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Diabetes - Type 2 Community
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Avatar universal

morning blood sugar higher than evening

I've been monitoring my blood sugar because my Hgba1c has been creeping up over the last couple of years from 5.6 to 5.8 and the last reading was 5.9. Yesterday I ate a salad and some brown rice for dinner at 7:30 and checked my blood sugar at 10:00 and it was 76. This morning at 6:00 it was 91. I'm trying to keep fasting levels, especially first morning, in the low 80's and don't understand what happened overnight to bring my blood sugar up to 91. Could this be a cortisol/adrenal issue?
6 Responses
141598 tn?1355675363
Yes, it is possible. Are you pregnant? Are you under undue stress? Are you taking any corticosteroids? Did you snack on anything after your 10pm test? Another possibility comes from your liver releasing excess stored glucose. Then we have Dawn Phenomenon which is the release of certain hormones in the middle of the night.
Avatar universal
I'm menopausal, under moderate levels of stress, did not eat anything after 10:00, slept well that night. Maybe my dawn phenomenon is more pronounced than average? Is that not related to the normal increase in cortisol in the early morning as we wake up and become active?

At any rate, when I see a first morning blood sugar of 90 to 100 I tend to wait a few hours before eating or drinking anything that might raise my blood sugar too much. Perhaps doing so will begin to decrease the ups and downs and help reduce my Hgba1c levels.

In the last few weeks since I started testing, I haven't seen it go above 127 and that happened only twice. Mostly its in the 80 to 100 range or a little over 100.

Is there a level at which Hgb begins to become glycosylated or does that vary from person to person?
141598 tn?1355675363
"Is that not related to the normal increase in cortisol Cortisol level in the early morning as we wake up and become active?"

In the middle of the night, there is a surge in the amount of growth hormone the body releases, followed by a surge in cortisol, which effectively cranks up glucose production in the liver in anticipation to prepare the body for daytime activity.

"Is there a level at which Hgb begins to become glycosylated or does that vary from person to person?"

From what I understand, the amount of adult hemoglobin that becomes glycosylated to form HbA1c is directly related to the average concentration of glucose in the blood. In a normal person about 3-6% of Hb is glycosylated.

One thing to investigate is whether you are experiencing the Symogi effect [reverse hyperglycemia while sleeping]. To counter this the liver releases extra glucose. One way to find out is to set your alarm and wake up at 2-3 am, or 4 hours after your bedtime, and test. Low glucose <70 mg/dl will signify this effect. One way to defeat this is to have a snack with protein before bedtime, like a piece of toast with peanut butter, or some cottage cheese, or yogurt, or some nuts and small piece of cheese [protein and fats].
Avatar universal
I'll try that, along with having a four-sample salivary cortisol test to see if adrenal stress is contributing. Yesterday I ate some brown rice with amaranth at 7:30 p.m. and my glucose at 10:00 p.m. was 115. This morning at 6:00 a.m. it was 88. My question about Hgba1c is what is the blood glucose level at which glycation occurs? Is it anything over 100? 120?
141598 tn?1355675363
"what is the blood glucose level at which glycation occurs?"

Huh? Glycation occurs when glucose reacts with protein.
Avatar universal
Yes, as I understand it, glycated hemoglobin is the attachment of glucose to hemoglobin, a globular protein molecule. It is a measure of blood sugar levels over about three months time and is elevated when blood sugar has been elevated. I'm looking for information on what levels of blood sugar typically result in glycation. I have not seen my blood sugar go over 127, and I'm wondering what level I should be keeping it under in order to lower my Hgba1c. If it is becoming elevated to the 90's overnight is that causing glycation? Should I be looking for spikes that occur within an hour of eating? I haven't done that yet, because the two and three hour readings seem to be standard practice outside of a glucose tolerance test.
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