My sugar rises in the early morning even if I don’t eat!
A puzzling and frustrating issue for many with diabetes and pregnancy is that the blood sugar may rise coming into breakfast time even though no food was taken. The usual scenario is the woman checks her sugar when going to the bathroom at five or six in the morning, takes nothing, goes back to bed and then at eight AM the sugar is higher by 1 mmol/lI (18 mgs/dl). Just what is going on?
In non diabetic people the lowest sugar throughout the full 24 hour day typically occurs at about three AM. Then during the night the hormones cortisol and growth hormone rise and these will raise blood sugar a little. During pregnancy the hormones from the placenta accentuate this so there is more pressure to raise the blood sugar. In addition the liver naturally wants to make sugar, it generates the equivalent of four slices of bread over night. Remember we need glucose for our brains to keep working. What holds everything in check is insulin, the pancreas must make enough insulin to regulate the liver’s production of sugar. When there is not enough insulin to control the liver overnight the blood sugar rises and the pressure to make sugar is strongest typically from four to eight-nine AM.
Thus a slight rise in the blood sugar from three to nine AM is normal but the blood sugar should not go over 5.3 mmol/l (95 mgs/dl). If it does then the insulin antagonistic hormones are too strong for this person’s pancreas. If the sugars are consistently up they likely will need tablets or insulin to control the situation. Of all the blood sugars measured during the day, the fasting one, before breakfast is least responsive to diet. The problem is less what one ate and more how much insulin the pancreas made overnight.