In this health presentation Dr. Priti Nanda Sibal explains why many diabetics experience elevated fasting blood glucose that drops after breakfast. She distinguishes two physiological phenomena: the Somogyi effect—nocturnal hypoglycemia around 2‑3 am that triggers a rebound glucose surge from the liver, and the Dawn effect—morning hormonal surges (cortisol, growth hormone) combined with insulin resistance that raise glucose without a prior low. She outlines a simple diagnostic test (checking glucose at 3 am) to differentiate the two. Based on the diagnosis, she recommends tailored lifestyle interventions: for Somogyi, a low‑carbohydrate, high‑fat dinner (e.g., coconut oil, nut butter) to prevent overnight lows; for Dawn, the same dinner plus stress reduction, adequate quality sleep, and addressing sleep apnea. She emphasizes the central role of liver health (fatty liver worsens glucose release), hormonal balance, and the timing/composition of dinner. A practical tip is to cool boiled potatoes for 12 hours to create resistant starch that moderates post‑prandial glucose and supports gut microbiome. Throughout, she encourages patients to share experiences on social media and highlights that correcting sleep and liver issues can dramatically improve glucose control and weight loss.
Chapters
Good morning. So today we are going to talk about high fasting sugar levels. You all know that a lot of you, when you check your fasting blood sugar, or the diabetics, you know, you will see that their fasting blood sugar comes high and it becomes low after they have taken their breakfast. Why does this happen, right? Because when I run these diabetic group coaching programs, what I have seen is this is something which puts people into stress, and rightfully so, because we don't know why this happens. Throughout our lifetime, since we realized what diabetes is and what sugar levels are, we have been told that fasting blood sugar is something we need to measure. and that is something which should be at its lowest. So let's look at what happens when fasting blood sugar is high and sugar post-breakfast or few hours after getting up becomes low. There are two basic effects which work in our body in such cases. First is samoglioi effect. What does samoglioi effect mean? So Mogi effect means that your blood sugar levels around 2 AM, 3 AM dips low, which means that you have an episode of hypoglycemia. Now we all know this human body is phenomenal. Every time I understand this body a little more, I fall in love with this body a little more. Now what happens here is when at 3 AM the sugar levels go down, the body's own homeostasis mechanism gets activated and liver releases lot of glucose in the bloodstream. Now this glucose, the body is not able to settle till the morning time. Why? Because generally diabetics tend to have fatty liver or they have insulin resistance, which means their body is not responding to insulin properly. The second thing which happens with people who have high fasting blood sugar levels is dawn effect. We know what is dawn— the time between the night sets and the sun rises, right? And that is the reason it's been given dawn effect, because here we do not say that you have had an episode of hypoglycemia. What we say is that in the morning, because of some problem in your liver and insulin resistance, and the hormones which get released in the morning, especially cortisol and growth hormone, which affect insulin levels, the sugar levels go out of balance and our sugar levels go higher. So friends, how can we differentiate between these two, especially in cases in children in type 1 diabetics when Children have high fasting blood sugar, or type 2 diabetics who have been diabetic for many years have high Biscayne. So we must also consider here that this tells us that there has been a progression of disease called diabetes, right? To differentiate between these two, we do one test. We check our sugar levels at 3 AM. If our sugar levels at 3 AM are low, then we know it is Samogi effect. But if our sugar levels at 3 AM are not low, then we know that high fasting sugar is because of Dawn effect. Why is it important that we know what is causing this? Simple. Why we must know it? Because the way to treat or correct it becomes different. And I am sure when we will talk about it, you'll say, wow, that's impressive. Somogyi effect means hypoglycemia. We all know, anybody who's a diabetic or anybody who knows a diabetic knows that somogyi effect or hypoglycemia episodes are more risky than hyperglycemic episodes. Those can lead us to coma also, right? So if this is coming low, what we will do? For our dinner, we will change our dinner foods to something which maintains our sugar levels for a longer time. That means we will not have carbohydrates in dinner. Something like coconut oil, something like apple with lots of peanut butter or almond butter or macadamia butter helps us manage these levels