December 29, 2001
Daily Care, Type 2
Question from Sylmar, California, USA:
I was diagnosed about seven months ago with type 2 diabetes and have established pretty good control, on daily Amaryl [glimepiride] and Precose (acarbose) with each meal. However, I have noticed my first morning blood sugar averages about 20-30 mg/dl [1.1-1.7 mmol/L] higher than my bedtime readings, even if I don’t eat for hours before bed, and if I test again after my morning dog walk ( two miles in 30 minutes) it goes up another 20-30 mg/dl [1.1-1.7 mmol/L]. In a review of some other questions on your site, that seems to be pretty common. Is this normal? If so, what is the cause? What can I do to prevent it?
Answer:
I would want to see a more detailed log of exact times of day for the blood glucose tests and food amounts as well as times eaten. Blood glucose levels are part of a total picture of diabetes management. See Standards of Medical Care for Patients With Diabetes Mellitus for general blood glucose targets.
MG
[Editor’s comment: It’s common to see elevated blood sugar levels in the morning, and they could go up with exercise. Basically, you need insulin to control these problems. Sometimes use of an insulin sensitizer pill (which you’re not on) might help. Talk to your doctor about whether to add either a “glitazone” or metformin or insulin.
WWQ]
