May 29, 2003
Question from Budapest, Hungary:
I have had diabetes for the past nine years, and my morning readings are high as well as my hemoglobin A1c. To find out why the morning readings are high, I tried checking my sugar in the middle of the night, However, each night before I go to sleep my blood sugar condition is different. What should I eat every night before I go to bed to create the best conditions to find out the cause of my high readings in the morning? Every small bit of food that I eat in the morning results in a drastic increase of my blood glucose. Is that related?
I would recommend you spend some time with a dietitian. The basic meal plan should be split into three meals with a variable number of snacks, usually including a bedtime snack. Hopefully, the bedtime blood sugar can be stabilized with a consistent intake at supper with an appropriate amount of rapid-acting insulin. A usual bedtime snack would be two-three carbohydrate servings. If you do not know what this means, it is further evidence you need more instruction.
The sugar should then be checked around 3:00 am. The target should be 80-150 mg/dl [4/4-8.3 mmol/L]. If this is not the case, your physician needs to work with you to change your insulin dosing. If your sugars are so labile that a small amount of food sends the sugars very high, you probably need more insulin for the food you are eating.