Why Oh Why Does My Blood Sugar Go So High (after fasting all night)?


Here are the top 3 possible causes:

  1. Maybe you had a really big dinner with saturated fat that delayed sugar release into the blood and the saturated fat created some insulin resistance, leading to higher morning readings….think pizza or Chinese food.
  2. You had a super healthy dinner, but your blood sugar went from 110 before bed to 150 when you woke up!  It could be your liver dumped a little sugar into your blood overnight and then when your “wake up” hormones started getting active around 4am, they blocked your insulin from working as well and you see a higher blood sugar than when you went to bed – aka Dawn Phenomenon.  Type 2 diabetes solution: take your Metformin dose in evening, (or all of it in the evening if it’s Metformin extended release), avoid snacking before bed (too much food and not a lot of movement can cause high blood sugars) OR weirdly enough, try a very small snack before you go to sleep (sometimes a little snack can stop your liver from dumping sugar into your blood)….keyword SMALL,  and last but not least, exercise is always a winner.  Exercise can affect blood sugar for days.  Type 1 diabetes solution: adjust your basal rate if you’re on a pump a couple hours before the elevated reading occurs(maybe 3am or so), or if you are on a fixed basal insulin, you may need to increase your basal insulin amount or take your dose in the evening instead of morning (as the dose could be wearing off), consider switching to a newer longer acting basal insulin. If you are on insulin, do you snack before bed to prevent lows?  If so, the snack could be too large and cause your blood sugar to be too high in the morning, so either cut back on the snack or consider covering part of it with insulin.  Better to lower insulin than to feed your body for insulin that you don’t need.
  3. Maybe you use insulin and you had a little too much on board over night, your sugar may have dropped too low and then rebounded from a surge of hormones….this is called the Somogyi Effect. It is a less common occurrence and tends to happen more in people with Type 1 diabetes.  A continuous glucose monitor can help here or waking up and doing a fingerstick for a couple nights to see if you catch any low blood sugars. Another big sign of Somogyi is if you wake up and can tell you were sweating a bit more than usual (for no apparent reason), signifying a possible low blood sugar reaction overnight.                                                                                                                                         Troubleshooting unexplained highs or lows can be very frustrating.  Partner up with you diabetes educator and start an investigation!  If you have any questions, please shoot me an email.

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Even though diabetes is present in your life, there is hope. Hope that harmony between you and diabetes can be attained.

Angela Manderfeld, RD

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