India is home to 77 million people with diabetes, the second highest in the world only after China, finds the 9th edition of IDF Diabetes Atlas, 2019. Factors that play a role in the rise, and situations where people with diabetes must look into are crucial to controlling mortality. One of the most common phenomena observed among people with diabetes is the rise in blood sugar levels in the morning. If you or someone you know experiences high glucose levels in the morning, keep reading to find out what you need to know.

 

Related Story: The Diabetes Guide: How To Balance Your Blood Sugar

 

A study conducted by Internal Medicine, 2017 that evaluated the data of 106 patients with type 2 diabetes found that most of them experienced the highest postprandial glucose level within 3 hours after breakfast. “Normally, diabetic patients on insulin should be able to maintain their blood sugar levels with ease, but the surge in human growth hormone (HGH) and cortisol (stress hormone) in the morning interferes with the effectiveness of insulin,” says Dr S K Wangnoo, endocrinologist, Indraprastha Apollo Hospitals, New Delhi.

 

A patient is said to have a high blood sugar level or hyperglycemia, in the morning when blood sugar is greater than 125 mg/dL (milligrams per deciliter) in fasting and over 180 mg/dL two hours after eating.

 

Related story: A Celebrity Nutritionist's Guide To Managing Hypertension

 

Ways to control high blood sugar in the morning

Dr Wangnoo suggests six ways to control high blood sugar in the morning. Please note that all the measures should be consulted with your doctor before trying any of these on yourself.

 

1. Eat before 8 pm at night

Eating dinner early improves 24-h blood glucose levels, confirms Nutrients, 2021. Also, another study conducted by The Endocrine Society that analysed data from 10,575 adults found that people who ate before 8:30 am in the morning had lower resistance to insulin and experienced lesser spikes in blood sugar.

 

2. Walk for 30 minutes post meals

“In addition to eating at the right times, a moderate-intensity walk for 30 minutes post-meal is beneficial to control blood glucose levels because muscles use up a lot of glucose when you walk, thereby reducing the amount of glucose in the bloodstream,'' says Dr. Wangnoo.

 

3. Use oral antidiabetic drug the night before

Speak with your doctor to explain how you feel with high blood sugar in the morning. Your doctor will likely prescribe oral antidiabetic drugs. These drugs control the ‘dawn’ phenomenon of the body where the liver triggers the release of glucose as a response to surge in cortisol, growth hormone and catecholamine (a kind of neurotransmitter). Oral antidiabetic drugs such as metformin restore the body’s response to insulin and decrease the amount of glucose absorbed by the intestine or stomach.

 

4. Inject basal insulin (BI) at night before bedtime

A slow-acting type of insulin, basal insulin helps morning glucose control by reaching the bloodstream several hours after the injection. The goal is to keep the insulin in the body for long so as to keep the glucose levels constant throughout the day and night. “The key to taking the injection at the right time is to understand your glucose patterns, i.e, when does it rise and when does it fall, says the doctor.

 

Related story: 10 Things To Know About Hypertension

 

5. Leave a two-hour gap between the last meal of the day and bedtime

“A practice for a good lifestyle, leaving a two-hour gap between your dinner and bedtime helps to control blood glucose spike in the morning,” says Dr Wangnoo. When you sleep, your metabolic rate (thus rate of glucose consumption) reduces by around 15 per cent.

 

6. Check your blood sugar levels at 3 am

Your blood sugar levels can rise in the morning if your blood sugar levels take a big dip at midnight. One reason could be attributed to rebound hyperglycemia. Also known as Somogyi effect (named after Dr Michael Somogyi), This may also occur if you took a heavy dose of insulin at night or did not consume any food before bedtime.

“You should check your blood sugar at midnight, at around 3 am, to note the count. If the count’s too low (less than 100 mg/dL), your doctor will most likely reduce the dose of insulin,” explains Dr Wangnoo.

 

Related story: How To Measure Your Blood Pressure At Home

 

7. Eat protein before carbohydrates for dinner

Food order has a significant impact on glucose and insulin levels, finds Diabetes Care, 2015. In a study where participants consumed protein (skinless grilled chicken breast) and vegetables such as lettuce and tomato salad, steamed broccoli and butter, for dinner, the researchers found a significant improvement in both glucose and insulin levels. You should have 0.8-1 grams of protein per kilogram of your weight when you have diabetes, says Current Diabetology Reports, 2011. Some things you can eat includes a cup of spinach and paneer with 2 multigrain rotis, a cup of brown rice and salad or lentil soup with multigrain rotis and salad.

 

Related Story: Diabetes-Friendly Dessert To Satisfy Your Sweet Tooth—Citrus Bhapa Doi