What Should Your Blood Sugar Be At Bedtime

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Correcting Morning Blood Sugar Highs — Know The Causes Of These Spikes And Ways To Treat Them

Today’s Dietitian Vol. 14 No. 11 P. 18 Jill is frustrated. Her type 1 diabetes seems out of control, and she comes to your office at her wits’ end. She says she’s doing everything right: counting carbs, taking her insulin as prescribed, monitoring her blood glucose levels four times per day. A look at Jill’s testing logs and most recent blood work confirms there’s a problem. She has a hemoglobin A1c of 9.2, and her blood glucose levels are all over the map. Her numbers generally are fine before she goes to bed but incredibly high in the morning. Recently, her physician increased her nighttime basal insulin dose to counteract the morning highs, but things seem worse now than ever. Her breakfast bolus doesn’t seem to be effective, and her high blood glucose levels persist into the afternoon. “Fluctuating blood sugars can be very frustrating,” says Eileen M. Sturner, RD, LDN, CDE, BC-ADM. “RDs can play an important role in helping patients get to the bottom of problems such as morning highs. Working with patients to gather the appropriate data and facilitating the sharing of those data with the healthcare provider that’s managing their diabetes can have life-changi Continue reading >>

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  1. Dr. D. Love

    Thank you for using JustAnswer. I will be glad to assist you today.
    This is a good question, but one that is more complicated than it would first appear. There is no single goal of bedtime blood sugar for hypoglycemics, as it would depend upon the pattern of hypoglycemia.
    Some people have the primary problem as a reactive hypoglycemia, so primarily occurs after meals and is not as much of a problem during the night. In this situation, there is less concern about the bedtime blood sugar and the goal would be to achieve a blood sugar that is in the normal range (i.e., 70-100).
    However, if the pattern is that there is more of a problem during the middle of the night, because it is the longest period of time that the person goes without eating, there would be a higher goal, so that there is some buffer before going to sleep. In this situation, the goal would be to achieve a blood sugar that is high in the normal range (i.e., 85-100).
    Another problem, though, is that there is a limitation in the accuracy of home glucose meters. They generally will provide 20% accuracy (so that the reported result is within 20% of the true value), but this would not differentiate between a value of 75 and 85; these two values are within the range of accepted accuracy for a home glucose monitor.
    For this reason, doctors will also strongly rely on a patients history and current symptoms, rather than just developing a strict threshold goal on a home glucose monitor.
    My goal is to provide you with excellent service and a complete answer. If I have completely answered your question, please remember to provide a positive rating so that I can be compensated for my time. If you have any further questions or need clarification, please let me know.

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