A complex array of factors affects blood sugar levels, including hormones, diet, and lifestyle. Q: I have prediabetes and now eat minimal carbs and sugar. My doctor told me to monitor my sugar levels, morning (fasting) and night. At night, two hours after eating, my sugar levels are between 112 and 130 mg/dL (6.2 to 7.2 mmol/L). But in the morning, my fasting sugar level is always higher than the night number. Why is that? What am I doing wrong?
There are a few reasons why your blood sugar may be elevated in the morning. First, it’s important to understand that certain hormonal changes that occur overnight may lead to high blood sugar levels (hyperglycemia) in the morning. The dawn phenomenon refers to hormonal changes that cause your blood sugar to increase in the early morning hours before you consume breakfast. Your body makes extra blood sugar (glucose) overnight in order to
avoid periods of low blood sugar (hypoglycemia) while you’re sleeping and to give you the energy you need to get out of bed. In people without diabetes, insulin — the hormone that regulates blood sugar — also rises to keep blood sugar stable. However, in people with diabetes who are resistant to the effects of insulin or who don’t produce enough insulin, blood sugar may rise dramatically in
the morning (1). Although the dawn phenomenon is more common in people with diabetes, it can occur in those who have prediabetes as well. Aside from the dawn phenomenon, there are a few other reasons why your blood sugar may be high in the
morning. It’s important to be aware that your nighttime meal choices can affect your morning blood sugar levels. For example, eating high-carb meals or snacking on sweets before bed can lead to elevated morning blood sugar levels. To keep your blood sugar stable throughout the night, eat a dinner high in protein, healthy fats, and fiber, and moderate in complex carbs. Avoid carbs that tend to
spike blood sugar, such as white bread and white pasta. If you choose to eat a snack at night, opt for a high-fiber option balanced with protein or a healthy fat, such as a small apple with a tablespoon of natural peanut butter. This can keep your blood sugar more stable while you sleep. If your doctor has prescribed you blood sugar medication, ensure that you’re following dosage and timing recommendations. Taking the wrong dose or taking medications at the wrong time can cause blood sugar fluctuations and can lead to elevated morning blood sugar levels. Exercise and weight loss — if needed — are some of the best ways to increase blood sugar control
in people with prediabetes. Going for a walk after meals can significantly reduce blood sugar levels, which can improve overall blood sugar control. For example, research shows that walking for 15 to 20 minutes after meals can significantly reduce blood sugar levels over a 24-hour period in people with prediabetes and diabetes (2, 3). Choosing the right foods, taking medications as directed, losing weight if necessary, and exercising — especially after
meals — are all ways to increase overall blood sugar control and decrease your chances of experiencing high blood sugar levels in the morning. If you’re still experiencing high morning blood sugar levels after making these changes, consult your doctor for advice. Jillian Kubala is a Registered Dietitian based in Westhampton, NY. Jillian holds a master’s degree in nutrition from Stony Brook University School of Medicine as well as an undergraduate degree in nutrition
science. Aside from writing for Healthline Nutrition, she runs a private practice based on the east end of Long Island, NY, where she helps her clients achieve optimal wellness through nutritional and lifestyle changes. Jillian practices what she preaches, spending her free time tending to her small farm that includes vegetable and flower gardens and a flock of chickens. Reach out to her through her
website or on Instagram.  There are a lot of articles online that explain why high morning glucose levels occur and what to do about them if you are diabetic or insulin-dependent. But if you are non-diabetic, you might be wondering: how relevant are those recommendations for me? For example, many in the diabetic/insulin-dependent community are (rightfully) excited if their levels get below 120 mg/dL upon waking. Mainstream recommendations are slightly more conservative and suggest a morning glucose level below 100 is normal. But studies have shown that levels above 90 mg/dL are correlated with adverse outcomes in otherwise healthy, non-diabetic populations. Research papers have consistently shown that morning glucose levels even between 95-99 mg/dL are predictive of increased cardiovascular death, increased incidence of diabetes, and elevated cardiovascular disease (CVD) risk. This is why we recommend our non-diabetic customers to target a morning glucose level between 70-90 mg/dL. If your morning blood glucose level is higher than you would like, then there are several strategies to lower it. But first, let’s look at why it is high in the first place. After all, as the cartoon G.I. Joe used to always say, “Knowing is half the battle.” Why is my blood glucose high in the morning?By analogy, if the temperature gauge in your car indicated the engine was running too hot, how concerned should you be? It would depend on why the engine was too hot, wouldn’t it? If you simply forgot to get an oil change, then the fix might be quite simple. Conversely, if