Nightly raising, raising hello

Hey there y’all! I am wondering if anyone else has or had issues with their blood sugars raising while you sleep? I have been aiming for my bg to be at 70 before I go to bed, because it rises while I’m sleeping. I don’t know if it’s my lack of movement and lowered blood flow, or maybe my long acting insulin needs to be tweeted? But it is highly frustrating me, because there is a fine line of trying to get it lower before bed, and going too far into actual low blood sugar and needing to counter balance. I have kind of talked to my doctor a little bit. I’ve gotten that she doesn’t think it’s a long acting insulin needing to be increased, because during the day, sometimes I get lows. So I am just wondering if anyone else is having similar issues, Or have had, and have found a correction for this issue?

There are many discussions about this, it is known as dawn phenomenon or dawn effect.

Here is a good summary.

I use an insulin pump and setting that increase my basal starting at 6 am.
Sometimes I also give small bolus immediately on getting up. Some call this the “feet on the floor” BG rise. No food eaten yet, but body triggers the release of glycogen from liver to raise BG, in anticipation of the new day. In non diabetic, insulin is also released to keep BG level.

Sounds like you are on injections, not a pump. Some switch to a pump just for this reason, since it is challenging to handle with long acting insulin.

What long acting do you use, and how, when do you take it?

Depending when the rise occurs, it’s not necessarily dawn phenomenon. DP is often seen as a rise around 3 or 4 a.m. But are you like me, struggling with sharp rises about an hour after you fall asleep, regardless what time you go to bed?


It could be you are eating supper too late. You should eat at least 4 to 5 hours before you go to bed. Otherwise, your digestion keeps chugging along after your insulin stops working without you testing and correcting. It could also be that your evening meal bolus is inadequate for what you are eating. I find that a very light evening meal works well for me.

I will add another question to @beacher’s - what long acting insulin are you on?

I don’t have a pump. And right now, don’t really have the time or the constant schedule to do the classes needed to get a pump. Uhm yeah… the long acting insulin I’m on is Tresiba. Also there is less than 4-5 hours between dinner and when I go to bed. There is no way that I could do that, unless I only got like 4-5 hours of sleep. It’s not d.p. because it doesn’t start before waking up, it starts to steadily rise like 1-2 hours after I start sleeping. I was told to try eating protein before going to bed, to not have my liver kicking out sugar?

If it’s a steady rise throughout the night, it still sounds like it might be a basal rate set too low. Perhaps your daytime lows revolve around bolus that’s too high?

If you think it’s “liver kicking out sugar”, that’s one of the benefits of metformin. Some find that metformin has some benefits even for those on insulin.

If it’s a rise early in the night, then a fall towards waking, I’d keep looking at the interactions of the evening food consumption.


But do you have a CGM (continuous glucose monitor, like the Dexcom).

On testing for lows - you would still get a nights sleep if you set an alarm, got up and tested, and went back to sleep. Do it on a weekend. There are two different things to check if you have a constant rise, or lows rebounding.

A cgm would let you have a better understanding overall without ever having to wake at night. If you don’t have one, your endo will set up a 2 week loaner for you.

Hey there, yes, I do have the dexcom G5. So that is how I know it’s more of a steady rising. I love my cgm!! It’s helped lower my a1c, and alert me to falling blood sugars when I’m at work. Very nice to have, because now I’m not shorting insulin to be sure I wouldn’t go too low. Not I can do more or the proper amount of insulin, with no fear, and a back up. *Update: after some more consulting with my doctor, and pharmD helper, my nightly long acting basal rate has gone up by 10%. Hasn’t really been long enough to tell if that is working well enough yet. But I am sure it’s a step in the right direction! Thank y’all for your comments/feedback/suggestions!