Why is your fasting sugar level much higher than after a meal?

The situation when blood sugar rises at night is associated with the patient’s diet or a malfunction of the body. If the glucose level in the evening does not exceed acceptable limits, the situation is considered normal, since in the morning the levels are always lower before meals. If sugar is higher in the morning, this indicates morning dawn syndrome in diabetics or heavy overeating or drinking alcohol the night before. Physiological changes in indicators (heavy load, thought process, experiences) introduce an imbalance for a short time, after which it returns to normal. In other cases, you need to contact an endocrinologist for help.

How to lower morning sugar levels

This question interests many patients. The normal level of sugar in capillary blood for healthy people in the morning on an empty stomach is 4.0-5.5 mmol/l.

Regardless of whether you have been diagnosed with type 1 or 2 diabetes or prediabetes, standard measures are required.

Train yourself to have an early dinner. Eat at least 4 hours before bed. It is better if the interval between the last meal and going to bed is 5 hours (for example, have dinner at 18.00 and go to bed at 23.00).

Patients with type 2 diabetes, in addition to an early dinner, need to take metformin in extended-release tablets (for example, Glucophage Long). The drug allows you to keep your readings within normal limits even in the morning.

Glucophage Long tablets

Diabetics suffering from an insulin-dependent form of the disease are recommended to use prolonged action in the evening hours to normalize indicators.

And remember, there is no food that can lower your morning performance! A decrease can occur either under the influence of medications, or as a result of correction of diet and daily routine. Therefore, you should not adhere to advice on the use of certain sugar-lowering products that are distributed on the Internet in forums by incompetent users.

Following a low carb diet

The main rule of such a diet is a reduction (or better yet, an absolute exclusion from the diet) of “fast” carbohydrates. These include:

• sugar (plus all sweets and treats);
• potato;
• flour (including pasta);
• carbonated drinks, juices;
• chocolate.

At the same time, you should often eat foods that can reduce the concentration of sugar. For hyperglycemia, it is recommended to use:

• some vegetables (cabbage, cucumber, zucchini, eggplant, beans, garlic, onion, spinach);
• meat, fish, poultry;
• seafood;
• eggs;
• mushrooms.

Keep in mind: you really can't do without a low-carb diet. This is the basis for treating diabetes, regardless of its type, and maintaining the patient’s normal condition. When following a diet, try to adhere to simple rules:

• the total amount of carbohydrates entering the body per day should not be more than 30 g. In this case, it is better to divide the indicated portion into three meals. This way, sugar will not rise, and the surviving beta cells of the pancreas will have a chance to survive;
• don't overeat. Finish your meal as soon as you feel the first signs of satiety;
• try to include an equal amount of carbohydrates, proteins, and fats in all meals every day;
• Plan your menu for the week ahead and stick to it.

Possible complications

If fats and carbohydrates are consumed in large quantities for lunch and dinner, then in the morning the sugar will be greatly increased.
Changing your diet can lower your morning sugar levels and also avoid adjusting your insulin and other glucose-lowering medications. People with insulin-dependent diabetes may experience elevated blood sugar levels if injections are administered incorrectly. It is necessary to adhere to established rules, for example, to give injections of long-acting insulin in the buttock or thigh. Injections of such drugs into the stomach lead to a decrease in the duration of the medicine, reducing its effectiveness.

It is also important to constantly change the injection areas. In this way, you can avoid hard lumps that prevent the hormone from being absorbed normally.

When producing, it is necessary to make a skin fold.

Critically high sugar levels are characteristic of type 1 diabetes. In this case, the central nervous system may be affected. This is indicated by a number of characteristic signs:

1. fainting,
2. decreased primary reflexes,
3. disorders of nervous activity.

To prevent the formation of diabetes mellitus or keep sugar levels under control, you should adhere to a therapeutic diet, avoid mental stress and lead an active lifestyle.

If a person has confirmed type 1 diabetes mellitus, he is indicated for the administration of external insulin. To treat the second type of moderate disease, it is necessary to use drugs that stimulate the production of its own insulin by the pancreas.

Late effects of low blood glucose include:

• decreased visual acuity,
• violation of orientation in space,
• deterioration in concentration.

It is urgent to increase your sugar level if the condition continues for a long time. This situation leads to irreversible brain damage.

The danger of low sugar

Often blood glucose goes down. This is as important a manifestation of problems in the body as high glucose levels.

It is necessary to find out the causes of these problems. Symptoms appear if sugar after meals is 5 mmol/l or lower.

If you have diabetes, insufficient sugar can have serious consequences. The characteristic symptoms of this pathology are:

• constant hunger
• decreased tone and fatigue,
• a lot of sweat
• increase in heart rate,
• constant tingling of lips.

If sugar increases in the morning and decreases in the evening, and this situation occurs constantly, then as a result, a person’s normal brain activity may be disrupted.

From a lack of sugar in the body, the ability for normal brain function is lost, and a person cannot adequately interact with the outside world. If sugar is 5 mmol/l or lower, then the human body cannot restore its condition. When the indicator is greatly reduced, convulsions may begin, and in some cases death occurs.

How to differentiate the disease

The causes and indicators of high blood glucose levels are determined by a laboratory test called (TSH). In the morning, on an empty stomach, blood is drawn to determine the indicator. After this, the person is injected with a glucose solution, and after 2 hours a repeat blood test is done.

