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I have type 2 diabetes and wonder why my blodd glucose levels

 

Customer Question

I have type 2 diabetes and wonder why my blodd glucose levels will rise overnight. I have lost over 50 lbs, am working out and eating better than I have in my life and just don't understand this rise in levels. For ex: last night my blood sugar was 77 at about 9:30 pm and this morning it was 147. I didn't get up and raid the fridge or eat anything after my reading (or for quite a while before the reading)...what's going on!!!! Thanks

 

Optional Information:
Person's Gender: Female
Person's Age: 54.5

Submitted: 332 days and 6 hours ago.
Category: Medical
Value: $75
Status: CLOSED

Accepted Answer

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Expert:  On Call MD replied 332 days and 6 hours ago.


On Call MD :

Welcome to Just Answer it is my pleasure to help you

On Call MD :

excellent question

On Call MD :

let me first ask you are you taking insulin?

Customer :

yes, I take lantus. I was on 140 unit and now I'm not sure what my dose will be but I am around 20 units. I also take glipizide and 1 , 1000mg metformin a day.

On Call MD :

ok

On Call MD :

for most diabetic people the most common reason for high blood sugar is inadequete insulin before dinner or bed time

On Call MD :

however there are 2 well known phenomena that would cause the high morning blood sugar

On Call MD :

they are called dawn phenomenon and somogyi phenomenon

On Call MD :

The dawn phenomenon is the end result of a combination of natural body changes that occur during the sleep cycle and can be explained as follows. Between 3:00 a.m. and 8:00 a.m., your body starts to increase the amounts of counter-regulatory hormones (growth hormone, cortisol, and catecholamines). These hormones work against insulin's action to drop blood sugars. The increased release of these hormones, at a time when bedtime insulin is wearing out, results in an increase in blood sugars. These combined events cause your body's blood sugar levels to rise in the morning.

On Call MD :

while somogyi phenomenon is a pattern of high morning sugars preceded by an episode of hypoglycemia (with no symptoms). Your blood sugar may drop too low in the middle of the night, so your body counters by releasing hormones to raise the sugar levels. This could happen if you took too much insulin earlier or if you did not have enough of a bedtime snack.

On Call MD :

that would explain why you have high blood sugar in AM

On Call MD :

to know exactly which one is causing that you may check your blood sugar between 2-3 am for several nights

On Call MD :

if low then usually somogyi is the cause

On Call MD :

if normal then dawn phenomenon would be the cause

On Call MD :

I hope i was able to answer your question

On Call MD :

if you need more clarifications or have any other questions please ask

On Call MD :

Unless you have other questions please press ACCEPT if satisfied so I would get compensated for my time and answer

Expert TypeMD
Category: Medical
Pos. Feedback: 89.4 %
Accepts: 664
Answered: 5/12/2012

Experience: US Board Certified Physician

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