Diabetic Living - Fall 2010

Your actions can make up for the hormonal imbalance of type 2 diabetes and give you better morning numbers.

220 pounds, has focused on not gaining weight—a realistic goal. For people who have had type 2 diabetes for many years, losing weight alone is unlikely to correct fasting highs— medications are needed.

Nibble a bit before bed. A small bedtime snack containing no more than 20 grams of carbohydrate can help you wake up with better fasting blood glucose, Monk says. A bedtime snack shortens the time span that the liver is in overdrive producing glucose. Pete says this has been one of several fasting fixes that work for him.

Get physical. No matter what kind of aerobic activity you do or what time of day you do it, moving more enhances the body’s response to insulin. “Being inactive is bad for us. Some is better than none; more is better than less,” Monk says.

Work with your provider to
mix and match solutions.
Consider the blood glucose numbers
on your meter, your A1C results,
your lifestyle, your schedule, the
medications your health plan covers,
and what you can afford. Use meter
checks and regular A1C results to
assess the solutions you try. Fasting
blood glucose numbers tell you how
you made it through the night.
Checks midway through your sleep
cycle cast light on what’s happening
overnight. Be ready to change your
solutions if you don’t hit your targets
immediately and as your years with
diabetes add up.

Other whys for morning highs

Here are two other situations that may cause high fasting blood glucose levels:

Dawn phenomenon happens as part of the body’s normal circadian rhythm to wake you up and get you going. Hormones, such as growth hormone and cortisol, are released and raise glucose. Without diabetes, the body simply responds to this early morning effect by putting out more of the hormones that keep blood glucose in control. That doesn’t happen when you have type 1 or type 2 diabetes.

Somogyi effect is very high fasting blood glucose thought to be caused by the liver making a lot of excess glucose in response to hypoglycemia (low blood glucose) during the night. Somogyi effect is uncommon in type 2 diabetes. There’s controversy as to whether it even exists with the rapid- and long-acting insulins available today.

Hope Warshaw, R.D., CDE, BC-ADM, coauthored Real Life Guide to Diabetes (American Diabetes Association, 2009) and is a contributing editor to Diabetic Living.