Scientifically Proven Way To Treat Dawn Phenomenon In Diabetes

A high fasting blood sugar level can be a nightmare for a diabetic who is on insulin therapy and trying their best to control diabetes. This high blood sugar on waking up can occur due to something known as Dawn Phenomenon. In this article, we will learn about what Dawn Phenomenon is and how to manage it.

What is Dawn Phenomenon?

First described in the 1980s by Schmidt, Dawn Phenomenon refers to a periodic elevation of blood sugar level or hyperglycemia which occurs in the early morning period.

Normally, during the early morning hours, the liver increases the blood sugar level by breaking down the stored sugar in the liver by a process called glycogenolysis and also converting other components into sugar by gluconeogenesis. These two processes increase the blood sugar level in the morning. In normal individuals, to counteract this rising blood sugar, there is a surge in insulin production as well, which eventually brings the sugar levels to normal.

However, in the case of diabetics, there is deficient insulin production in the body. Also, the action of the exogenous insulin taken at night starts to fade by early morning. As such, there is not much opposition by insulin to the liver producing sugar in the morning. This leads to early morning raised blood sugar or hyperglycemia in Diabetics and is known as Dawn Phenomenon.

This phenomenon can be seen in both type 1 and type 2 diabetes and across all age groups. Dawn phenomenon could be a reason for uncontrolled diabetes and must be treated to prevent long-term complications of Diabetes.

How to Diagnose Dawn Phenomenon in Diabetics?

The most effective way to diagnose Dawn Phenomenon is by Continuous Glucose Monitoring (CGM). It is a device that is attached to your body and records the blood sugar level throughout attachment and the result of which is interpreted by a physician. If the provision of Continuous Glucose Monitoring is not available, then an alternative but a crude method to determine the same is by measuring the blood sugar level at 3 A.M followed by another measurement of Fasting Blood Sugar level. If both the tests result in abnormally high levels, then one can be said to be having Dawn Phenomenon.

Treatment for Dawn Phenomenon in Diabetics

Before treating Dawn Phenomenon, it is very important to differentiate it from Somogyi Effect, as both present with a similar picture of raised fasting blood sugar level but has a different mechanism and different treatment approach as well. People suffering from Dawn Phenomenon usually are on Insulin. Under the supervision and guidance of your Physician, the following can be done:

• Switch the Insulin you are on to another insulin type with a longer duration of action.
• If you are on regular insulin, then one basal insulin might need to be added at bedtime if not contraindicated.
• Increase the dose of nighttime insulin. This also happens to be the most preferred approach.

Dawn Phenomenon is one of the reasons for uncontrolled blood sugar levels. There have been reports that a 1% increase in HbA1c level (the test that gives an overview of glycemic control over the last three months) increases the risks of cardiovascular complications by 15-20%. As such, it is quite important to get the blood sugar levels under control. And if Dawn Phenomenon is the reason behind it, it should be identified promptly and treated under a physician’s guidance.