Usually they just give you sweetened water to drink. Sometimes glucose is given intravenously. Testing is carried out in biochemical laboratories. It is also possible to conduct a test with a home glucometer.

Before the procedure, special preparation is necessary, since many factors of life and nutrition can distort the correct picture.

To obtain informative results you must:

• take the test on an empty stomach, you cannot eat for 8-12 hours, no more than 14;
• do not drink alcohol for several days, do not smoke before the study;
• follow the recommended diet for a certain time;
• avoid excessive stress and stress;
• stop taking medications - hormones, sugar-burning drugs and others.

After taking glucose, you need to spend 2 hours at rest before the next blood draw. The study is not done if a simple blood test shows a sugar level of more than 7.0 mmol/l. A high result already indicates diabetes.

The study is not performed in case of acute somatic diseases and if it is necessary to constantly take certain medications, in particular, diuretics, glucocorticosteroids.

TSH results:

Disturbances in glucose metabolism also make it possible to determine the indicators of other compounds that will help to understand why the increase in sugar levels occurred:

• amylin – regulates glucose levels together with insulin;
• incretin – regulates the production of insulin;
• glycohemoglobin - reflects glucose production over three months;
• glucagon is a hormone that is an insulin antagonist.

The tolerance test is informative, but requires careful adherence to all rules of behavior before blood collection.

Physiological reasons for increased blood glucose

There are situations in our lives that require an emergency release of glucose into the blood to save a person’s life. Sugar may rise temporarily in the following cases:

• during heavy physical labor or training
• during prolonged mental work (for example, during an exam)
• with fear and fear (for example, with fear of medical procedures)
• in life-threatening situations (war, flood, earthquake, etc.)
• in case of acute stress (for example, death of loved ones)

A feature of this behavior of glucose levels is its normalization after the cessation of exposure to the provoking factor. Blood sugar rises due to stimulation of the adrenal cortex and the release of counter-insular hormones, which promote the breakdown of liver glycogen and the release of glucose into the blood.

In this case, the increase will be short-term and does not pose a real threat. On the contrary, it is the body's defense mechanism to cope with difficult situations.

Frequently asked questions and their answers

The article indicates blood sugar standards for healthy people. But the doctor said that it was dangerous for me to lower my sugar to such limits. Is he right?

If you have lived for several years with high sugar, 12 mmol/l and above, then it is really not advisable to quickly reduce it to 4-6 mmol/l, as in healthy people. Because unpleasant and dangerous symptoms of hypoglycemia may appear. In particular, the complications of diabetes on vision may increase. It is recommended for such people to first lower their sugar to 7-8 mmol/l and let the body get used to it for 1-2 months. And then move towards the indicators of healthy people. Read more in the article “Goals of diabetes treatment. What kind of sugar should you aim for? It has a section “When you need to specifically keep your sugar levels high.”

I discovered that my sugar levels rise only if I eat something sweet. Is this already diabetes?

You don't measure your sugar often enough with a glucometer. Otherwise, you would notice that bread, cereals and potatoes increase it in the same way as sweets. You may have prediabetes or early stage type 2 diabetes. To clarify the diagnosis, you need to provide more information. How to be treated is described in detail in the article above. The main remedy is a low-carbohydrate diet.

Why does blood sugar increase in the morning on an empty stomach? After all, a diabetic patient does not eat anything all night.

Sugar in the morning on an empty stomach rises due to the fact that in the hours before dawn the liver actively removes insulin from the blood. This is called the dawn phenomenon. It occurs in most patients with type 1 and type 2 diabetes. Read more about how to normalize your blood sugar in the morning on an empty stomach. This is not an easy task, but it is doable. You will need discipline. After 3 weeks, a stable habit will form, and sticking to the regime will become easy.

When is it more important to measure sugar - on an empty stomach or after a meal?

It is important to measure your sugar every morning on an empty stomach. If you inject insulin before meals, you need to measure your sugar before each injection, and then again 2 hours after eating

This happens 7 times a day - in the morning on an empty stomach and another 2 times for each meal. If you have type 2 diabetes and control it with a low-carbohydrate diet without rapid insulin injections, then measure your sugar 2 hours after meals.

Is it possible to measure sugar without pricking your fingers every time?

There are devices called continuous blood glucose monitoring systems. However, their inaccuracy is too high compared to conventional glucometers. At this time, Dr. Bernstein does not yet recommend their use. Moreover, their price is high.

Sometimes try using a lancet to pierce not your fingers, but other areas of the skin - the back of your hand, forearm, etc. The article above describes how to do this correctly. In any case, alternate the fingers of both hands. Don't prick the same finger all the time.

What to do if your blood sugar is high? How to reduce it quickly?

The only real way to quickly reduce sugar is to inject short-acting or ultra-fast insulin. A low-carbohydrate diet lowers sugar, but not immediately, but within 1-3 days. Some type 2 diabetes pills work quickly. But if you take them in the wrong dosage, the sugar may drop excessively and the person will lose consciousness. Folk remedies are nonsense, they don’t help at all. Diabetes mellitus is a disease that requires systemic treatment, accuracy, and precision. If you try to do something quickly, in a hurry, you can only do harm.

