I am a 37 year old male recently diagnosed with type 2 diabetes who is currently taking 500 mg of Glucophage at breakfast and dinner. My blood sugar average is 120 mg/dl [6.7 mmol/L], but my fasting is always on the high side (around 165 mg/dl [9.2 mmol/L]) even though my bedtime can be as low as 100 mg/dl [5.6 mmol/L]. What causes this? What can I do to remedy this spike in fasting blood sugars?

High fasting blood sugars are a hallmark of diabetes. This is because the liver makes additional glucose during the night while you are sleeping and exports it into the blood. The teleologic reason for this is that the brain has to have glucose as a required fuel, and If there is a long time between meals, the body has to have a way of providing glucose to the brain. In diabetes, there is dysregulation of the amount of glucose exported into the blood such that it is too much and results in a high blood sugar.

You can treat this by increasing the dose of Glucophage [metformin]. Please speak with your physician about any medication changes before carrying them out.

JTL