the problem is stemming from a glitch in one of the onboard computers and is affecting multiple systems, then you need to get to a mechanic ASAP. Similarly, there are several known reasons for your metabolic engine to “run too hot”. Here are some of the more common ones: What you ate the night beforeThere is research suggesting that a high fat, high calorie meal can cause increased liver glucose production and temporary elevated fasting glucose levels. The increase in free fatty acids from that meal can impair insulin sensitivity and increase glucose production. This effect is especially pronounced if you combine high fat + high carbohydrate + high calorie, which is a common formula found in foods such as pizza, ice cream, fried food, etc. In fact, the high-fat + high-carb + high-calorie phenomenon is something we consistently see in the CGM data from our users. Our Director of Nutrition, Kara Collier, made this observation while on the Fundamental Health podcast: “A refined carbohydrate plus a refined oil, this is every snack food that has ever existed…and this food, when you have the combination of refined carbohydrate and refined oil, it creates a huge area under the curve. The fat slows down digestion, but you still have the refined carbohydrate in your system so your body is processing it for a long time…[T]hese sort of meals lead to a massive area under the curve because your body is processing this huge load of carbohydrates/glucose and it’s stressful on the cell and the mitochondria.” When Kara refers to the “area under the curve”, she is referring to the amount of time that your body is in a state of high blood glucose. When you consume a meal that is high in the “Trifecta” (high-fat + high-carb + high calorie) late at night, your glucose readings will be elevated into the morning. Instead of quickly clearing the glucose, your body spends hours and hours in a high-glucose state, which sets you up for high readings in the morning. When you ate the night beforeIn addition to what you eat, you also need to consider when you eat. Eating late into the night can cause your morning glucose values to be high. Your cells are not as sensitive to insulin later at night, which can cause a higher and more prolonged glucose response to meals eaten late. A 2017 study showed that shifting one’s eating window from 8am-7pm to 12pm-11pm decreased fat oxidation and increased glucose oxidation. In other words, participants were burning less body fat and relying more on glucose for fuel. Since glucose stores are limited in the body, this meant their bodies had to produce more glucose to manage blood levels. Not good! Conversely, another study in 2019 showed that compressing the eating window to the first half of the day significantly improved glucose response and had beneficial effects on fat metabolism and circadian rhythm. The participants ate the same amount of calories, but by simply shifting when they ate them, they were able to positively influence a number of biomarkers. High stress levelsThe phrase “don’t be so stressed” can feel like a bit of a cliché. But like most clichés, it contains a significant kernel of truth. The underlying physiological response to stress goes back over 500 million years. The stress response appears to have evolved because it provided a survival advantage in situations that were life-or-death. If your body needs energy right now to escape a threat, then relying on your digestive system is insufficient. You need a system that will liberate energy stores immediately. Fortunately, that is exactly what your body’s stress response does. When your body senses a stressful situation, it causes a release of hormones like cortisol and adrenaline that tell the body: “Produce energy NOW.” Part of this signal stimulates the liver to create and release new glucose into the bloodstream so that energy is readily available to fuel muscular activity. In the context of an ancestral environment, this system works great. The problem, however, is that chronic stress can cause this response to occur at low levels all the time. When that occurs, it can cause your glucose values to rise even if you have not eaten, as happens in the case of sleep. If you want to learn more about the role of stress and how to combat it, you can find additional strategies and resources in our article on managing stress and biohacking the cortisol response. Poor night of sleepA poor night of sleep (both disrupted sleep and shortened sleep) can cause your body to be in a state of insulin resistance the next day. Insulin resistance means the cells of your body are less sensitive to the signal from insulin. Since insulin is one of the main mechanisms by which your body manages glucose levels, this can lead to higher fasting glucose values and higher glucose responses to meals. Surprisingly, even a single night of poor sleep can increase insulin resistance the following day. Compound that day-in and day-out, and the stage is set for chronically high glucose levels. Lack of physical exerciseExercise is a powerful tool for controlling glucose levels. There are multiple mechanisms by which exercise positively impacts glucose levels, including:
