While wearing a continuous glucose monitor (CGM) I have noticed drops in my blood glucose levels. I have the alarm notification enabled on the app I’m using which has gone off quite a few times at night and in the mornings. The reason I am wearing a CGM is for personal research/data gathering insights to better understand my body and its response to food and exercise. The alarms and being in the ‘red zone’ of the graphs have caused me some concern, however after doing research/readings and talking my doctor it is normal for blood glucose levels to drop during sleep in a healthy non-diabetic person. During periods of fasting, such as overnight while you sleep, the body's metabolism adjusts to conserve energy. This can lead to a decrease in blood glucose levels. In a healthy individual, the body releases hormones like insulin and glucagon to regulate blood sugar levels. Insulin helps to lower blood glucose by facilitating the uptake of glucose into cells, while glucagon raises blood glucose levels by promoting the release of stored glucose from the liver.
During sleep, when there is no food intake, the body relies on stored glycogen in the liver for energy. As the night progresses, the glycogen stores gradually deplete, and the body starts to produce more glucagon, which helps maintain stable blood glucose levels. Consequently, this can result in a slight drop in blood glucose. Research as shown that on average there can be a 5% drop in glucose levels during REM sleep compared to non-REM sleep stages which can contribute to the periodic dips seen at night in nondiabetic people.
However, the body has mechanisms to prevent blood sugar from dropping too low during sleep. If blood glucose levels fall too much, the body may release additional hormones like cortisol or epinephrine, which stimulate the liver to release stored glucose, preventing hypoglycemia (low blood sugar).
Another interesting theory is that drinking alcohol in the evening could lead to low glucose values overnight as this decreases the liver’s ability to make new glucose (gluconeogenesis) resulting in lower circulating glucose levels. This is more common in people who have been fasting or are in a ketogenic state as there is less glucose stored as glycogen in the liver and muscles.
Sometimes the glucose levels may be lower at night simply due to your sleeping position as studies have found a strong correlation to dips and subjects lying on the sensors.
Is it normal for my blood glucose levels to be lower in the morning?
It is common for blood glucose levels to be slightly lower in the morning when you wake up, a condition known as "morning fasting hypoglycemia." This can occur even in healthy individuals without diabetes.
During the night, as mentioned earlier, your body continues to use glucose for energy, and the liver releases stored glucose to maintain stable blood sugar levels. However, in some cases, the body may release too much insulin or not enough glucagon, resulting in a temporary drop in blood glucose levels by the time you wake up.
There are a few factors that can contribute to low blood sugar in the morning:
1. The Dawn Phenomenon: In the early morning hours, the body releases hormones, such as cortisol and growth hormone, that can cause a temporary rise in blood glucose levels. This natural hormonal response is known as the "dawn phenomenon." However, in some individuals, the counterregulatory response to these hormones may not work efficiently, leading to a decrease in blood glucose levels.
2. Somogyi Effect: This occurs when blood sugar levels drop during the night, causing the body to release hormones like cortisol and epinephrine in response. These hormones trigger the release of stored glucose from the liver, leading to a rebound effect where blood sugar levels become higher in the morning.
It's important to note that persistent or severe morning hypoglycemia should not be ignored and could be a sign of an underlying health condition. If you consistently experience low blood glucose levels in the morning or have concerns about your blood sugar regulation, it is recommended to consult a healthcare professional for a thorough evaluation and appropriate guidance. They can assess your specific situation, perform necessary tests, and provide personalized advice based on your medical history and symptoms.
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