December 24, 2003
Type 2
Question from Naples, Florida, USA:
For the past nine months, I have been controlling my sugar very well with diet and exercise. My fasting levels have been between 110-120 (6.1-6.6 mmol/L] and after eating levels below 130 (7.2 mmol/L]. In the last three weeks, my fasting levels have been between 135-160 (7.5-8.9 mmol/L] and I have tried everything (exercise and diet) but nothing seems to be working. At night, before going to bed, my levels are 120-125 (6.6-6.9 mmol/L], but in the morning when I wake up they are back up to 150s (8.3 mmol/L). Is something happening while I’m sleeping? I’ve received two types of conflicting information:
My sugar is going a low in the middle of the night and starts creeping up, so I need to eat something either very late at night or wake up in the middle of the night and eat a snack. (This won’t help with my effort to loose weight.)
Don’t eat a snack. The problem is that my residual sugar is out of control and I need to fast (only liquids) for three days to clean my system out.
Answer:
Neither one is probably correct. It sounds like you have Type 2 diabetes. You are trying to control the sugars with lifestyle changes (essentially exercise and diet). Your sugars are now higher in the morning than they use to be. This is the natural history of Type 2 diabetes. The reason the sugars are high in the morning, and higher than the night before, is that the liver puts out glucose during the night. When there is poor glucose tolerance, too much glucose is put out. You may need to be treated with medicine to suppress the glucose output over the night that raises your fasting blood sugar.
JTL