The child's sugar rises sharply at night. What could it be

No. 17 294 Endocrinologist 02/13/2015

Hello, My daughter is almost seven years old. She fell ill with type 1 diabetes at the age of 4. Before the new year, we started having stomach upsets, although we ate everything the same. I began to lose my appetite, my stomach started to hurt, I started to feel sick. At first I started giving pancreatin after every meal, sometimes it helped. Then, after the new year, nothing went away, she began to complain more often about her stomach, almost stopped eating altogether, I naturally reduced the dose of insulin. It had already reached the point that her sugar did not rise at night. At 10 pm, as ordered, sugar 2.2.3, 3.7. She gave me sweet tea and caramel. Nothing, it would rise a little and an hour later it would fall again. An ambulance was called. They took her to a regular children's hospital, where she was examined by a surgeon and pediatrician. They diagnosed it with a disorder and told me to solder it with rehydron or ringer. In general, within three days, we were almost back to normal, we did enemas, as the doctor said, because I didn’t go to the toilet. And after the enemas, what I had eaten a week ago began to come out. Slowly I began to increase the dose of insulin back, and of course my sugar levels went up. In the end, we reached the same dose as before all this trouble. Everything would be fine, the sugars are excellent throughout the day. But at night, it increased significantly, I already increased the long-term overnight (livemir) anyway, at an hour even less sugar, at three - from 17 to 25. At the same time, I tease you a little bit when it’s 17.0. 5 short shots, after an hour I measure, then sugar comes in, 20 already, then I still 2.2. 5 I inject, and then it begins to fall and by the morning the sugar is excellent. I don't know what it could be anymore. During the day everything is fine. And yet, before the disorder, I injected her with five long injections and 4.5 short injections. And now, having tried several times (we keep a diary in the same way), it turns out to be 4.5 for breakfast and lunch, but for dinner it’s already 4 units. Does this even happen? Because if I inject the same 4.5, then the sugar at night is low. And in the morning it turns out to be a long 5, and at night I try to inject 6, and it still rises ((it still doesn’t go down so easily. She eats the same thing, in the same quantities. Here’s an example, at night (23:00) sugar 7. 2, I inject 6 long-term, I give 2 regular cookies, at 1 am the sugar drops 5. 2, I give half a marshmallow. At 3 o'clock in the morning 6. 4, I give marmalade. And at 10 o'clock she has breakfast 5. 8 Everything is fine Almost the same situation, sugar at night 6.6 (even less than the previous one) I also inject 6 units of long-term and also give 2 cookies, and plus (based on last night, so as not to feed in the middle of the night) four dried small ones. In the end , at 1 am it’s 15.8, and at two it’s already 20. I no longer understand what it could be. I’ve never had this kind of stomach upset before. Now the digestive system is working well, she goes to the toilet every day, she doesn’t complain about her stomach . And there is no one to turn to. There are no diabetologists in our area, all you have to do is go to the regional hospital and go to bed. You have to stay up at night for almost a month and monitor your sugar levels, the child has pricked all his fingers, and you can’t get enough strips, and they are expensive now .

Fedorova Elizaveta, Volgograd

NO ANSWERS

Additional Information

Often you have to take measurements yourself, especially at night. In order for the measurements to be as transparent as possible, you need to keep a diary in which to record all sugar levels, the daily menu and the amount of drugs consumed.

In this way, sugar levels are monitored at each time period, and the effectiveness of drug dosages can be determined.

To prevent sugar from rising, you must constantly be under the supervision of your doctor. Regular consultations will help correct treatment deficiencies and prevent the formation of dangerous complications.

The patient can also buy an Omnipod insulin pump, which makes it easier to adjust medications and administer them.

The causes of hyperglycemia are discussed in the video in this article.

How to deal with the phenomenon

So, we have determined why sugar is lower after a meal than before a meal. Now let's talk about how to bring your fasting sugar back to normal. Based on the reasons that explain the process, there are several ways to combat this:

• Consult a doctor who will prescribe you medications that normalize hormonal levels;
• If high fasting sugar is caused by improper distribution of medications, then the doctor will prescribe you a different method of taking them and determine how long you will have to adhere to the new method;
• If you go to bed hungry, then stop doing it. On an empty stomach, your blood sugar will normalize if you drink a glass of kefir at night. But remember that this will be quite enough to maintain normal metabolism. You should also not overeat;
• If you have a cold, your fasting glucose will normalize if you consult your doctor and start taking additional medications.

So, we figured out what this phenomenon is and how to deal with it. And remember, if your blood levels are higher before meals, you need to consult a doctor. The reason why sugar is lower after meals may be hidden in unexpected phenomena that the doctor will determine very quickly.

Remember that following a special diet, regular physical activity and following all the doctor’s recommendations is your way to ensure that such phenomena never happen to you.

The rules described above should be followed not only by patients, but also by healthy people, since neglecting them can provoke the appearance and rapid development of the disease.

How glucose levels fluctuate throughout the day

Almost any changes that our body undergoes are accompanied by changes in well-being and health problems. So, for example, when there is a load on some organ, the reaction can be a sharp increase in sugar and a disease such as hyperglycemia.

