The Overnight Blood Sugar Conundrum
How do I stay in range while sleeping?
In the past week, Ive seen these two 24-hour CGM traces:
Its amazing that the same overnight insulin dose produced those two markedly different midnight-to-9am glucose outcomes .
The example on the right, I believe, was caused by: a big late-night dinner after barely eating all day, and changing my pumps infusion set and reservoir right before bed, without confirming a few hours later that it was working properly.
Whatever the cause, I woke up at 7:50 am on Tuesday at 262 mg/dl exhausted, frustrated, and late for a team event. I changed my pump site quickly, took a huge six-unit insulin bolus, and decided at the last minute to ride my bike 4.5 miles to the event.
Halfway down the steep hill from my house, I had that sinking feeling: Gah! I should go back home and get glucose tabs, just in case. I cycled back, grabbed the tabs, and then my prediction turned out to be correct 15 minutes later halfway to the event, my glucose was dropping faster than Id ever seen in my life. I ate three tabs as a buffer and luckily avoided going low.
Overnight BGs in a tight, safe range : early dinner, no snacking, disciplined bedtime corrections
When I have a Bright Spot night of BGs , there are usually some key enablers:
Use automated insulin delivery overnight, if its accessible to you . These systems are outstanding overnight almost every morning while wearing one, most people wake up around 90-120 mg/dl.
Evening Meals With Fat And Carbohydrates
Meals full of both fat and carbohydrates may require a longer time for digestion, resulting in higher glucose readings several hours after eating.
One study with young, healthy participants showed that eating a late dinner composed of 50% carbs, 35% fat, and 35% of total daily calories caused a prolonged glucose intolerance and reduced fatty acid oxidation< sup> 2< /sup> during sleepâparticularly in those who hit the hay earlierâand an increase in cortisol. Researchers hypothesized that these same metabolic reactions could contribute to obesity if repeated consistently.
Diagnosing And Treating Hyperglycemia
Diagnosing hyperglycemia is done by assessing symptoms and performing a simple blood glucose test. Depending on the severity of the condition and which type of diabetes the patient is diagnosed with, insulin and a variety of medication may be prescribed to help the person keep their blood sugar under control. Insulin comes in short, long and fast-acting forms, and a person suffering from type 1 diabetes is likely to be prescribed some combination of these.
Individuals who are either diagnosed with type 2 diabetes or are considered at risk for the disease are recommended to make alterations to their diet, lifestyle habits and exercise routine in order to lower blood sugar and keep it under control. These changes generally help to improve blood glucose control, individuals with type 2 diabetes may require medication eventually. These can include glitazones, acarbose, glucophage or sulphonylureas.
Don’t Miss: What Does Diabetic Retinopathy Feel Like
Blood Sugar Higher In The Morning Here’s Why
Everyone wants a perfect start to their days. Most people have a preferred morning routine that they like to follow. Many people also like to have certain boundaries in the morning that they would like people to respect. Some people start their mornings with a workout, others like to drink coffee or tea, some like to have some quiet me time, some scroll through social media on their beds, etc. All of these routines are subject to the fact that there are no unprecedented variables that might affect these plans impromptu. This luxury, however, is not something a person with diabetes can afford every single morning. This means that the first thing a person living with diabetes would have to do would be to think about and check their blood sugars in the morning.
A person with diabetes, too, would like a perfect start to their days. However, contrarily and very often, if they see a fasting blood sugar high, they would have to begin their routine by correcting that before anything else. Since mornings can set the tone for the day, whether it comes to routine, mood, or even sugar level, you would want to put in enough effort to reduce the morning blood sugars down to an acceptable level to have a good rest of the day.
Is 200 Blood Sugar Normal After Eating
Irrespective of what you had for your meal, a blood sugar level of 200 mg/dL or more highlights diabetes. Since the body takes time to process the food you had, you should always take your blood sugar readings after two hours of having a meal. It will give you a relatively accurate reading of your blood glucose levels.
