What is the cause of my high blood sugar levels in the morning and can exercise help?

  • Q: I am taking metformin 30 minutes before breakfast and supper. I eat egg whites and oatmeal for breakfast, brown rice for lunch and whole grain flour bread for my supper. My blood sugar is still showing 120 to 130 in the morning. Will exercise control the excess sugar and what time should I exercise?
  • A: Diabetes is a condition where the sugar levels in the blood may become elevated. This may be due to a decrease in the amount of insulin produced by the pancreas or the body may become less sensitive to the insulin in the body. Depending on what your sugar levels are throughout the day, there may be a couple of reasons why your blood sugar is high in the morning. The Somogyi Effect, named after the physician who first described this theory, is also referred to as "rebound hyperglycemia". The Somogyi Effect is a pattern of hypoglycemia followed by hyperglycemia. If you go to sleep at night and your sugar readings are relatively normal, then wake up in the morning with high readings, this could be due to a drop in sugar levels during the night. Sometimes the medication is too strong or is administered at the wrong time of day, and the sugar levels may drop during the middle of the night. In response to this drop in blood sugar, the body will naturally release hormones which will cause an increase in glucose to counter the hypoglycemia. Thus, when you wake up and take your blood sugar levels, it is now high. Another possibility is known as the Dawn Phenomenon. The Dawn Phenomenon refers to the body's natural release of hormones in the early morning. While we sleep, our bodies release these hormones to maintain and restore the cells in our body. These hormones can cause the levels of glucose to rise. In diabetic patients, the insulin levels may be lower than a person without diabetes or the body may not be as responsive to the circulating insulin, and therefore the body is unable to keep the increase of glucose under control. This will result in a high blood sugar level in the morning. The underlying cause of increased morning blood sugar levels may be unrelated to either the Somogyi Effect or the Dawn Phenomenon. It is important to consult with your doctor to determine the underlying cause of your elevated morning readings. Exercise is always good to help reduce or maintain weight and to promote heart health. Exercise may help to decrease the blood sugar. However, there is no specific time in which exercise should be done. Exercising for at least thirty minutes a day, five days a week is ideal. Even low-impact exercises such as walking, swimming, biking, and yoga have proven to be beneficial. The first step in controlling your blood sugar is to speak with your doctor for proper evaluation and to determine the cause of your elevated levels. Keep a food journal and show your doctor a record of all of your glucose readings so that they can try to figure out a pattern to help them determine the cause and best treatment for you. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Megan Uehara, PharmD
This question was answered on June 08, 2011.


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