We received many questions about why blood glucose goes up during the night.  Here was Dr. Jackson’s response:

“Your body never wants to run out of its main fuel, which is the glucose in your blood. So even when you aren’t eating, your liver keeps the glucose above 70 mg/dl by releasing glucose it has stored. Glucagon is the main hormone that controls this release, along with insulin. In type 2 diabetes the liver behaves inappropriately by putting out glucose even when it shouldn’t. This is most noticeable during the night, so that sometimes your morning glucose can be higher than your bedtime glucose.

Another factor is the “dawn phenomenon”, and is part of your body’s natural biorhythms. Your metabolic factory starts working in the early morning, releasing hormones such as cortisol and growth hormone, which help you to get ready for the day. They also raise your blood glucose slightly, and this effect is more noticeable in people with diabetes.

In short, it’s not you… it’s your hormones!”

Richard Jackson MD spent 30 years at the Joslin Diabetes Center as Director of Medical Affairs, Healthcare Services, a Senior Physician and the Director of the Hood Center for the Prevention of Childhood Diabetes. He is an Assistant Professor of Medicine at Harvard Medical School. He has been studying diabetes for over 30 years and led the first National Institutes of Health clinical trial to study diabetes prevention.  He is the founder and Executive Director of the non-profit Grassroots Diabetes.


11 comments:

  1. Geneva Terry

    01/29/2017 at 11:20 PM

    Thank you very much. I notice this during the night and did not understand. I test often at night because I am taking new Medicine.

    Reply
  2. Darlene

    01/29/2017 at 11:51 PM

    THANK YOU! This is the first time I’ve gotten an answer for this question. So, long story short, don’t worry about it??

    Reply
    • admin

      02/04/2017 at 11:52 AM

      Darlene, if your A1c is at or below your target (which for most people is 7% or below0 and you’re not having troublesome lows, then yes– you don’t need to worry about it. If your A1c is above your target, you will want to talk to your doctor about how to adjust your medications to bring down your numbers in the morning. Hope that’s helpful!

      Reply
  3. Ivy Lundrigan

    01/30/2017 at 12:13 AM

    When is it an absolute must to go on insulin?How high have blood sugar levels go before considered Dangerous?

    Reply
    • admin

      02/04/2017 at 11:54 AM

      Ivy, this is something that you need to talk with your physician about. You and your doctor can look at your A1c to figure out when you need to add more medications and possibly insulin to your regimen. If your A1c is above your target (the target A1c for most people with diabetes is 7% but talk to your doctor about what’s right for you), sit down with your doctor to talk about what your medication options are to best get your A1c to your goal. Hope that’s helpful–

      Reply
  4. Robin Thompson

    01/30/2017 at 1:39 AM

    Why r my toes so cold???

    Reply
  5. Harry Toole

    01/30/2017 at 5:56 PM

    I try so hard to get my levels down I mean I am honestly trying and it is always high. I do watch what I eat. I need help and really don’t know what to do. Starting to get the shooting pain in my right hand and left foot. I don’t know how to fix this.
    Help me

    Reply
    • admin

      02/04/2017 at 11:57 AM

      Harry, sounds like it’s time to talk to your doctor about where your A1c is and plan an approach with him or her to figure out how to get your A1c and your glucose numbers to your goal. For many people with type 2 diabetes, medications are needed to get your A1c to target. There are lots of different types of medication– you and your doctor can figure out what the right approach is for you. And I would also definitely talk to your doctor about the pains in your hand and foot…

      Hope that’s helpful to you–

      Reply
  6. Christi

    01/30/2017 at 9:38 PM

    I wonder how many units of insulin do you need for each 15 carbs to keep Bain an even number?

    Reply
    • admin

      02/04/2017 at 11:57 AM

      Christi, this is different for every person with diabetes– you will need to talk to your doctor to figure out what this number is for you. Good luck!

      Reply
  7. Marie Heath

    01/31/2017 at 10:20 AM

    So is there some way to control the highs in the morning. You explained the why but is there no way to control it so your numbers should be in the normal range.

    Reply

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