But perhaps the most important aspect of exercise is consistency. Research has found that even a 10-day break in exercise in fit individuals decreased insulin sensitivity. Metabolic syndromeElevated fasting glucose values could be a sign of a temporary problem, like we discussed with a lack of sleep. However, they can also be a sign of a bigger problem, like metabolic syndrome. According to the US Department of Health & Human Services, metabolic syndrome is “the name for a group of risk factors that raises your risk for heart disease and other health problems, such as diabetes and stroke.” In addition to fasting blood glucose levels, there are 4 other risk factors involved in metabolic syndrome: triglycerides, HDL, blood pressure, and waist circumference. If your markers are outside the recommended ranges for these risk factors, then you may want to consult with a qualified professional. Dawn phenomenonThe dawn phenomenon is a natural occurrence that happens in all people. In the early morning hours, certain hormones – such as growth hormone, cortisol, and catecholamines – cause the liver to release extra glucose. This signal acts like your body’s natural “alarm clock” and gives your body access to easily available energy to get moving. Some people seem more sensitive to this effect and have slightly higher glucose values upon waking, but about 1 hour after waking they are back down to normal, optimal levels. If you don’t already have a CGM (continuous glucose monitor), then try monitoring your glucose levels about 1-2 hours after waking to see if they have naturally lowered on their own. How to prevent high blood glucose in the morning?We have explored why your morning glucose level might be high. Now, let’s explore how we can take action to address it. Our team has analyzed thousands of users’ CGM data, and there are several strategies that consistently improve morning blood glucose levels. The ones that tend to produce the biggest ROI include: Prioritize protein and non-starchy vegetables at dinnertimeRemember how we talked about the “Trifecta” of glucose-raising badness: high-fat + high-carb + high-calorie? If we knock out one or more of the “legs” of the Trifecta stool, then we can mitigate its adverse effects. Based on our data, we recommend knocking out the “high-carb” leg and the “high-calorie” leg. Focusing your evening meal around full-fat protein and fiber (as tolerated) helps to create a meal that results in stable glucose levels throughout the night and into the morning. This could look like:
Of course, individual response to food varies, but this food pattern tends to work very well for most people. Avoid food at least 3 hours before bedFood too close to bedtime causes us to metabolize food poorly while we are sleeping, which can lead to higher glucose values the next morning. Eating earlier, however, allows you to take advantage of higher insulin sensitivity and gives adequate time for the parasympathetic nervous system to begin the process of digestion. The remedy is simple: try to finish eating all food for the day at least 3 hours before you go to bed. Ideally, this would also include beverages that contain non-caloric sweeteners since they appear to have metabolic effects in the body. Monitor stress levelsWhen we are in a fasted state, most of the glucose in circulation is coming from the liver. Hormones like cortisol send a direct message to the liver to release more energy (glucose). Since cortisol is preferentially stimulated as part of the stress response, managing stress levels is key to stable morning glucose values. What counts as “stress” is highly variable from person to person, as are the strategies for mitigating it. Some of the tried-and-true stress management techniques include:
Get adequate quantity and quality of sleepYour mom was right – sleep is important. Sleep is a bit of a Catch-22. Both the quantity and quality of sleep are affected by blood glucose levels, yet blood glucose levels are also modulated by sleep. So, where do you start? You can always begin with the fundamentals of sleep hygiene:
Additionally, rather than thinking of sleep as an isolated tool, think of it as a synergistic link. Like a chain of people connected together, each link supports the other. If your sleep consistency and quality are inadequate, sometimes strengthening the other “links” can indirectly improve them. We’ve already discussed some of these links: nutrition, exercise, and stress management. Keep a consistent exercise routineThe best exercise is the one you do regularly. Don’t let the “perfect” become the enemy of “good enough”. It is far better to consistently walk 15 minutes a day or strength train three times per week than it is to grind out a marathon-like workout once every 3 or 4 months when the motivation strikes. Find a movement practice that you love doing (or that you can learn to love!) and make it a non-negotiable part of your life. Leverage the insights from behavioral science to design your environment for success. What if my blood glucose is low in the morning?Low glucose in the mornings is much less common for a non-diabetic than high glucose levels. We have many counter-regulatory processes in place to make sure our glucose never goes low, since low glucose can be very dangerous. The body has a wide arsenal of tools at its disposal for managing low glucose states including insulin, glucagon, norepinephrine, growth hormone, cortisol, and more. All that being said, if you are experiencing low glucose in the morning here are a few things to consider: Alcohol intakeIt is well known in the diabetic community that alcohol consumption can increase hypoglycemic events. In those who are insulin-dependent, these