low night reading high fasting reading

Good morning all. I am in need of some informaiton, that hopefully someone on the board will have. I am currently on Metformin once a day 250mg dose. I am also on Byetta10 twice daily. Through out the day and evening hours my blood sugar will remain in the randge of 89 to 105. I think this is very good for me. I always take a readign before bed and will get somewhere in the range mentioned previously. The concern is my fasting blood sugar over night. I wake up and test first thing in the morning and will always get a reading 129 or higher. I do not know what causes this increase over night. Can someone shed some light on this for me?  Thanks Brad

Hi Brad,

It could be that the timing of your medication needs to be changed. You could also be getting hypoglycemia episodes in your sleep and then a rebound effect ("the symogi effect"), or this could be the "dawn phenomenon" or "dawn effect". An explanation follows, taken from the linked page.

http://www.diabeteshealth.com/read/1993/02/01/77.html

"The dawn effect is an increase in insulin resistance (or decrease in insulin sensitivity) caused by hormones released about two hours before you wake. These hormones are under the control of the pituitary gland, and thus the brain. The dawn effect is influenced by testosterone and tends to be more significant in men. It is highly variable from person to person. Your overnight insulin is taken to counter the dawn effect, and on average, diabetics take 20% of their insulin overnight. Mr. Metabolism requires more than 20% of his insulin at night.

The Symogi effect is the tendency of the blood sugar to rise as a result of low blood sugar. Low blood sugar can trigger release of hormones such as glucagon that raise blood sugar.

The liver would normally respond to declining blood sugar by increasing glycogenolysis, as I discussed above. But insulin inhibits glycogenolysis, and as you may have observed, low blood sugar occurs most often near an insulin peak."

You should discuss this with your diabetes professional, who will probably recommend a few nights of testing your blood sugar every couple of hours to get a picture of what is happening with your BG in the night (you could actually just do this first so that you have the info at hand before you go in to discuss strategies for handling it).

Good luck,

Rosemary

 

Talk to your doctor about when you should be taking your meds.  The liver gives off sugar while you sleep and this maty be why you are experiencing the higher readings in the morning. I was having the same issue.  Changing the timing of my meds made all the difference.  Now my am's are between 80-100 :-)