November 10, 2013

Causes of Morning Highs

Do you have morning highs? I used to, but once I got my insulin adjusted, I have been able to get back to readings between 78 to 105 mg/dl. I would never accept morning blood glucose levels up to 130 mg/dl. Granted your levels may be different and if you are comfortable with them, then good.

There can be many reasons for having high blood glucose levels in the morning and some of them are:

#1. The dawn phenomenon that results from your liver dumping blood glucose into your system to assist in waking up.

#2. Eating the evening meal late with too many carbohydrates.

#3. Having a snack before bed that was larger in carbohydrates than normal.

#4. Having too low a dose of medication for the evening meal.

These and other factors can cause an increase in morning blood glucose levels. This should cause you to talk about this with your doctor to see what may be possible. The following are some points to discuss with your doctor.

#1. Often an adjustment in medication dosage will be sufficient, but not always.

#2. Sometimes a change in medications will be necessary.

#3. A change in lifestyle habits may sometimes be all that is needed.

#4. Even a change in sleep habits and getting the proper length of sleep might be the answer.

The above is for people on oral diabetes medications. While some of the above points will work for people taking insulin, here are some points to discuss with your doctor if you are on insulin.

Note:  This is where the saying "what works for you, may not work for me" is important to remember.  According to the "experts", people on insulin should not have the dawn phenomenon.  Why I need to be the exception is no longer puzzling and I have adapted.

#1. If you are on long acting insulin (generally Lantus or Levemir), discuss splitting the dosage into two parts, 12 hours apart. Some people will benefit from this as I have, while others that get the full 24 hours of benefit and not the 18 to 20 hours some of us receive, will have no problems.

#2. If on insulin, the bedtime snack should not be necessary and this needs to be discussed with your doctor.

#3. Do not let the doctor ignore your desire to have the correct blood glucose readings in the morning. Sometimes more medication may be the only answer.

This blog by Joslin may also give you more ideas.

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