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High BG Reading in the Morning

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J

Julesb

New Member
Relationship to Diabetes
Type 2
Hi All
I'm very new to testing but think I understand what to look for given the advice on this website. I just have a bit of a query if anyone could advise. I've been testing my levels 8 times a day and am pretty ok with most of the results I'm getting back but the fasting morning test is always, always way over what I'm aiming for, usually between 8.1 and 8.7. I understand this is high but I'm not sure how to reduce this, I eat my last meal at about 7.00 - 7.30 pm, test two hours after and this result is usually within the range it should be, I don't eat anything after my tea and only drink water. The test I do before I go to bed is always in the correct range and then I wake in the morning to find it is elevated. I'd really appreciate any advice about this please.
Just to add to this, my HBa1C level was incredibly high (158 mmol) when I was diagnosed at the very beginning of August 2021 and am trying to count my carbs (eating around 80 to 100 g carbs per day on the whole) and eat to my meter most of the time, do you think I'm expecting too much too soon? Could it reduce to a good level over time?
I'm going for a GAD antibody test on Monday that I'm paying for - I had a conversation with the nurse at my surgery and she said that I could be in the Type 1 range but they wouldn't test me for 6 months (after two further blood tests and being on Metformin for 6 months), I think this is pretty ridiculous so have opted to have the test my self - could the possibility of being Type 1 have anything to do with my early morning 'high'? Sorry for the long post but am a bit puzzled - thanks for any replies.
 
Hi.
Am I reading correctly, that you have been diagnosed just over one month, your HbA1c at that point was 158 😱 and you are now getting normal range readings for most of your readings apart from your morning fasting reading? If so, it sounds like you have reduced your levels very rapidly and that can be risky, on the eyes particularly. Have you had your retinal screening yet?
It is quite surprising that you have managed to drop your levels so fast, especially as you are still eating just moderately low carb. Well done on that!
The morning fasting reading is usually the last to come down into range and if you haven't upped your exercise, you might find that a brisk daily walk will help, but it is often just a question of your body taking time to adjust and 4 weeks is a very short time in the diabetes scheme of things. It will almost certainly have taken a lot longer for your levels to become as bad as they were, so you can't expect your body to recover very quickly and in fact it is better if it doesn't because those fine blood vessels in your eyes can be fragile and vulnerable to dramatic change in pressure or BG levels.

Good luck with your GAD antibody test but do be aware that sometimes it can be inconclusive and diagnosis is best made in conjunction with C-peptide and clinical presentation, so you might not necessarily get a definitive diagnosis unless the result is really high.
 
I think you’re sensible getting the GAD test @Julesb As @rebrascora said, if you’re able to get the C Peptide test in conjunction with that that would be good.

Our bodies often pump out extra glucose ready to start the day, and that could be the cause of your higher sugar then despite going to bed on an ok number.
 
HI @Julesb welcome to the forum.
Your results sound very impressive. I know there is concern amongst people with Type 1 with regard to lowering our levels too quickly after diagnosis but I though this was less of a concern fro someone with type 2. Hopefully, someone with type 2 will be along soon to give us the low down.

With regard to your higher morning readings, this is common and likely to be due to something call Dawn Phenomenon. This is a perfectly normal thing and has nothing to do with diabetes. When we start the day and our bodies start to wake, one thing that happens is that our liver dumps a load of glucose into our blood to give use the energy to get moving. Some of our livers predict what time we will need this and dump glucose in the early hours. Some livers wait for a more direct signal and dump the glucose once we get up. The latter is sometimes called Foot On The Floor (or FotF).
A healthy pancreas will spot this extra glucose and release insulin which unlocks the energy we need and you wouldn't see the morning rise.
Those of us with dodgy pancreases (pancreai ... I really should learn the plural of pancreas) are either slow to react or, in the case of Type 1, don't react at all. As a result, we see a rise in blood sugars at the start of the day.
As @rebrascora mentioned, our body takes some time to relearn habits so the morning levels are the last to come down.
Some people find a bit of exercise such as a walk will help, some find that breaking our nighttime fast (eating a little breakfast, even if it is low or no carb) will convince our liver that it can stop the glucose dump.

The type of diabetes you have will not impact the morning highs. We all have defective pancreases/pancreai but I hope you get some answers with your GAD test.
 
Hi @Julesb As @rebrascora says, there is a discussion elsewhere in this and another diabetes forum about if it's possible to reduce Blood Glucose 'too fast' using lifestyle or bariatric surgery rather than with drugs such as insulin. You don't appear to be taking any medication except for Metformin which doesn't have a dramatic effect. Are you still taking that?

So far I personally haven't seen first hand evidence of this, however it is certainly possible to get temporary vision distortion by reducing (or increasing) Blood Glucose faster than the body can adjust to it.

Metformin is supposed to stop your liver being 'helpful' and provides Glucose (made in your body) when your BG levels are lower than what your body is accustomed to.

There is a phenomenon called Dawn Phenomenon or 'Foot on the Floor' which sometimes happen even in non-diabetics. This is when the liver is 'helpful' and provides glucose in order for us to 'hunt or gather' our breakfast like a cave dweller. I still suffer from that even though my HbA1C is now below even the pre-diabetic range. Though in my case my highest BG levels (first thing in the mornings) are below 8.0 and have been steadily going down over the last couple of years.

In short, if I were you I wouldn't worry about either an 8.7 BG reading before breakfast (so long as it went down by 2hrs after breakfast) or about being a possible Type 1. Instead I would be celebrating and telling everybody how well I had done in such a short time!
 
Hi @Julesb - As others have said, your rise in the morning could be due to dawn phenomenon. If you look at this page https://www.diabetes-support.org.uk/info/?page_id=143 it explains in more detail and a little way down are suggestions for strategies for dealing with this mainly aimed at T2s though.

Good luck with the GAD test. Not that anyone would actually want T1 as often T2 can be put into remission whereas T1 can't be.
 
Hi All, thank you all for your rapid responses, I really do appreciate all of your comments. I am only taking Metformin, 1500mg per day and have three small meals religiously each day. I have been lucky because I was diagnosed almost at the beginning of my six week holidays so I've had no distractions such as work to steer me off course with my diet and have had plenty of time to read up on things on here and exercise a bit more than I would normally. Apart from a couple of BBQs and a meal or two out I've lived like a foodie nun since diagnosis, I'm a vegetarian who can't stomach eggs or soya so tend to eat quite strictly anyway, my 158 mmol reading was a massive surprise which I still don't really understand but hey ho, it is what it is. I did read about reducing things too quickly but if I'm in I'm in and want to do things properly so have really tried, my eyes, when I started taking Metformin to be honest, went a bit blurry but I have noticed in the last three days or so are starting to settle which is a massive relief.
I did think about getting the CPeptide test at the same time but sort of thought that if I got the results from the GAD test, if they didn't come out as I hoped, then I could arm myself with that result and then put that to my doctors surgery in order to get the CPeptide test, this may not work out and if they still say no then I will go for the CPeptide test too.
I've looked back at the readings I've taken and I would say about 75% of the time they have been within the limits expected, some days have been a slight rollercoaster and the mornings have all been high but now I understand that a bit more (thanks for the info) I can accept that and not worry that I'm not doing as much as I can and just keep an eye on it. Thank you all so much xx
 
Well done on your progress so far @Julesb

Let us know the results of your antibody checks when they come in. And I hope your morning levels gradually come into line.
 
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