Managing Diabetes Fatigue in the Morning

Waking up and feeling lethargic can be frustrating. After a full night’s rest, your body should feel rejuvenated. Fatigue can strike for a variety of reasons. For those living with diabetes, however, diabetes fatigue in the morning could be a cause for concern, causing you to wonder if you're managing your diabetes correctly. Checking your blood glucose levels regularly and identifying trends can help you understand how to best manage your exhaustion.

What Causes Diabetes Fatigue in the Morning? 

If you practice consistent diabetes management, you may wonder why you feel exhausted first thing in the morning. While we often feel tired when we first wake up, fatigue is a much stronger feeling that affects our physical and mental health. It feels as if no amount of sleep could ever generate enough energy.

Unfortunately, even with the most effective diabetes management plan, various factors, including medications, diabetes-related complications, stress, and other lifestyle factors, can cause diabetes fatigue in the morning. However, hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar) are the most common causes of this cumbersome feeling.

Overnight Hypoglycemia

Overnight hypoglycemia, also known as nocturnal hypoglycemia, occurs when blood sugar levels fall below your normal range (typically below 70 mg/dL or 3.9 mmol/L) in the middle of the night. Nocturnal hypoglycemia is particularly dangerous because it occurs while you’re sleeping, preventing you from noticing signs of low blood sugar.

Those who take basal insulin, or background insulin, have been found to be the most affected by overnight hypoglycemia. A basal-bolus insulin regimen involves administering insulin injections throughout the day, particularly at meal times.

The purpose of this regimen is to help keep blood glucose levels stable throughout the day by mimicking how the body produces insulin in people without diabetes. For example, a regimen may include injecting a longer-acting form of insulin during periods of fasting and a shorter-acting form of insulin after meals to prevent high blood sugar spikes.

However, if you administer too much insulin before you go to sleep, it could cause blood sugar levels to fall too low, causing hypoglycemia during the night. Similarly, if you don’t administer enough insulin, blood glucose levels may rise.

Other causes of overnight hypoglycemia include the following:

• Exercising before bedtime
• Skipping dinner
• Consuming alcohol
• Having an infection
• Neglecting nighttime snacks (if blood sugar levels permit)

Signs of low blood sugar at night include excessive sweating, headaches, and unusual tiredness first thing in the morning.

Overnight Hyperglycemia

Overnight hyperglycemia occurs when blood sugar levels rise during sleep. Those living with type 1 diabetes are the most at risk for hyperglycemia because their bodies don’t produce insulin. People with type 2 diabetes produce insulin, but their bodies don't use it effectively. Causes of high blood sugar levels during the night include the following:

• Consuming a high-fat or high-carb dinner
• Snacking late at night 
• Managing insulin or medication poorly
• Moving too little throughout the day 

Diet and nutrition are commonly associated with blood sugar levels rising, particularly if you stray from foods permitted in your diabetes meal plan. Consuming a high-carb meal can dramatically affect blood sugar levels, even the next morning.

Another potential cause of overnight hyperglycemia is the “dawn phenomenon.” The dawn phenomenon occurs in the early hours of the morning when hormones in the body signal the liver to make glucose, providing the body with the energy it needs to wake up. This could cause high blood sugar levels that are difficult to manage first thing in the morning. Signs you may be experiencing hyperglycemia in the night include frequent urination, excessive thirst, blurred vision, and shortness of breath.

If you’re experiencing any of the symptoms of nocturnal hypoglycemia or hyperglycemia, consult with your healthcare team.

Managing Morning Fatigue

For someone living with diabetes, fatigue can strike at uncertain times, but feeling worn down first thing in the morning may be discouraging. Luckily, there are effective ways to manage diabetes proactively to prevent diabetes fatigue in the morning.

1. Check Blood Sugar Levels Right Before Bed

Checking levels before bed to determine how high or low your blood sugar is before sleeping can help you prevent nocturnal hypoglycemia or hyperglycemia. If your blood sugar levels are high, you may need to avoid snacking in the evening or adjust your mealtime insulin (if that’s a part of your diabetes healthcare plan). If your blood sugar is low, try incorporating a snack of 15 grams of carbs in the evening, such as yogurt or almonds, to raise your levels before you go to sleep. To identify the methods that work best for you, also check your blood sugar first thing in the morning.

Pairing this routine with an accurate blood glucose monitor can simplify it. The POGO Automatic® Monitor is the first FDA-cleared, all-in-one blood glucose monitor with 10-test cartridge technology that allows users to lance and collect blood in one simple step. Results are available in seconds, so you can go back to sleep quickly and with peace of mind.

2. Stay Clear of High-Carb Meals and Snacks Late in the Evening

A nutritious diet and regular exercise can help keep blood sugar levels in your target range. While it isn’t possible to eat healthy all the time, meals higher in carbs may be what is causing your fatigue the following morning. Avoid eating dinner too late in the evening to prevent levels from entering an unsafe range right before bedtime. It’s also important never to skip dinner. Eating regularly throughout the day can contribute to steady blood sugar levels, preventing spikes that could threaten your health.

3. Avoid Alcohol Consumption Before Bed 

Consuming alcohol in the evening may also contribute to fluctuating blood sugar levels, as many alcoholic beverages have hidden carbohydrates. But more importantly, alcohol can affect the liver’s ability to release glucose into the bloodstream, preventing levels from reaching the target range. Because alcohol consumption can affect your blood sugar levels for up to 24 hours, your healthcare team may recommend that you check your blood sugar levels more often than you usually do the day you drink as well as the next day.

4. Check Blood Sugar Levels in the Middle of the Night 

Many people living with diabetes don’t require middle-of-the-night blood sugar checks; however, if you constantly feel fatigued in the morning, they may be worth trying. This tip may be most beneficial for those requiring insulin because inconsistent levels throughout the night may be a result of an insufficient insulin regimen.

Checking blood sugar levels in the middle of the night may seem inconvenient, but the Patterns® for POGO Automatic app makes keeping a record of nighttime checks fast and easy. Patterns is a free app that comes with the POGO Automatic that syncs data from your POGO Automatic monitor. You can easily track your blood glucose results from POGO Automatic on your iOS- or Android-based device right from your bed; once you quickly test your blood sugar, you can go back to sleep and review your results on the app the next day to determine what you need.

5. Adjust Your Diabetes Treatment Plan

For many people living with diabetes, poor insulin management is a primary cause of fluctuating blood sugar levels. If you feel unusually tired each morning, speak with your healthcare team about adjusting your insulin routine. Additionally, certain medications may cause fatigue as a side effect. Lastly, work with your healthcare team to adjust your meal plan if you think certain ingredients are now affecting your blood sugar levels. Our bodies are constantly changing and may require these kinds of adjustments to function at their best.

Fatigue affects those living with type 1 and type 2 diabetes. Analyzing your diabetes plan with your healthcare team and consistently checking blood sugar levels can help you identify trends to better manage diabetes fatigue in the morning.

Jaclyn Owens Jaclyn Owens is a product director specializing in diabetes management tools. She is committed to using technology to empower people with diabetes and help them take control of their health.

All content on this website is for educational purposes only and does not replace the guidance of your healthcare practitioner. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new healthcare regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

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