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From Quebec, Canada:

I have had Type 1 diabetes for 5 years and in the past couple of months have had a real problem to keep my bloodsugar in normal ranges. Especially, I don't understand why my blood sugar is higher when I wake up than just before I go to sleep if I don't eat any snack in the evening. Is there a logical reason?


Without knowing something about the kinds and amount of insulin that you are giving before supper or about the times of your evening meal and bed time snack, it is difficult to be more precise about the reason for higher blood sugars in the morning when you dont take a snack.

Probably it is either because the before-supper Regular insulin is still acting before you go to bed and the NPH, if that is the second insulin, has begun to fade before you do your morning test.

Or it is what is known as the Somogyi effect. What happens there is that if your blood sugar becomes low in the middle of the night, it may rebound and give high morning sugars. To find out, you need to do some occasional blood sugars at 3:00 A.M. to see if they are low. The distinction is important because in the first case you may need a little more evening NPH and in the second a little less. What matters most, of course, is that you keep your A1c below the upper limit of normal + 10%.


Original posting 21 Feb 97


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Last Updated: Tuesday April 06, 2010 15:08:54
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