Question for luvdadus

As an internist, could you give me a brief explanation for morning blood sugar spikes?

My morning sugar levels run about 140, and it does not matter if I fast the night before or eat a small bedtime meal.

I’ve tried all sorts of methods to regulate the problem, but still come up with the morning levels higher.

My afternoon levels are pretty consistant at 115.

(last A1c test was 6.7)

I would really have to know much more about the details of your diet, insulin/drug doses, exercise (not pe), sleep and on and on to give you any accurate answer. One thing that comes to mind however (and this is not to say that this is your case) is nocturnal hepatic gluconeogenesis. Do you have high protien meals at night?

Let’s see if I remember the doses….

1500 mg glucophage-1 in morning, 2 @ night

5 mg glyburide @ night.

30 minutes of “power walking” 5 days a week

usually eat a high protein late night meal-piece of broiled chicken, turkey etc.

I usually get 6 hours of sleep a night-no matter how much I try to sleep longer, I wake up every morning at 4:30.

I assume that the glucophage is 500 mg each so your total dose is 1500mg/day. You may want to ask your Dr (assuming it was he that suggested the high protien meal at night) if you should change that to something lower in protien (perhaps a bowl of cereal). Over all it looks like your control is meeting ADA standards (A1c less than 7.0).

I can sure ask……The thing that I could not understad is why it was high-fasting or not.

Thanks for your thoughts!!!!!

The liver has the ability to transform amino acids (protien building blocks) to glucose. At night, especially when abundant protien is available, the liver is able to produce extra glucose via this mechanism (gluconeogenesis) which may overide medications and endogenous insulin’s ability to keep the number within normal range. Overall you seem to have good glycemic control and there may be a reason that your MD may want you have the protien at night so that is why I say to check with him if that type of night meal was specifically suggested.

I will do just that-I appreciate your help!
(Because of the HMO heirachy its hard to get to the right guy….such is the future of socialized medicine)

Thanks again!