Every morning, your body wakes up due to signals from growth hormones. For some time in the morning, they suppress the active effect of insulin on glucose levels, giving a so-called “bell” about the beginning of a person’s wakefulness. Increases in blood glucose levels occur between four and eight in the morning. High sugar may also be due to the release of an additional dose of glucose from the liver, which helps to wake up and begin vigorous activity.

Of course, you need to constantly monitor how your blood sugar rises or falls. And if the increase persists throughout the day, then it is better to consult a specialist who will prescribe you medications that will help adjust the insulin dose released in the evenings. Insulin in the morning will help balance the released glucose from the liver. In addition, there is a healthy way to reduce morning awakening syndrome without taking any medications. The solution may be to avoid eating large amounts of carbohydrates for dinner. It is possible to suppress morning spikes in blood sugar by injecting insulin between four and six o'clock in the morning. This will help quell morning sickness, but the prescription is strictly prescribed by your doctor. In cases of incorrect dosage or irresponsible use of sugar-lowering tablets, a disease such as hypoglycemia can occur.

Why is blood sugar higher on an empty stomach than after a meal?

In a healthy person, the level of the indicator before meals is within the normal range on an empty stomach. After eating, the level increases. If temporary and permanent deviation factors appear, the indicator may be higher before meals than after it.

Endocrine changes

Hormonal changes leading to an increase in the amount of hormones that break down carbohydrates. The level in the blood increases. But over time it normalizes, decreasing after eating. If persistent disturbances occur, consult a doctor and undergo laboratory tests to rule out inflammation of the pancreas or hormonal imbalance.

Nocturnal hypoglycemia

The appearance of nocturnal hypoglycemia, which the body is trying to eliminate. By producing substances, they help increase glucose in the blood. When it reaches its normal values, the indicator gradually decreases, reaching a lower level after eating.

Neglect of doctor's recommendations

Neglect of the doctor’s recommendations, failure to comply with the doses he prescribes, lead to the body’s inability to compensate for the disorders occurring in it. The pancreas does not cope with its function. There is a deficiency of substances that regulate processes in the body.

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Viral, infectious diseases

The appearance of viral, infectious agents in the body.

It tries to protect itself from pathogenic factors by producing increased amounts of glucose for additional energy. With its help, additional forces are activated against the pathogen.

Nutritional factor

Eating large amounts of foods containing carbohydrates. After a person falls asleep, his hormones and enzymes that break down and deliver glucose to the organs decrease. Therefore, it remains in the blood for a long time. After waking up, it gradually begins to decrease, reaching normal values.

Climax

Postmenopausal manifestations in women. At this time, the amount of sex hormones decreases. This leads to increased sugar levels in the morning. A constant occurs often.

Why is blood sugar normal in the evening, but elevated in the morning? Let’s study the problem from the inside

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High blood sugar is a problem that worries many diabetics. It becomes especially noticeable when sugar is normal at night and in the evening, and elevated in the morning and during the day. Every time you observe a high level of this indicator in the body, you must understand that there are reasons for this that need to be immediately identified and eliminated. Today we will look at why blood sugar is elevated in the morning, although it was normal the night before. So, why blood glucose rises in the morning depends on several factors.

Why are indicators elevated in the morning?

• Dawn syndrome. This is a phenomenon in which special hormones are activated in the body in the morning, releasing carbohydrates, which are immediately broken down and enter the blood. This condition can go away on its own, without your intervention, but there are times when it develops too intensely. If this causes your blood sugar to rise in the morning, discuss your diet and the medications you are taking with your doctor;
• Somogyi syndrome. This is another factor due to which sugar is higher in the morning than in the evening. This happens because its quantity decreased sharply at night. In response to the stress that has arisen, the body uses already existing reserves, as a result of which the breakdown of reserve carbohydrates begins, and the indicators rise sharply.

These are factors that explain why blood sugar rises in the morning. Each of them can be eliminated if you approach the issue of treatment correctly. But morning glucose above normal is not the only problem for diabetics.

Reasons for increased glucose levels at night

• For dinner you eat foods that contain a large amount of carbohydrates. This is a standard situation when energy splitting begins and all indicators rise sharply;
• You eat small portions during the day and overeat at night. Then the greatest load on the body occurs precisely in the dark.

As you can see, the answer to the question of why sugar rises in the evening is obvious. This is not affected by hormones or medications. It's all about your diet. Adjust it after consulting your doctor to avoid possible complications. You may be prescribed pharmaceuticals.

Why are the readings normal at night, but elevated in the morning?

Now we will talk about why sugar in the evening is within the normal range, but in the morning you observe elevated levels. After all, this is an unnatural process, it should be the other way around. However, in the morning sugar increases for several reasons:

• You have eaten a lot of carbohydrate foods since the evening;
• An attack of hypoglycemia at night provoked a jump in glucose in the morning;
• You went to bed on an empty stomach, as a result of which the body used hidden reserves of glucose;
• You are taking medications incorrectly. Perhaps the doctor made a mistake with the prescription. In any case, you need to visit him so that he can adjust his recommendations.

Thus, if your body reacts to certain actions of yours with changes in blood glucose, you need to see a doctor. But if you neglect diet, exercise, or expose yourself to constant stress, then first of all you need to change your lifestyle.

