give myself extra time in the mornings to wake myself up, tend to my sugars, and do any necessary treatments before starting the rest of my day.”
Have you found any particular strategies or technologies especially effective in managing these levels?
Since 2021, Adair has successfully integrated insulin pump and CGM technologies to help manage stubborn high blood sugar levels
She highlights the benefits of connectivity:
“The Dexcom Follow app has been very helpful during this time. When I was on MDI, I would often have random spikes in the middle of the night that regularly led to ketones. With other people following my sugar, such as my mom, I would be woken up by a phone call to be reminded to take insulin.”
Adair also discusses her experiences with different devices.
“I originally was on the Medtronic pump and unfortunately, that system did not work with my body. That semi-helped with my high AM sugars, but switching to the Omnipod 5 and Dexcom system helped and lowered my A1c by two points.”
Do high morning blood sugar levels affect your mood, energy, and daily activities?
For Adair, the impact of high morning blood sugar levels on her daily functioning is profound.
She describes the experience, saying,
“High sugars in the morning ensure feeling ‘dragged’ the rest of the day. I have said on multiple occasions that ‘diabetes is the thief of all sleep’ and that is true throughout the day as well. If I am high in the morning, I cannot function properly for the rest of the day. It can be challenging to focus, get tasks done, and be productive.”
What adjustments have you had to make in your daily life to accommodate these levels?
Adair has made several key changes to manage her blood sugar effectively.
“My endocrinologist put me on 70/30 insulin to help lower my evening/early AM sugars. That was the best thing that helped my sugars before getting on a pump,”
she explains.
Dietary modifications have also played a crucial role. Adair notes,
“My endo also discussed strategies for dosing for coffee and high protein/fat meals.”
She stresses the importance of adaptability in managing diabetes.
“I see my diabetes care team about every 10-12 weeks. I periodically send them my CGM data, and we will adjust pump settings to better manage my sugars.”
Over time, what have you learned about your body’s response to insulin and food intake?
Managing diabetes is a constant learning process.
Adair shares,
“I got my T1D diagnosis the summer before my senior year of high school. I was two months from being a legal adult. My management matured as I did. Throughout my first year of being diabetic, I was navigating the stress of planning for college, leading multiple organizations at my school, and working a minimum of 20 hours a week. I did not have a good grasp on nutrition and did not understand how macronutrients could affect the body’s response to insulin.”
As Adair transitioned into adulthood, her approach to managing diabetes matured.
“Over the years I became more and more of ‘an adult’ and started to take ownership of my diabetes care. I was passed between peds and adult endos at the beginning of my diagnosis, and my diabetes education fell through the cracks. I officially met with an educator and later a nutritionist who really helped me understand the factors that impact sugars.”
How have your management strategies evolved as you have learned more about your diabetes?
Getting access to cutting-edge technology is often out of your control, a reality Adair knows well.
“It took a while to get approved for diabetes technology. The biggest change in my management came with access to CGMs and then access to a pump. I am hypo/hyper unaware so these systems regularly save my life. My management has also become a lot more proactive. I pre-bolus now, I start correcting earlier, and I have improved my carb-counting skills.”
What advice would you give to someone else dealing with high morning blood sugar levels?
Adair is a strong advocate for embracing technology in diabetes management.
“The biggest piece of advice I can give is to get on an automated insulin delivery system! This helps with preventing highs in the first place and helps you not have to worry so much.”
Are there any resources or tools you would recommend for managing these issues?
For Adair, tapping into community support has been key. “
Get into some diabetes support groups,”
she suggests.
“There are free and paid ones where T1Ds gather and can share their lived experience. I have learned a ton from other diabetics about management, coping, dealing with insurance, and navigating healthcare advocacy. There are a multitude of reasons why people have higher sugars in the morning and in these groups, you can crowd-source advice from folks who actually live it and get it.”
What do you wish more people understood about the variability of blood sugar levels in type 1 diabetes?
Type 1 diabetes is not merely a physical condition. It profoundly affects every facet of life, including mental health. Adair emphasizes this broader impact, saying,
“I wish people would understand how closely blood sugars impact mood and mental health. If I have a rollercoaster sugar day, I feel awful, and it can take a few days to recover. Having compassion when I share that I have had a bad diabetes day goes a long way.”
Do you want to address common misconceptions about managing morning highs?
Adair addresses a common misconception about the difficulty of managing morning high blood sugar levels.
“Morning highs can be really hard to manage on MDI,”
She explains.
“One day, due to hormone cycles, one may be more insulin sensitive, so that changes how we can treat a high. Managing blood sugars with the morning hormone dump is really challenging and can change from day to day.”
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