May 9, 2002
Daily Care, Type 2
Question from Belvidere, Illinois, USA:
I am a 40 year old female, diagnosed with insulin resistance one year ago, I am on Glucophage [metformin] once a day, and I understand and follow my diet fairly well. My current labs are cholesterol — 264, triglycerides — 157, HDL — 35, LDL — 198, hemoglobin A1c — 6.5%, average blood glucose — 130 mg/dl [7.2 mmol/L], and fasting blood sugar — 184 mg/dl [10.2 mmol/L]! How can my fasting blood sugar be so high when I did not eat for nine hours?
My morning blood usually run 130-170 mg/dl [7.2-9.4 mmol/L], and my bedtime value is usually less than 130 mg/dl [7.2 mmol/L]. I am still having a terrible time with depression; up and down daily which makes it nearly impossible to motivate myself to exercise. It is all that I can do to get through the day sometimes. I so desperately want to have even a little energy again, but I have terribly strong sugar cravings. Can you give me any insight to my situation? Any ideas to increase my energy and lower the morning blood sugars?
Answer:
A frequently asked question is how can the fasting blood sugar be so high when my glucose is lower at bedtime and I don’t eat anything? The reason for the high glucose in the morning is that the liver puts out glucose during the night. In diabetes, this condition is made worse because there is either a lack of insulin or insulin resistance in the liver to keep the glucose levels down. Your physician may have to discuss with you an increase in your medication to address this.
I would also suggest the LDL-cholesterol be addressed as this is very high. Depression is very common in people with diabetes; higher than in the general population. Talk to your physician about using an anti-depressant. This may help. If you are feeling overwhelmed with the diabetes, it would help to talk with a counselor or psychologist.
JTL
