If you ever feel like your blood sugar levels are playing sneaky tricks on you, you may actually be onto something. Let’s say you follow your regimen exactly, take your meds on time, and watch your diet, yet crazy things often seem to happen with your blood glucose levels… You may be suffering from some well-documented "swing patterns" that plague the hapless diabetic.
Early Morning Highs
First, there’s something called the Dawn Phenomenon. This is the name for very high blood glucose in the early morning (typically between 4am and 8am) caused by the release of hormones in the middle of the night. The body makes counterregulatory hormones – including glucagon,epinephrine, growth hormone, and cortisol – that work against the action of insulin. In a healthy person, these hormones work to raise blood glucose levels when necessary by signaling your liver to release more glucose and by inhibiting glucose utilization throughout your body.
According to the experts at Diabetes Self-Management magazine, there’s also a surge in the amount of growth hormone your body releases in the middle of the night, followed by a surge in cortisol, which “cranks up” glucose production in the liver, presumably to prepare the body for daytime activity after a period of fasting. In people who don’t have diabetes, these processes are offst by increased insulin secretion by the pancreas, so blood glucose levels remain relatively stable. But in people with Type 1 diabetes, whose pancreases don’t make insulin, and in people with Type 2 diabetes, whose livers may not respond to insulin well enough to stop glucose production, changes in glucose metabolism during sleep can have a profound effect on morning blood glucose levels.
And here’s the trick: high blood sugar in the morning can also be caused by something else, namely the body’s rebound from low blood glucose levels at night. This one’s known as “Rebound Hyperglycemia” or the “Somogyi Effect” (after researcher Michael Somogyi) and is also caused by the release of counter-regulatory hormones. It is believed to be a natural defense mechanism against low blood sugar.
The only way to tell these two phenomena apart is to check your blood glucose level in the middle of the night (around 3am). If you are high at that hour, you’re probably experiencing Dawn Phenomenon; if your BG is low then, it’s probably Rebound Hyperglycemia at work.
If you sometimes feel shaky and ravenous after eating, you may be experiencing Reactive Hypoglycemia. This is a syndrome in which the body releases too much insulin into the bloodstream in response to a very sugary or high-carbohydrate meal. As a result, you get repeated bouts of low blood sugar causing symptoms like fatigue, insomnia, dizziness, mood swings, headaches, heart palpitations and depression. Not good.
Many people without diabetes are starting to experience this condition as well, since our human bodies are struggling to handle the large amounts of sugar and carbs that make up our modern diet.
Note that Reactive Hypoglycemia is often a precursor to Type 2 diabetes. When your blood sugar drops after eating, the brain craves more glucose, so you consume more simple carbs to get your blood sugar back up again. This kicks off a “vicious cycle” of low sugar, high sugar, low sugar, high sugar, low sugar, high sugar. And that taxes your pancreas, which then leads to either insulin deficiency or to greater insulin resistance and, therefore, Type 2 diabetes.
Carbohydrates and YOU
Finally, there’s the simple fact that the way certain carbohydrate foods effect people with diabetes is very individual. My own doctor says: “Some people can eat English muffins or cereal for breakfast, take a certain amount of insulin, and they’re fine. While somebody else might eat exactly the same muffin or cereal — exactly the same amount of carbs and insulin — and they’ll still go sky-high. You just have to learn which type of carbohydrates your body can best handle.”
How true! Personally, I find that I can eat a small bowl of cereal for breakfast and sometimes even go low afterwards. Yet a few simple corn crackers send me reeling.
So just to sum it up, your blood sugar does indeed play some aggravating tricks. There’s no simple solution, but it helps to at least know what you’re up against.