Read Also: Best Blood Glucose Monitor 2021
Why Blood Sugar Levels Rise Overnight
When you go to bed, your blood sugar reading is 110, but when you wake up in the morning, it has shot up to 150. Why does this happen?
To understand how blood sugar levels can rise overnight without your eating anything, we have to look at where glucose comes from and where it goes while we sleep.
During the day, the carbohydrates we eat are digested into glucose and absorbed into the bloodstream. Some of this glucose goes to the liver, where it is stored for later use.
At night, while we are asleep, the liver releases glucose into the bloodstream. The liver acts as our glucose warehouse and keeps us supplied until we eat breakfast. The amount of glucose being used is matched by the amount of glucose being released by the liver, so blood sugar levels should remain constant.
Dont Miss: What Vitamin Deficiency Causes Sugar Cravings
How To Prevent Morning Hyperglycemia
While morning hyperglycemia could be the bodys automatic response, you can certainly take steps to try to prevent it.
General steps
You could try some general steps that could help lower blood sugar in the night, such as eating your evening meals earlier in the day or having fewer carbs in your evening meal.
Alternatively, you could consider doing exercise in the evening, such as a brisk walk before bed. You might also consider changing your medication doses for the night or changing the type of insulin you use. As always, make such changes in consultation with your healthcare professional.
Dawn phenomenon
If you think that the high blood sugar might be caused by the dawn phenomenon, then try to make sure that you are well-rested. If your body is getting enough rest, with a full eight hours of sleep, then it might not think that it needs to release that extra energy. More generally, stress and diabetes leads to higher blood sugar levels so it is worth getting enough sleep.
Somogyi phenomenon
With the Somogyi phenomenon, youll want to take the opposite steps because you want to prevent low blood sugar during the night. It may seem somewhat counterintuitive, but you might need to take less insulin, or eat more carbs, or do less exercise before bed.
Also Check: Healthy Diet To Lose Weight For Diabetics
Why Is My Blood Sugar High In The Morning But Normal All
Modified: Apr 22, 2022 by John Coleman · This post may contain affiliate links ·
Elevated blood sugar, or abnormal blood glucose, is a health-threatening condition requiring steps. It is an alarm from the body that should not be ignored. Hyperglycemia can be lowered through proper diet and physical activity in many cases.
Contents
Diabetes is a disease characterized by elevated glucose levels in the blood, or what is called hyperglycemia. There are different types of diabetes:
Type 1 – insulin-dependent diabetes is an autoimmune disease that develops due to a lack of insulin, which occurs because of damage to the pancreatic islets.
Type 2 – insulin-dependent diabetes is characterized by high blood sugar levels, insulin resistance, and relative insulin deficiency.
There is a reason why fasting blood glucose targets are the most stringent – we should wake up with sugar between 70-110 mg/dl. Upon waking up too high, a blood sugar level can effectively spoil our mood because it makes it challenging to maintain normoglycemia during the day. Still, above all, it is awful for health.
What Does Insulin Do
alternative agents if possible.
The pancreas releases insulin into the blood, based upon the blood sugar level.
It s extremely important to work with your diabetes care team to develop an individualized hyperglycemia action plan for you.
Four were outside the borders of the mRNA transcript of the gene all of the others Is Blood Sugar Of 135 High For The Morning were found in a large intron between exons 2 and 3.
This will Normal Blood Sugar Level assist .
Recommended Reading: Simple Diabetic Diet Meal Plan
Why Does Blood Sugar Go Up At Night
There are many factors that can cause your blood sugar to increase at night. For example: what food you ate during the day, how much and when you exercised, whether you ate snacks before bed, the timing of your insulin doses, and your stress level. You can experience different patterns of high blood sugar at night. You may start with high glucose when you go to bed, start the night in range but go high several hours later, or spend most of the night in range until the hours just before you wake up. By identifying your bodys patterns, you can figure out what is causing your high blood sugar and how to address it.
