What Is The Normal Range For Blood Sugar Levels, And What Blood Sugar Level Constitutes A True Emergency?
Question:What is the normal range for blood sugar levels, and what blood sugar level constitutes a true emergency? Answer:Now, in a normal individual we measure blood sugar under different circumstances. What we call fasting blood sugar or blood glucose levels is usually done six to eight hours after the last meal. So it's most commonly done before breakfast in the morning; and the normal range there is 70 to 100 milligrams per deciliter. Now when you eat a meal, blood sugar generally rises and in a normal individual it usually does not get above a 135 to 140 milligrams per deciliter. So there is a fairly narrow range of blood sugar throughout the entire day. Now in our diabetic patients we see both low blood sugar levels that we call hypoglycemia, or elevated blood sugars, hyperglycemia. Now, if the blood sugar drops below about 60 or 65 milligrams per deciliter, people will generally get symptoms, which are some shakiness, feeling of hunger, maybe a little racing of the heart and they will usually be trenchant or if they eat something, it goes away right away. But if blood sugar drops below 50 and can get down as low as 40 or 30 or even 20, then there is a progressive loss of mental function and eventually unconsciousness and seizures. And of course that is very dangerous and a medical emergency. On the other side, if blood sugar gets up above 180 to 200, then it exceeds the capacity of the kidneys to reabsorb the glucose and we begin to spill glucose into the urine. And if it gets way up high, up in the 400s or even 500s, it can be associated with some alteration in mental function. And in this situation, if it persists for a long time, we can actually see mental changes as well. So either too low or very exceedingly high can cause changes in mental function. Next: W Continue reading >>
Controlling The Dawn Phenomenon
One of our most stubborn challenges is to control the dawn phenomenon. That’s when our fasting blood glucose readings in the morning are higher than when we went to bed. The dawn phenomenon is a normal physiological process where certain hormones in our body work to raise blood glucose levels before we wake up, as we wrote in The New Glucose Revolution: What Makes My Blood Glucose Go Up…And Down? Professor Jennie Brand-Miller of the University of Sydney, Kaye Foster-Powell, and I co-authored that book (Marlowe & Co., first edition 2003, second American edition 2006). These so-called counter-regulatory hormones, including glucagon, epinephrine, growth hormone, and cortisol, work against the action of insulin. They stimulate glucose release from the liver and inhibit glucose utilization throughout the body. The result is an increase in blood glucose levels, ensuring a supply of fuel in anticipation of the wakening body’s needs. If you take insulin injections, it could be that the effect of insulin you took is waning. Your blood glucose will rise if you didn’t take enough to keep your insulin level up through the night. The dawn phenomenon varies from person to person and can even vary from time to time in each of us. That much was clear when our book came out. But how to control it was a different story. A couple of years ago here I wrote about several efforts for “Taming the Dawn Phenomenon.” People have tried everything from eating a green apple at bedtime to high-maize grain to uncooked cornstarch. None of these remedies that I have been able to try ever worked for me. I always thought that the most promising remedy was one that a correspondent named Renee suggested – vinegar capsules. “I am still using vinegar tablets (usually 8) each night and have us Continue reading >>
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-changing results.” Hyperglycemia In type 1 diabetes, the pancreas can no longer provide either the steady drip of basal insulin that keeps blood sugar levels stable between meals or the bolus release of insulin that directs the uptake of glucose after eating. Patients must take basal insulin to keep their fasting blood sugar levels steady and bolus insulin to match their carbohydrate intake and correct highs. The primary cause of hyperglycemia in type 1 diabetes is carbohydrate intake that isn’t matched with bolus insulin dosing. Perhaps Jill is underreporting her carbohydrate intake, administer Continue reading >>
Why Blood Sugar Can Be High In The Morning
You wouldn’t expect hours of sleep and fasting to leave you with high blood sugar. But elevated morning glucose may be more common than you think. Although it’s not a major problem when it occurs from time to time, consistently high morning levels need your doctor’s attention. Causes of Morning Hyperglycemia High blood glucose in the morning typically occurs due to one of three distinct causes: Dawn Phenomenon The “dawn phenomenon” describes high morning glucose that occurs due to a natural rise in hormone levels. During the early morning hours between about 4 and 8 a.m., your body releases hormones like cortisol and growth hormones to get ready for the day. For reasons experts don’t completely understand, your liver produces extra glucose in response to these hormones. People without diabetes secrete more insulin to handle the extra glucose. But for people with diabetes, blood glucose levels can rise too high. Increased blood sugar due to the dawn phenomenon is usually treated with diabetes medication. If you are on insulin, your insulin levels may need to be changed. The Somogyi Effect It’s possible to experience low blood sugar, or hypoglycemia, while sleeping and not even know it. The potentially dangerous problem can occur for a number of different reasons—from not eating enough or taking too much insulin, to drinking too much alcohol. In some people, the body compensates for the hypoglycemia by producing a lot of hormones. This, in turn, causes blood sugar levels to rise. Not everyone wakes in reaction to low blood glucose levels. But being sweaty or having a headache in the morning can be a sign. If you suffer from the Somogyi effect (named after the scientist who first described the condition), your doctor may recommend that you eat a snack befor Continue reading >>
Is Your Fasting Blood Sugar High Every Morning?
