Diabetes symptoms: What is the 3 am blood sugar phenomenon? (2024)

It is regular for everyone to wake up once or twice at night to drink water or use the loo. After we are done with the work, we get under the sheet and within minutes we fall back asleep to complete our 8 hours of sound sleep. For those suffering from diabetes, things are a little different.

Most diabetic patients wake up almost every night at the same time, around 3 pm, not by some noise or anything else, but because of the sudden spike in the blood sugar level. It can happen due to two reasons - the Somogyi effect or the dawn phenomenon.

As we know that our body uses glucose to produce energy and to wake up in the morning you need to have some extra energy. So, the body starts using stored glucose to prepare for the upcoming day. At the same time, the liver releases extra glucose in the bloodstream due to growth hormone, cortisol, and catecholamines. It generally happens in the morning around 2 am to 3 am to prepare the body to wake up for the day. While these events are happening, your diabetes medication doses taken a day before starts to wear off. All these phenomena together lead to a rise in the blood sugar level in the morning.

The second cause of high blood sugar in the morning is due to the Somogyi effect also called rebound hyperglycemia. This happens when your blood sugar level drops too low in the middle of the night and to recuse you from an extremely low sugar level, the body releases hormones that force the liver to release the stored glucose to stabilise the amount of glucose in the body. But in the case of diabetes, the liver releases some extra glucose to which leads to a high blood sugar level in the morning.

The major difference between the two is that the Somogyi effect leads to hypoglycemia followed by hyperglycemia. One of the easiest ways to find out if the spike in the blood sugar level is due to the Somogyi effect is to check blood sugar levels at bedtime and after waking up. If the blood sugar level is low at night then it is due to the Somogyi effect. In case it is normal or high it can be due to the dawn phenomenon. Another point to keep in mind is that the Somogyi effect can occur any time of the day when your body has a high blood sugar level.

Once you are sure what is causing the spike in the blood sugar level, you need to take measures to control them accordingly. You can discuss your situation with your doctor and based on your situation, he may prescribe you one of the following options.

For dawn phenomenon:

Changing the timing or type of your diabetes medications

Eating a lighter breakfast

Increasing your morning dose of medication

For Somogyi effect:

Decreasing the dose of diabetes medications at night

Adding a bedtime carb-loaded snack

Changing your exercise schedule