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April 30, 2005

Other, Type 2

Question from Arlington Heights, Illinois, USA:

My question is two-fold. Sometimes, but not always, my blood sugar is higher in the morning than before bed. I exercise on the treadmill each morning. I always do it without eating. My blood sugar goes up 40 to 50 mg/dl [2.2 to 2.8 mmol/L]. I often go 14 hours without eating, from dinner until breakfast. During the day, if I check my numbers, about two to three hours after eating, the numbers are good. My last blood test showed my A1c was 6.5 so the doctor was happy. I just don't understand why it goes up so much when I exercise and when I go so long without eating. Just so you know, I take four metformin (Glucophage) 500 mg at night and one 10 mg glipizide at night.

Answer:

To make a long story short, when you don’t eat for a long time your blood sugar drops and your liver tries to help you out by changing stored sugar (glycogen) into glucose (sugar) in your blood. Glucose is our body’s fuel. We run on glucose much like a car runs on gasoline. In type 2 diabetes, this effort to balance the sugar level in our blood doesn’t work properly and you may change more glycogen into glucose and send it into your blood. This happens most often during the night when you are not eating. This might explain your occasional high morning blood sugar and the rise after exercise. You should try having a small snack before you exercise and see if that helps.

JS