November 5, 2005
Daily Care, Type 2
Question from Wethersfield, Connecticut, USA:
The other night I went to bed and my blood sugar was 95 mg/dl [5.3 mmol/L]. The next morning, my fasting blood sugar was 124 mg/dl [6.9 mmol/L]. Can you explain why my blood sugar went up? Also, I was on Avandia for two years and I was not pleased with it. I told the doctor that I was going to stop taking it. My A1c was 6.1 after four months of not taking Avandia. My only concern is that my blood sugar in the morning, before eating, has been 115 to 144 mg/dl [6.4 to 8.0 mmol/L]. Is there a way to control this morning blood sugar? During the day, my blood sugar is always below 120 mg/dl [6.7 mmol/L]. When I talk to people about my blood sugar, they say that it is normal. What do you think?
Answer:
I think your level of control is good, compared to many other people with diabetes. Given that, it is still not normal. If you are off the Avandia, you may want to consider metformin as it works well to suppress glucose output in the morning. You see, the high blood sugar in the morning is the result of the liver putting out too much glucose over the night. Successful treatment requires pharmacologic treatment to put a break on the higher blood sugars. Metformin will do this. Sulfonylureas will also do this, but are also associated with more weight gain and hypoglycemia. Therefore, the recommendation is for metformin.
JTL