It is worth noting that maintaining the right lifestyle will guarantee that you will never encounter these problems. Therefore, watch your health. In addition, a healthy person should also follow the rules of a healthy lifestyle, otherwise diabetes may also appear in his life. Any disturbance in the body entails a failure and, as a result, an increase in performance. And in a healthy person as well.

Why is blood sugar higher on an empty stomach than after a meal?

Usually in the morning before meals, sugar is low, and after breakfast it rises. But it happens that everything happens the other way around. There are many reasons why glucose is high on an empty stomach, but after eating it drops to the standard level.

The most common factors that provoke high blood glucose levels in the morning:

• dawn syndrome . This phenomenon is understood as a surge in hormones that break down carbohydrates. As a result, serum sugar increases. Over time, the condition returns to normal. But, if the syndrome occurs frequently and causes discomfort, then pharmaceutical drugs are used;
• Somogyi syndrome . Its essence is that hypoglycemia develops at night, which the body tries to eliminate by increasing the concentration of glucose. This condition is usually caused by starvation. Somogyi syndrome is also provoked by taking a large dose of medications that affect sugar levels;
• taking insufficient amounts of drugs that normalize the functioning of the pancreas . Then there is a deficiency of substances that regulate vital processes in the body;
• cold . Defense forces are activated. A certain amount of glycogen is released. This leads to increased fasting glucose;
• eating large amounts of carbohydrates before bed . In this case, the body does not have time to process sugar;
• changes in hormonal levels . Typical for the fairer sex during menopause.

If you do not reduce sugar with special medications and diet, then the disease can take a chronic form.

Women often complain of high sugar levels during pregnancy. During this difficult period, restructuring occurs in the body, and the load on internal organs increases. Pregnant women have a high risk of developing, which goes away some time after delivery.

Reasons for increased morning sugar in type 1 and type 2 diabetes

Patients with type 1 and type 2 diabetes mellitus often complain of a sharp jump in glucose in the morning.

Most often, this phenomenon is observed between 3 and 5 a.m., which is why it received the poetic name “morning dawn” from experts.

This syndrome does not occur in all patients with diabetes. In most cases, it affects teenagers.

Also, the “morning dawn” makes itself known to adults, regardless of the type of disease. At the moment, the causes of the development of the disease have not been definitively established by experts.

However, scientists suggest that the main factor causing the sharp jump is natural endocrine processes aimed at awakening and occurring in every human body.

The factors that most likely cause the onset of “dawn” include:

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To diagnose the syndrome, you will have to conduct an additional examination at home between 00 and 7 am.

How many times a day should you measure your sugar?

To manage your diabetes well, you need to know how your blood sugar behaves throughout the day. For most diabetics, the main problem is high sugar in the morning on an empty stomach, and then again after breakfast. In many patients, glucose also increases greatly in the afternoon or evening. Your situation is special, not like everyone else’s. Therefore, you need an individual plan - diet, insulin injections, taking pills and other measures. The only way to gather important information to control your diabetes is to check your sugar frequently with a glucometer. Below we tell you how many times a day you need to measure it.

Total blood sugar control is when you measure it:

• in the morning - as soon as you wake up;
• then again - before starting breakfast;
• 5 hours after each injection of fast-acting insulin;
• before every meal or snack;
• after each meal or snack - two hours;
• before bedtime;
• before and after physical education, stressful situations, hectic work activities;
• as soon as you feel hungry or suspect that your sugar is below or above normal;
• before you drive a car or do dangerous work, and then again every hour until you finish;
• in the middle of the night - to prevent nocturnal hypoglycemia.

Rebound hyperglycemia

An increase in nighttime glucose levels may be due to the so-called Somogyi syndrome. The patient's blood sugar concentration is excessively low. In response to this, the body begins to release glycogen from the liver, and the diabetic develops hyperglycemia.

As a rule, sugar levels drop in the middle of the night. By morning the numbers are rising. Night surges are due to the fact that the body reacts to hypoglycemia as if it were under severe stress. As a result, the release of counter-insular hormones occurs: cortisol, adrenaline, norepinephrine, glucagon, somatropin. They are a trigger for the removal of glycogen from the liver.

Somogyi syndrome develops when there is an overdose of insulin. In response to the administration of an excessive dose of the hormone, hypoglycemia begins. To normalize the condition, the liver releases glycogen, but the body cannot cope on its own.

It turns out to be a vicious circle: seeing high sugar levels, the diabetic increases the dose of insulin. Its administration causes hypoglycemia and the development of rebound hyperglycemia. The condition can be normalized if the dose of the hormone is gradually reduced. But this must be done under the supervision of an endocrinologist. The dose is reduced by 10-20%. At the same time, the diet is adjusted and physical activity is added. Only with an integrated approach can you get rid of the Somogyi phenomenon.

Somogyi syndrome and its treatment

Somogyi syndrome explains why blood sugar rises in the morning. The condition is formed as a response to low sugar levels that occur at night. The body independently releases sugar into the blood, which leads to an increase in morning sugar levels.

Somogyi syndrome occurs due to chronic insulin overdose. This often happens when a person injects a lot of this substance in the evening without adequate compensation with carbohydrates.

When large doses of insulin enter the body, hypoglycemia occurs. The body defines this condition as life-threatening.

