Ask Joslin: Morning Highs

What should I do about morning highs?

The goal for the morning blood glucose is to be less than 130. High blood glucose levels in the morning can be caused by a number of factors, such as not taking enough diabetes medication, too much snacking at night, or eating a supper high in carbohydrates.

In order to figure out what might be causing the problem, it’s important to get some blood glucose readings before and 2 hours after supper. If a person is eating a reasonable amount of carbs and/or is taking the right medicine their blood glucose levels should not rise more than 50 points from the pre-supper reading as compared to the 2 hour post-supper reading. If the post-meal readings are high, it usually indicates more medicine is needed at supper time.

Also it’s a good idea to check the blood glucose before bedtime and then the next morning. Do this several times—a rise in blood glucose numbers overnight without snacking is usually a sign that more medicine is needed either at supper or at bedtime. The reason blood glucose can go up overnight even without food is because during fasting states the liver makes glucose and without enough insulin to help regulate it, the liver does not know when the body needs less glucose to be made.

You want to think of it like a water faucet that leaks. The insulin is what can turn the faucet off and without enough insulin the faucet (liver) continues to leak (not literally of course but figuratively). In this case, more medication is needed to help the liver stop overproducing glucose. Certain diabetes pills can help do this and so can longer acting insulins, such as Lantus, Levemir, or NPH.

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5 Responses to Ask Joslin: Morning Highs

  1. Chris Thompson says:

    Thank you for posting this! My sugar is usually over 200 in the morning when I wake up. I’m going to do the things you suggested and I see an endocrinologist on 11/14. I appreciate this information! :)

  2. Melissa says:

    My 11 year old with type 1 has recently been waking up around 320-360. We test before bed and her numbers are good or we correct then make sure they are but I know they grow mostly at night but this has been going on for weeks we just uped her Basel rates at night and a couple of times she wakes up around 80 so besides us having to test and correct all night what is going on???

    • thomas2002 says:

      there might be many reasons…

      rising after 3:00 -> adrenalin as antiinsulinica

      basal dosent work 24 h/d
      NPH -> maybe 3 injektions insted of 2
      24h-basal -> split into 2 injektions

      btw when had been the last basaltestings?

      etc
      etc
      etc

  3. Frances M Burton says:

    To check pre-supper BG, for how long before supper should I have not had anything to eat? (2-3 hrs?)
    I know the goal 70-130 for Fasting.
    Or does it matter?

  4. malcolm d starling says:

    Thanks I am having trouble with my Blood Sugar I just changed shifts from working Nights and Sleeping Days to working Days and Sleeping Nights,BUT my afternoon B/S is between 80 and 100 and my morning (after sleep) is between 150 and 180.I try checking my B/S before my supper meal and after my supper meal as outlined.
    I take Lantus 42 units at bedtime and take glimepride 2 mg in the mornings..

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