I recently had an issue where no matter what I did, my fasting blood sugar levels were always high every morning. They were in the range of between 12 mmol/L to 16 mmol/L. At first I chalked it up to overdoing it around the holiday season. Eating way more carbs than usual, especially late at night and very close to bedtime. I figured that I was off with my bolus for the meals I ate at night. However, after I cut out the extra carbs and still got high readings in the morning, I knew something was off. I realized that every morning religiously, I would wake up between 3 am and 4 am with a high blood sugar. Unfortunately if my blood sugar is above 8 mmol/L I cannot sleep. This problem prevented me from getting good quality sleep. I would often have to correct and monitor before I could go back to bed. I started to analyze my diet and my habits to see where I was going wrong. If you are experiencing a similar issue you can start with the below recommendations. Things to rule out as causes of high fasting blood sugar levels. The main concern is having a high fasting blood sugar for more than 4 or 5 days consecutively. The first step is to eliminate all of the below issues as being the culprit. Sometimes we overlook the simplest or most obvious things. 1. Not taking enough meal time insulin This is the first thing to look into. Make sure that you correctly determine the number of carbohydrates in your last meal of the day and take the insulin to suit. Be sure to also look out for sources of hidden carbs as well. Our bodies react to food and insulin differently at different times of the day. Many individuals including myself have a different carb to insulin ratio at night. I normally have to take a bit more insulin at night especially if the meal is high in carbohydrates(50 gr Continue reading >>
A Simple Trick To Lower Morning Blood Sugar
If you’re type 2 diabetic, you may be wondering why your blood sugar is so high in the morning. Every other time you test, your levels seem to be within range… But those morning levels, sometimes they are sky high and it puts you in a panic, questioning what on earth you may be doing wrong. Firstly, stop panicking — morning rises are a common occurrence in diabetics. However, it is important to understand why it happens and what you can do about it… The dawn phenomenon Logically you’d think that your blood sugar reading should be at it’s lowest in the morning. After all, you’ve eaten nothing and done nothing but sleep. But regardless of whether you eat, glucose production continues anyway… The reason for this is your body’s cells need fuel for your heart to beat, your brain to work and your organs to keep functioning. When you don’t eat, or when you’re asleep, the body can break down stores of available glucose (glycogenolysis) or enter a process called gluconeogenesis — a process that can use non-carbohydrate stores such as amino acids to produce glucose. Various hormones such as glucagon, growth hormone and cortisol, are also involved in raising glucose levels. To wake you up every morning, your body naturally activates these hormones from around 3 am onwards, which explains why it’s called the dawn phenomenon. In people without diabetes, insulin would normally counteract these hormones to prevent excessive glucose production. But since the insulin response and insulin sensitivity are altered in diabetes, your body may not compensate effectively. The Somogyi effect There is another phenomenon called the “Somogyi effect” or “rebound hyperglycemia.” This is when your body’s glucose levels decrease during the night (nocturnal hypoglyce Continue reading >>
Why All The Morning Highs?