Excessive amounts of insulin in the body and hypoglycemia lead to the production of counter-regulatory hormones, causing rebound hyperglycemia. Thus, the body solves the problem of low blood sugar by demonstrating a response to excess insulin.

To detect Somogyi syndrome, you should measure your glucose level at 2-3 am. If the indicator is low at this time and the indicator is high in the morning, we can talk about the Somogyi effect. When glucose levels are normal or above normal at night, high sugar levels in the morning indicate the dawn phenomenon.

In these cases, it is important to adjust the amount of insulin; usually the doctor reduces it by 15%. . Somogyi syndrome is more difficult to treat because lowering your insulin dose may not immediately help your diabetes.

Somogyi syndrome is more difficult to combat because reducing the dose of insulin may not immediately help diabetes.

Blood indicator norms

Blood sugar level is not constant; its value is influenced by various factors. The normal level is 3.5-5.5 mmol/liter. Blood taken from a finger has a lower rate than venous blood.

The standard value for children is 2.8-4.4 mmol/liter.

The permitted limit is higher in older people, as well as in pregnant women. Blood sugar levels fluctuate throughout the day and depending on food intake. Some body conditions can lead to increased sugar levels (hyperglycemia); there are diseases other than diabetes for which this is typical.

Low blood glucose (hypoglycemia) is also a pathology.

Complications

For most people, the dawn phenomenon is a short-term phenomenon and does not cause additional problems. For people who experience a slight increase in blood sugar in the morning, the phenomenon usually goes away over time.

Impact of insulin resistance

Some people are more insulin resistant in the morning. In such cases, it is recommended to limit carbohydrate intake in the first few hours after waking up.

If you continue to eat carbohydrates in the morning, your blood sugar may continue to rise. Thus, high blood sugar levels can persist for quite a long period of time. This process should be controlled, because it is dangerous to health. In such cases, you need to consult a doctor who will help you adjust your diet schedule and choose the right treatment.

Impact of hormonal changes

If you ignore the Somogyi effect, complications may arise over time. Because the hormones in our bodies are constantly changing, a person's response to low blood sugar may also change. This can cause the body to fail to adjust properly to low sugar levels.

Even if you don't notice any symptoms, your body may not be able to cope with the situation and may stop signaling your liver to release sugar into your blood.

Causes of low sugar during the day with high morning blood sugar

The reason for high morning sugar with low or normal afternoon or evening sugar in diabetics lies in the “dawn” syndrome.
Between 3 and 5 a.m., the body deliberately begins to store sugar for the coming day, using hidden reserves or using up the dinner consumed the day before.

Such jumps in indicators are also observed in those who do not suffer from diabetes. However, healthy people usually do not notice such changes and do not react to them.

In some cases, when a patient has prediabetes or type 1 or 2 diabetes, the reason for a sharp change in indicators is a heavy dinner consumed the day before, or a stressful situation.

Reasons for deviations

Depending on what specific results were identified - an increase in sugar or a decrease in it - this may be influenced by a variety of factors

Speaking about the increased ratio, it is strongly recommended to pay attention to reasons such as diseases of the endocrine system, in particular thyrotoxicosis, acromegaly and some others. We should not forget about the likelihood of developing inflammation of the pancreas, a tumor in the presented area, chronic liver disease

Further, experts draw attention to the fact that sugar levels may be higher due to kidney disease, cystic fibrosis, stroke, as well as autoallergic processes.

Paying attention to the main reasons for the downward change in indicators, experts note the following reasons:

• prolonged inflammation of the pancreas;
• oncology associated with the liver, stomach or adrenal glands;
• endocrine disorders, namely aggravated functioning of the thyroid gland.

In addition, one should take into account the high likelihood of developing hepatitis and cirrhosis of the liver, poisoning with certain compounds, as well as drug overdose. The presented processes can also be identified in the presence of high temperature as part of infectious diseases. This can be influenced by such things as prolonged fasting, intestinal diseases and prolonged physical activity.

High or low sugar levels after meals should be identified as early as possible. In order to prevent such changes in the future, it is strongly recommended to implement certain preventive measures. In order for them to be most effective, it is necessary to consult with a specialist - this will protect not only the stomach, but also other physiological systems.

Why do you need to check your glucose levels at night?

By checking your glucose levels at night, you can answer many questions that would otherwise be impossible to answer.

For example, if your glucose level is elevated in the morning , then the reason for this may be:

1. “Dawn phenomenon” , when glucose levels before bed and at night are close to target levels, but rise in the morning. In order for your doctor to choose the appropriate treatment for dawn phenomenon, he or she will need to know what your glucose levels were at bedtime, at 2-3 a.m., and in the morning on an empty stomach. Thus, it is necessary to measure the glucose level for, for example, 3–4 days. Of course, you don’t need to take measurements every night, but once will not be enough to understand whether it was an accident or not.

2. A second cause of high morning glucose levels may be unidentified hypoglycemia at night . Perhaps you didn’t even wake up, just remember that you slept restlessly, sweated, and got up in the morning sleep-deprived and with a headache. In order to avoid a decrease in glucose levels, the body produces the so-called. counter-insular hormones (for example, cortisol, glucagon), which remain in the blood until the morning, so glucose levels are elevated in the morning. If you do not monitor your glucose levels at night, then in this case you can make the wrong decision and increase the dose of long-acting insulin. That is why - in order to detect unidentified hypoglycemia at night - it is necessary to monitor glucose levels also at night.

