Whether you have type 1 or type 2 diabetes, a morning blood sugar high can be due to several causes. But with a little detective work and the help of yourdiabetes care team, you can isolate the cause and take steps to correct it. Here are three common scenarios:
1. The Dawn Phenomenon
这在夜间发生时发生，而睡着了，身体释放压力激素。这种现象通常在3周至下午8点之间发生。并涉及生长激素，皮质醇, andadrenaline，这引发了肝脏的生产和释放葡萄糖。这种化学级联的最终结果是血糖增加。
“These hormones are designed to get us up and moving in the morning,” says endocrinologistRenee Amori，MD, assistant professor of medicine in the division of endocrinology at the Drexel University College of Medicine in Philadelphia. While everybody experiences these natural changes in hormone levels, in people with diabetes the body may not adjust appropriately. This can lead to higher-than-normal blood sugar at the start of the day. Testing for these elevated first morning blood sugars is one way to diagnose people with type 2 diabetes.
2. The Somogyi Effect
早上读数也可能是由Somogyi效应引起的，当机身过度补偿时发生的反弹反应低血糖晚上反应。如果你服用血糖降低药物 - 如胰岛素 - 在晚上，这可能会让你有一个hypoglycemicreaction while you're asleep, and your body will then release these stress hormones, causing you to have high blood sugar in the morning.
如果这是贡献你的高早晨血糖，阿莫里博士说，你可能会遇到低血糖的症状，可以在半夜睡眠中唤醒你，包括头痛和过度出汗。You may also experience difficulty waking in the morning. If your physician is increasing your eveningdiabetes medication为了降低早晨的血糖，但你的血糖继续上涨，你可能会经历Somogyi效果。
3. Waning Insulin
高早晨血糖水平的第三次常见原因是胰岛素的量，这意味着您的胰岛素水平正在下降，不再保持血糖检查。结果，您唤醒了升高的阅读。
找到你早晨血糖的原因
虽然全部治疗了高早晨血糖的三个最有可能的原因，首先，您必须知道哪一个是您条件的来源。"If you’re not sure, you might have to take the somewhat inconvenient step of waking up to check your blood sugar levels in the middle of your sleep pattern (for example at 3 a.m. if you go to bed at 11 p.m.)" suggests Amori. Here’s why:
- Consistent blood sugar from bedtime until about 3 a.m. and then a rise suggests the dawn phenomenon.
- Low blood sugar at 3 a.m. suggests the Somogyi effect.
- Blood sugar that increases from bedtime to 3 a.m. and then is even higher when you wake is probably due to waning insulin.
Using a连续葡萄糖监测器enables you to get this information without having to wake up for it. "These monitors potentially help identify patterns and severity of high and low blood sugars," explains Amori.
治疗高早晨的血糖
一种blood sugar high in the morning "can be tough to treat,” acknowledges Amori, but with the help of your medical team, you can try different approaches. Talk with your doctor about these strategies:
调整泵。If you’re testing high regularly and you use an胰岛素泵，您可能能够编程它来帮助管理您的早晨高位。
Check blood sugar before bed.施用后，许多人在睡前可接受的血糖后早晨高血糖。即便如此，“不要用高血糖睡觉，”阿罗斯注意到。
服用基础胰岛素。Takingbasal insulin在睡前可以帮助，但在尝试之前，请务必清除与医生一起使用的任何变化。
调整药物。如果实际上你的高早晨血糖是对低血糖水平的反弹反应，而睡着了，你可能需要改变你在晚上服用的药物的剂量，这可能导致低血糖。与您的医生讨论您的药物时间表是否应调整以治疗晨高。
有一个健康的浸渍小吃。For those experiencing the Somogyi effect, a healthy mixed snack of protein and carbohydrates could help prevent your blood sugar roller coaster at night. Amori advises working with a registered dietitian if you’re not sure how to fit a pre-bed snack into your daily diet.
增加身体活动。Being physically active during the day can help you manage blood sugar more effectively in general. If your diabetes is treated with insulin or you have a concern about low blood sugar, find out how to exercise safely before increasing your physical activity.
较高的早晨血糖水平是一个问题，特别是如果他们经常发生并且似乎难以满足你的血糖目标。但是，考虑到阶梯解决这一早晨的高度可以改善您的整体糖尿病管理，并避免糖尿病相关的并发症。