Common causes of a glucose increase at night include:
How To Lower Morning Blood Sugar
Trying to learn how to lower morning blood sugar? Heres why your glucose levels rise in the morning and a few things you can try to keep them in range.
Waking up with high glucose levels may feel like it doesn’t make sense. You spend several hours asleep, not consuming any carbs, and yet somehow your glucose levels are still high when you wake up in the morning.
Why does this happen? What can you do to make sure your glucose levels are safely in range in the morning? Learn more about some tips on avoiding high morning blood sugar levels so you can start your day off right.
Also Check: How To Lower Glucose In Blood
How Soon After Waking Up Should You Test My Blood Sugar
Since people can now check their blood sugar levels at home, doctors generally recommend fasting blood sugar test almost immediately after waking up. An empty stomach is generally the best time to test blood sugar in the morning. You should get the reading done when you havent had breakfast or any morning drink.
Why Is Blood Sugar High In The Morning
According to the American Diabetes Association, fasting blood sugar should be between 70-130 mg/dL, while the American College of Endocrinologists recommends a fasting blood sugar below 110 mg/dL. If blood sugar is higher than this range, it could be due to several different causes.
Insulin resistance: One of the most common causes of type 2 diabetes is insulin resistance. Insulin resistance occurs when the cells dont respond well to insulin, causing the pancreas to release more insulin to try to compensate. Over time, this can cause the pancreas to lose some of its functioning and lead to insulin deficiency.
Some of the possible symptoms of insulin resistance include:
- Waistline over 40 inches in men and 35 inches in women
- Blood pressure 130/80 or higher
- Fasting glucose over 100 mg/dL
- Fasting triglycerides over 150 mg/dL
- HDL cholesterol under 40 mg/dL in men and 50 mg/dL in women
- Patches of dark, velvety skin called acanthosis nigricans
Certain genetic and lifestyle factors are associated with insulin resistance. Some of these risk factors include:
- Sedentary lifestyle
Not enough insulin. In people who take insulin for diabetes, such as those with type 1 diabetes, high blood sugar in the morning before breakfast is likely a sign that they arent receiving enough basal insulin. It can also be a sign that the dosages of other types of diabetes medications need to be increased.
Don’t Miss: What Is Basal Bolus Insulin
A1c Goals Should Be Individualized
A1c goals should be individualized based on the individual capabilities, risks, and prior experiences, explains Gary Scheiner, MS, CDE, founder of Integrated Diabetes, and author of Think Like a Pancreas.
For example, we generally aim for very tight A1c levels during pregnancy and more conservative targets in young children and the elderly.
However, Scheiner highlights important factors that could justify aiming for a higher A1c, like hypoglycemia unawareness, which is described as when a person with diabetes no longer feels the oncoming warning signs of low blood sugar. This can put you at significant risk for severe low blood sugars resulting in seizures or death. To reduce that risk, you would aim for higher target blood sugar ranges.
Someone with significant hypoglycemia unawareness and a history of severe lows should target higher blood glucose levels than someone who can detect and manage their lows more effectively, adds Scheiner. And certainly, someone who has been running A1cs in double digits for quite some time should not be targeting an A1c of 6% better to set modest, realistic, achievable goals.
Keep A Consistent Exercise Routine
The best exercise is the one you do regularly. Donât let the âperfectâ become the enemy of âgood enoughâ. It is far better to consistently walk 15 minutes a day or strength train three times per week than it is to grind out a marathon-like workout once every 3 or 4 months when the motivation strikes.
Find a movement practice that you love doing and make it a non-negotiable part of your life. Leverage the insights from behavioral science to design your environment for success.
Recommended Reading: Type 1 Diabetes Natural Supplements
How Do I Pick A Glucose Meter
Your doctor will make a recommendation. Check with your health insurance plan to see if it will pay for your BGM, its supplies, or a CGM. If so, your plan may only pay for a certain meter.