hypoglycemic events can even be fatal. Alcohol is technically a toxin in the human body, and the organ responsible for alcohol detoxification is the liver. Unfortunately, the detoxification process impairs the liver’s ability to release glucose into the bloodstream. As a result, you can end up with low glucose levels in the blood. Try changing your exercise timingYour body only has two major storage pools for glucose: the muscles and the liver. Late evening exercise – particularly if it is long in duration or high-intensity – can significantly deplete those stores. Combined with inadequate re-fueling, some people can experience hypoglycemia the following morning. History of bariatric surgery or altered digestive tractInterestingly, research indicates that operations like Roux-en-Y gastric bypass can potentially cause hypoglycemia while fasted. Adrenal insufficiencyWhile rare, the 2008 Endocrine Society Clinical Practice Guideline notes that hypoglycemia can be a result of adrenal insufficiency in a subset of patients. Eating disorders or malnutritionMalnutrition, particularly in the setting
of high body fat and muscle depletion, can also cause hypoglycemia due to limited substrates for gluconeogenesis and glycogenolysis. Monitor your alcohol intakeAccording to the National Institute on Alcohol Abuse and Alcoholism, drinking is considered “to be in the moderate or low-risk range for women at no more than 3 drinks in any one day and no more than 7 drinks per week. For men, it is no more than 4 drinks a day and no more than 14 drinks per week.” If you still find your glucose levels are low, try cutting the NIAAA’s recommendation in half (3-4 drinks per week for women and 7 drinks per week for men). Switch up your exercise timingAs previously discussed, exercise done too close to bed can result in hypoglycemia. If you tend to exercise in the evening, try exercising in the morning or at lunch and see if it makes a difference in your morning glucose level. If you are particularly stretched for time, you can also try splitting up your exercise into two smaller time-blocks. This has the added advantage of giving your body more time to recover. Make sure you’re getting adequate nutrition throughout the dayIf you are restricting calories to lose weight, your body may not be getting enough of the basic building blocks it needs to properly manage glucose levels. The same thing can happen in those who are very physically active and consuming energy-dense, but nutrient-poor, diets. While it is beyond the scope of this article, there is a dynamic interplay between the various metabolic pathways of the body: fat metabolism, ketone metabolism, glucose metabolism, protein metabolism, and more. Your glucose needs can significantly vary depending on which of these metabolic pathways are dominant. The liver holds approximately 100g of glucose in the form of glycogen. It takes about 24 hours for it to be depleted while fasting or ~90 minutes of moderate-high intensity. Glucose can be synthesized from several substrates (fatty acids, lactate, amino acids, etc.), but generally speaking, it is easiest to simply consume the glucose you need. Therefore, a relatively sedentary person may do well with 50-100g of carbohydrates per day, whereas an athlete or a person with a physically demanding job may do best with 2-4 times that value. The best way to determine your needs, of course, is through accurate monitoring of your glucose levels. Troubleshooting morning glucose levels can be tricky. As we have discussed, there are a lot of factors that influence overall glucose status in the body. Exercise, stress, circadian rhythm, macronutrient composition, nutrient timing, and more are continually affecting glucose management in your body. If your morning glucose levels are higher (or lower) than you would like, always start with the four fundamentals:
Engage with Your Blood Glucose Levels with NutrisenseYour blood sugar levels can significantly impact how your body feels and functions. That’s why stable blood glucose levels can be an important factor in supporting overall wellbeing. With Nutrisense, you’ll be able to track your blood glucose levels over time using a CGM, so you can make lifestyle choices that support healthy living. When you join the program, our team of credentialed dietitians and nutritionists are available for additional support and guidance to help you reach your goals. Ready to take the first step? Start with our quiz to see how Nutrisense can support your health. What is a good blood sugar level in the morning?What should your blood sugar be when you wake up? Whenever possible, aim to keep your glucose levels in range between 70 and 130 mg/dL in the morning before you eat breakfast, and between 70 and 180 mg/dL at other times.
Is 120 blood sugar high in the morning?A fasting blood glucose less than 100 is normal. 100-120 is called "impaired fasting glucose", or pre-diabetes. A person with a fasting blood sugar over 120, or a non-fasting blood sugar over 200, is diabetic.
What is a good morning blood sugar for a diabetic?According to the American Diabetes Association (ADA) guidelines, patients with diabetes should strive to achieve fasting blood glucose levels below 131 mg/dL, and levels following meals below 180 mg/dL.
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What should blood sugar be first thing in the morning
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