Also, glucose levels should be monitored at night if attacks of hypoglycemia recur at night and there is a change in diabetes treatment.

Important!

Hypoglycemia is considered to be a blood glucose level below 4.0 mmol/L, or if there are signs of hypoglycemia, such as sweating, rapid heartbeat, weakness, hand tremors (glucose levels may be above 4.0 mmol/L).

Brief dictionary

Contrinsular hormones are hormones that act opposite to insulin, that is, they increase blood glucose levels. Some of them are adrenaline (this is why during hypoglycemia a person sweats and the heart rate increases), cortisol, glucagon.

Preventive actions

The primary measure of influence in this case is the use of products that take the longest to digest, namely items with a low GI

It will be equally important to replace regular bread with whole grain bread, because this type of products presented includes a higher amount of fiber. In addition, it is whole grain bread that is digested much more slowly in the stomach.

It is strongly recommended to include vegetables and fruits in your diet, which should be exclusively fresh. This is necessary because the presented items are saturated with mineral and vitamin components, as well as antioxidants and fiber. In order to maintain a high standard of living even with diabetes, it is highly recommended to consume more protein because it quickly satisfies hunger. In addition, the presented component prevents the development of overeating.

It will be very important, having received sugar levels after meals, to resort to other measures, in particular, to reduce the ratio of so-called saturated fats. Regardless of how much they are used, they will in any case contribute to the formation of obesity. That is why it is strongly recommended to replace them with unsaturated varieties, which will make it possible to significantly reduce the GI of any dishes consumed for diabetes.

It is important to reduce portions because even healthy foods should not be consumed in significant quantities. It will be equally important to combine dietary restrictions with moderate physical activity. You can use certain foods that have a sour taste because they act as a counterbalance to the sweetness. They can eliminate sudden changes in the blood sugar ratio.

Action tactics

If your blood glucose level:

• decreased after meals;
• increased on an empty stomach;
• increased at night;
• lowered at night;
• increases in the pre-dawn time;
• high in the morning after getting up is a serious reason to see a doctor.

Treatment tactics are determined after an accurate diagnosis. In some cases, drug therapy is required.

If you have dawn syndrome, you may need to review your evening diet. Sometimes - additional injection of insulin in the wee hours.

It is more difficult to normalize the condition with Somogyi syndrome. This pathology is difficult to define and even more difficult to treat. For an accurate diagnosis, it is better to check several nights in a row. Treatment is complex: changing diet, physical activity, reducing the amount of insulin administered. As soon as the condition returns to normal, nocturnal hyperglycemia will go away.

Author: Gunta Freimane · April 20, 2016

Master of Psychology, executive editor of the magazine “Diabetes and Health”, Chairman of the Board of the Latvian Diabetes Association

You may have never listened to your endocrinologist's advice about monitoring your glucose levels at night. This seems unnecessary, because no one eats at night, there is no physical activity and stress... Why then get up in the middle of the night? We all already know that sufficient and high-quality sleep is also important for a patient with diabetes. However, for many patients with diabetes (not all, of course!) it is very important to control glucose levels at night in order to achieve a good and stable level of diabetes control.

Important!

Blood glucose targets for patients with diabetes who are taking insulin medications:

• before bedtime – 6.0–7.5 mmol/l;
• around 2.00–3.00 a.m. – above 4 mmol/l;
• in the morning, on an empty stomach – 4.4–6.1 mmol/l.

The dawn phenomenon

The morning dawn phenomenon (syndrome) in diabetic patients most often occurs in adolescence, when hormonal changes in the body occur, however, adults are not immune from this.

The human body is designed in such a way that in the pre-dawn hours the production of certain hormones increases. This is especially true for growth hormone, the maximum peak of which is reached in the early morning hours. As a result, insulin administered before bed is actively consumed and destroyed before dawn. The morning dawn phenomenon is the answer to a common question about why a patient has high blood sugar in the morning.

To determine dawn syndrome, it is necessary to measure glucose levels every hour and an hour and a half between three and five o'clock in the morning. It is during this time period that the activity of the endocrine system is especially pronounced, so blood glucose rises significantly.

As a rule, morning fasting sugar in the range of 7.8 - 8 mmol/L is a common indicator for this condition.

The morning dawn phenomenon (syndrome) can be reduced by changing the injection schedule. In this case, an injection of extended-release insulin between 10:30 pm and 11:00 pm will help avoid a morning rise in sugar.

Another option to correct the morning dawn phenomenon is to administer a short-acting drug early in the morning, around four o’clock in the morning. This method requires utmost attention and correct selection of the dosage of the drug to avoid hypoglycemia. Such adjustments to the insulin therapy regimen should be applied only after consulting a doctor.

The most effective way to reduce the dawn phenomenon or syndrome is to use. The advantages of this method are that the patient does not need to wake up at night or in the morning to administer the injection. The device can be programmed so that insulin enters the blood at a specified time without the direct participation of the patient. The main disadvantage of the method is the high cost of the pump, which not everyone can afford.

