Monday, Jan 30, 2023

Why diabetics are at risk of increased blood sugar levels in the morning

Diabetics should be extra careful during the morning hours as cortisol - a hormone responsible for maintaining glucose levels in the blood - peaks between 6 am to 10 am

diabetesIt has a direct impact on diabetics as elevated cortisol levels can increase insulin resistance. (Source: Getty Images/Thinkstock)

We have previously reported how one is more susceptible to cardiac arrests and heart attacks early in the morning due to the release of the cytokinin hormone. Turns out, diabetics, too, should be extra careful during the morning hours as cortisol — a hormone responsible for maintaining glucose levels in the blood — peaks between 6 am to 10 am. “The stress level is correlated with cortisol hormone, and this hormone is highest during the morning hours. It gradually goes down as the day progresses, and is at its lowest by midnight,” Dr Shyam Sundar C M, Consultant Endocrinology and Diabetology, Sparsh Hospital said.

Agreeing, Dr Manira Dhasmana, Associate Consultant, Internal Medicine, Max Super Specialty Hospital, Dehradun added that the cortisol levels remain the highest immediately or during the first hour after waking up. “In patients who are already stressed, morning cortisol levels are at peak. This has also been studied as Cortisol Awakening Response (CAR),” he said.

Why does it happen?

“Due to prolonged overnight fasting, the glucose levels go down in the morning hours. To maintain that, three hormones — glucagon, epinephrine, and cortisol — act as counter regulators. But, cortisol is a stress hormone; it increases as a response to prevent a person from developing low blood sugar levels during the fasting time in the early morning hours, “Dr Shyam said

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Not just that, cortisol levels increase in the morning due to stressful lives, too. “Busy work schedule, deadlines, EMI, loans, managing work-life balance along with other responsibilities make us stressed. So in the morning, our body releases a stress hormone which typically gives you a feeling of dreadfulness, emptiness etc. For this reason, patients are always advised never to go to bed worrying,” Dr Dhasmana said.

While the cortisol levels usually remain low during midnight, they tend to remain high in the case of night shift workers. “This affects the circadian rhythm of the cortisol and it chronically increases which, further, worsens glucose control,” Dr Shyam said.

How does it affect diabetics?

It has a direct impact on diabetics as elevated cortisol levels can increase insulin resistance. “Higher levels of stress hormones can interrupt the insulin-producing cells in the pancreas from working properly and even reduce the amount of insulin they make, which contributes to the development of type 2 diabetes,” Dr Aishwarya Krishnamurthy, Consultant, Endocrinology and Diabetes, Max Hospital, Vaishali said.

Relaxing and Meditating can help relieve pressure and stress (Source: Getty Images/Thinkstock)

Agreeing, Dr Shyam elucidated that high cortisol levels impair insulin functioning, increasing its resistance. “Thereby, it precipitates diabetes mellitus or worsens the glucose control in existing diabetes patients,” he said.


Another factor affecting the two is overeating, Dr Krishnamurthy added. “Some people tend to overeat when stressed which can lead to the development of type 2 diabetes and weight gain.”

Other health impacts

Not just diabetics, these increased stress hormones can affect others, too. “Early morning stress also causes high blood pressure, anxiety, heart attack (very common early morning), and brain stroke. It also aggravates conditions like irritable bowel syndrome, chronic body pain, depression, and lung diseases,” Dr Jayanta Thakuria, Associate Director – Internal Medicine and Rheumatology, Accord Super Speciality Hospital, Faridabad said.

Further, it also leads to mental health problems such as depression and disruption of one’s sleep cycle, Dr Dhasmana added.

What can you do?


Diabetics and other patients can prevent early morning stress levels by following these measures, as suggested by Dr Thakuria.

*Practise early morning exercise and yoga
*Consume healthy foods with lots of antioxidants
*Taking medications on time
*Ensure proper sleep
*Avoid drinking alcohol, smoking and other addictions

Sharing the benefits of meditating in the morning, Dr Krishnamurthy said, “Meditating can help put the mind at peace. In this fast-paced world, we sometimes forget to sit back and relax. Relaxing and meditating can help relieve pressure and stress.” She added that one set realistic goals and expectations as overly pressuring oneself can lead to a lot of stress.

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First published on: 17-11-2022 at 10:00 IST
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