better. Now for Dawn's effect, what should we be doing? Dawn's effect again, of course, we should have low carbohydrate dinner, but very important is that we work on our stress levels. We sleep properly for 6 to 8 hours. Deep quality sleep is very critical, and you know, all the studies have shown that sleep is an important parameter when we want to balance diabetes, diabetic sugar levels. Unfortunately, in allopathy we are not talking about it, but in my separate video I will share with you that in my diabetes group program we measured the quality of sleep of these patients and we found that about 80%+ patients had sleep problems. And unless you correct those, you cannot correct sugar levels or You know, you would also see, and in my practice I see this very often, that some patients come to me who are not able to lose weight or sugar levels are not getting in control. And they are eating right, they're taking their medicines, everything is being done. But what they are ignoring is their sleep. So let me share a study of a 62-year-old female patient who came to me. She had the same history. She was on medications, she was taking a very good modified ketogenic diet and was exercising, but her sugar levels and her weight around her tummy was not going away. And what did I diagnose? I know you know it. I found that she was a sleep apnea patient, and the moment we started working on sleep apnea and insulin resistance together, She started seeing miracles in her life. So very important that we must know that if a patient like this comes, or a patient who's not getting benefit from lifestyle changes comes to you. Now friends, let's see, once we have diagnosed it, let's see what all plays a role which I have mentioned here, but let me share that with you in more detail. There are 3 things which is very important for us to know when we are looking at patients of high fasting blood sugar levels, right? First is liver. We all must always remember that any diabetic patient would have a compromised functioning of the liver. In fact, I tell patients in my practice that fatty liver is a clear indication that you are on your way to diabetes. But the good news here is fatty liver can be reversed, and everybody who has fatty liver or any compromised liver functioning should work on that before the patient becomes diabetic. Why? Because liver is the organ which stores glucose, right? And when the messaging goes to the body that release insulin, we need glucose, this is where the glucose gets released. Now if you have fatty liver or you have insulin resistance, what happens is liver does not get to know how much glucose it needs to release. and that is when sugar levels become high, which the body takes longer time to clarify and settle, right? Second, when you see a patient of high fasting blood sugar or you yourself have high fasting blood sugar, you need to remember that hormones play a role. Two hormones which are very, very critical here are Cortisol and growth hormone, right? You know that with circadian rhythm, after the sun rises, 1 to 2 hours later, cortisol is at its highest level. Cortisol and insulin are in triad. More the cortisol, more the insulin, and therefore it needs to work properly for our sugar levels to be normal. So for an individual where liver is not compromised, insulin resistance is not there, the body is able to manage that balance. But in patients where one of that is not working properly, it leads to hormonal imbalance and which leads to high fasting blood sugar. Perfect. And then comes dinner. Friends, on one side, we need to remember that 12 hours of our sleeping time is good enough time for our body to digest any food we eat. But what happens when we eat a high carbohydrate food is that the insulin glucose peaks and then it falls down, and chances of getting into hypoglycemia and all increase, right? So having a dinner which is high in fat, normal in protein, and almost no carbohydrates is a great idea for people who have high fasting sugars. And I have, as I've already mentioned, that, you know, foods like chicken and meats and lots of vegetables which are low-starchy vegetables with good amount of fat are critical here. One tip before, you know, I end this is starch changes its way and form depending on the way we cook it or store it. So such patients, what they can try is they can boil a potato and keep it in the fridge for 12 hours. This leads to change in the form of starch, which does not increase your sugar levels highly, but it works on your gut microbiome and strengthens itself. And also what it does is it helps you get balanced sugar levels in the morning. Do follow this tip and do ask your questions if you have any on this topic. If you know somebody who has high fasting blood sugar and is struggling to settle it up, please post your selfie on my Facebook where we will share this video link, or on my Insta and hashtag #highfastingbloodsugar. See you guys. Thank you.