It should be remembered that dawn syndrome sometimes occurs in adults. In this case, an increase in glucose levels occurs by lunchtime.

Causes of high blood sugar in men and women

Seeing high glucose numbers in a biochemical blood test, the worst immediately comes to mind, but increased sugar does not always mean pathology, namely diabetes, which is most often implied.

Let me start with the fact that glucose levels can rise for physiological reasons, that is, this happens in healthy people. In what cases?

What is the difference between sugar on an empty stomach and after a meal?

The minimum sugar level in people is on an empty stomach, on an empty stomach. When the food eaten is digested, nutrients enter the bloodstream. Therefore, glucose concentration increases after eating. If carbohydrate metabolism is not impaired, then this increase is insignificant and does not last long. Because the pancreas quickly releases additional insulin to lower blood sugar to normal after meals.

If there is not enough insulin (type 1 diabetes) or it has little effect (type 2 diabetes), then the sugar after meals rises for several hours each time. This is harmful because complications develop in the kidneys, vision deteriorates, and the conductivity of the nervous system is disrupted. The most dangerous thing is that conditions are created for a sudden heart attack or stroke. Health problems caused by high sugar after meals are often considered natural changes of age. However, they need to be treated, otherwise the patient will not be able to live normally in middle and old age.

Glucose tests:

A fasting blood sugar test is a poor choice for diagnosing diabetes. Let's find out why. When diabetes develops, the first thing to do is increase blood glucose after eating. For various reasons, the pancreas cannot cope with quickly reducing it to normal. Increased sugar after meals gradually destroys blood vessels and causes complications. During the first few years of diabetes, fasting glucose levels may remain normal. However, at this time complications are already developing in full swing. If a patient does not measure their sugar after eating, they are unaware of their illness until symptoms appear.

To check if you have diabetes, get a glycated hemoglobin blood test from a laboratory. If you have a home glucometer, measure your sugar 1 and 2 hours after meals. Don't be fooled if your fasting sugar levels are normal. Women in the second and third trimesters of pregnancy must undergo a two-hour glucose tolerance test. Because if gestational diabetes has developed, a glycated hemoglobin test will not detect it in time.

Why does it rise periodically?

The reasons why sugar rises do not always indicate type 2 or type 1 diabetes. It may be greater due to the following physiological reasons:

• intense physical activity;
• high concentration and mental activity;
• fear;
• during pregnancy;
• stress.

Spicy foods can cause an evening increase in blood glucose.

If the evening normal value is elevated, the cause may be heavy, fatty foods or caffeine-containing drinks. Spicy and spicy foods can also provoke an increased level. In type 1 and type 2 diabetes, this tendency is found in high-carbohydrate and starchy foods, especially in the evening. Antidepressants and corticosteroids cause high blood sugar. Physiological disturbances in the organ system create a situation when glucose levels rise:

• liver diseases;
• problems with the endocrine system;
• pancreatic diseases;
• hormonal disbalance.

High fasting sugar is possible after lack of sleep, alcohol abuse and increased body temperature

If glucose is below normal, the patient should pay attention to the intensity of work, increase the amount of rest and avoid starvation. The causes of such conditions indicate the need to consult a doctor for advice and diagnosis.

Ignoring symptoms can lead to serious health problems. Diabetics often suffer from dawn syndrome. In this state, glucose levels exceed 6.1 mmol/L. This can only be adjusted by the doctor by changing the dosage and timing of insulin administration.

High sugar symptoms and signs

Most often, a person has high blood sugar due to diabetes. But there may be other reasons - medications, acute stress, disorders of the adrenal glands or pituitary gland, infectious diseases. Many medications raise blood sugar. These are corticosteroids, beta blockers, thiazide diuretics (diuretics), antidepressants. It is not possible to provide a complete list of them in this article. Before your doctor prescribes you a new medicine, discuss how it will affect your blood sugar.

Often hyperglycemia does not cause any symptoms, even when blood sugar is much higher than normal. In severe cases, the patient may lose consciousness. Hyperglycemic coma and ketoacidosis are serious complications of high blood sugar that are life-threatening.

Less acute but more common symptoms:

• strong thirst;
• dry mouth;
• frequent urge to urinate;
• skin is dry and itchy;
• blurry vision;
• fatigue, drowsiness;
• unexplained weight loss;
• wounds and scratches do not heal well;
• unpleasant sensations in the legs - tingling, goosebumps;
• frequent infectious and fungal diseases that are difficult to treat.

Additional symptoms of ketoacidosis:

• frequent and deep breathing;
• smell of acetone on breath;
• unstable emotional state.

Diabetes symptoms

When blood sugar rises, the patient may notice some changes or symptoms of a serious illness. The most common is constant thirst. This phenomenon is due to the fact that with elevated sugar, the body constantly loses water and is not able to retain it for a long time. Dry mouth is considered an additional or separate symptom of diabetes. Glucose absorbs all incoming water, which sends a signal to the brain from all organs about a lack of water.

A person with diabetes may feel a constant urge to urinate and notice an increase in the amount of fluid coming out. Also a symptom of the disease is increased blood pressure, which indicates impaired kidney function. In addition, in different cases and at different degrees of the disease, diabetics may suffer from excessive weight loss or gain.