Shop around and compare costs. Consider what features are important to you. For example, some meters are made for people who have poor eyesight. If you want to pay a little more money, you can get a BGM that stores the results in its memory. This allows you to compare results from several days at one time.
Recommended Reading: Is 104 Blood Sugar Normal
Avoid Food At Least 3 Hours Before Bed
Food too close to bedtime causes us to metabolize food poorly while we are sleeping, which can lead to higher glucose values the next morning. Eating earlier, however, allows you to take advantage of higher insulin sensitivity and gives adequate time for the parasympathetic nervous system to begin the process of digestion.
The remedy is simple: try to finish eating all food for the day at least 3 hours before you go to bed. Ideally, this would also include beverages that contain non-caloric sweeteners since they appear to have metabolic effects in the body.
Also Check: Can Low Blood Sugar Cause Diabetes
What Causes High Blood Sugar At Night
Hyperglycemia, the technical term for elevated blood sugar, occurs when glucose levels are greater than 180 mg/dL.
For people without diabetes,average blood sugar ranges are:
- Fasting glucose: < 100 mg/dL or 5.6 mmol/L
- Glucose range before eating: 80â130 mg/dL or 4.4â7.2 mmol/L
- Glucose range 1â2 hours after eating: < 140 mg/dL or 7.8 mmol/L
For people with diabetes, average blood sugar ranges are:
- Fasting glucose: 126 mg/dL or higher
- Glucose range before eating: 80â130 mg/dL
- Glucose range 1â2 hours after eating: < 180 mg/dL
If your blood sugar readings at bedtime are higher than your goal, consider whether one or more of the following factors could be the cause.
Why Is My Blood Glucose So High When I Wake Up
It doesn’t seem fair, does it? You haven’t eaten anything all night and you still wake up with high blood glucose! What is going on? For those of you with diabetes, this post tells you how to lower morning blood sugar.
It doesn’t seem fair, does it? You haven’t eaten anything all night and you still wake up with high blood glucose! What is going on? For those of you with diabetes, this post tells you how to lower morning blood sugar.
Also Check: What Are High Blood Glucose Levels
Low Sugar Levels Range In Adults
Summary
High blood sugar range is between 180 to 250 mg/dL, while below 70 mg/dl is low. Above 250 mg/dL and under 50 mg/dL requires immediate medical attention.
Why Is Blood Sugar High In Morning
The dawn phenomenon
In the early hours of the morning, hormones, including cortisol and growth hormone, signal the liver to boost the production of glucose, which provides energy that helps you wake up. This triggers beta cells in the pancreas to release insulin in order to keep blood glucose levels in check.
Recommended Reading: How To Dispose Of Diabetic Pen Needles
Oral Glucose Tolerance Test
The OGTT takes a little more time than the other two glucose tests for diabetes. In this test, a healthcare professional draws your blood once after an overnight fast and again 2 hours after you drink a sugary beverage.
Its normal for your blood sugar to rise after you consume the drink. However, normal blood sugar falls to below 140 mg/dL within 2 hours.
If your blood sugar level is 140 to 199 mg/dL, a doctor will diagnose prediabetes. A level of 200 mg/dL or higher indicates type 2 diabetes.
| Result |
|---|
Its important to consume healthy fats each day as well.
Using the information from your food log, you can start to make small changes. The goal is to choose more minimally processed whole foods instead of highly processed foods that contain added sugar, little fiber, and unhealthy fats.
For example, if youre not eating the recommended servings of vegetables, try adding one serving of vegetables per day to your diet.
You can do this by having a salad with lunch or dinner or snacking on carrot sticks. Just be careful with add-ons such as salad dressings or dips, which can add unhealthy fats or extra calories. Check out these 8 healthy salad dressing recipes.
Its also important to work on choosing nutrient-dense foods instead of foods high in empty calories, as well as switching out simple carbohydrate foods for complex carbohydrates. Here are some examples of substitutions you can try:
of exercise 5 days per week.