Sometimes diabetes doesn’t make a lot of sense. Think of those mornings when you wake up to find your blood glucose looking as if you’ve been up all night eating cookies. What’s up with that? You’d think that not eating for those seven or eight hours would give you lower blood glucose, right? Such morning highs are common in people with diabetes, but one of the reasons has a particular name: the dawn phenomenon. The dawn phenomenon is a natural rise in blood glucose between 4 and 8 a.m., which happens because of hormonal changes in the body. All people have the “dawn phenomenon,” whether they have diabetes or not. People without diabetes would never notice it happening, as a normal body’s insulin response adjusts for this. However, because people with diabetes don’t have normal insulin responses, they may see an increase in their fasting blood glucose. This is primarily because people with diabetes produce less insulin and more glucagon than they need. The less insulin produced by the pancreas, the more glucagon the pancreas makes as a result. Glucagon, in turn, signals the liver to break down its storage supplies of glycogen into glucose. This is why high fasting blood glucose levels are commonly seen in patients with type 2 diabetes. The effects of dawn phenomenon vary in each person, and your blood glucose may be higher on some mornings than on others. But not to worry—there are steps you can take to get those numbers down and start your days more comfortably in your target blood glucose range. Treatment for dawn phenomenon depends on how you treat your diabetes. If you take insulin, you may be able to adjust your dosing so that peak action occurs closer to the morning rise in your blood glucose. If you have type 2, diabetes pills provide options as Continue reading >>
Blood Sugar: What Causes High Blood Sugar Levels In The Morning
There are two reasons why your blood sugar levels may be high in the morning – the dawn phenomenon and the Somogyi effect. The dawn phenomenon is the end result of a combination of natural body changes that occur during the sleep cycle and can be explained as follows: Your body has little need for insulin between about midnight and about 3:00 a.m. (a time when your body is sleeping most soundly). Any insulin taken in the evening causes blood sugar levels to drop sharply during this time. Then, between 3:00 a.m. and 8:00 a.m., your body starts churning out stored glucose (sugar) to prepare for the upcoming day as well as releases hormones that reduce the body's sensitivity to insulin. All of these events happen as your bedtime insulin dose is also wearing off. These events, taken together, cause your body's blood sugar levels to rise in the morning (at "dawn"). A second cause of high blood sugar levels in the morning might be due to the Somogyi effect (named after the doctor who first wrote about it). This condition is also called "rebound hyperglycemia." Although the cascade of events and end result – high blood sugar levels in the morning – is the same as in the dawn phenomenon, the cause is more "man-made" (a result of poor diabetes management) in the Somogyi effect. There are two potential causes. In one scenario, your blood sugar may drop too low in the middle of the night and then your body releases hormones to raise the sugar levels. This could happen if you took too much insulin earlier or if you did not have enough of a bedtime snack. The other scenario is when your dose of long-acting insulin at bedtime is not enough and you wake up with a high morning blood sugar. How is it determined if the dawn phenomenon or Somogyi effect is causing the high blood sug Continue reading >>
What A High Blood Sugar Feels Like? Signs & Symptoms Of Hyperglycemia
I get my first cup of coffee and sit on the sun deck with the birds singing. I feel as if I have not slept a wink, and my head aches. I could go back to bed and sleep all day, but work awaits. It’s a beautiful, sunny day, but my body feels heavy, and stuck to the chair. It hurts to lift my arms. My blood sugar was 381 this morning. Again. I think about having to face the day at the office. Driving down the interstate, the lines are blurry. I know that if the DMV got wind of it, I might not be driving as high as my A1C had been. When I get to the office, I walk in with a dark fog feeling surrounding me, and take some deep breaths at my desk. As I begin to review the end of the month reports, the numbers get fuzzy, and I can’t concentrate on them. My 36 ounce water bottle with only a few sips left beads sweat on the desk, and it’s across the building to get to the bathroom. Sometimes it’s a race to get there in time. My body is taught and swollen, like the Blueberry Girl from Willy Wonka’s Chocolate Factory. My blood sugar is a blue river of sticky blueberry filling as I roll down the hall toward the bathroom. I feel that if I had a needle, I could pop myself. That would surely be a mess. My skin is so dry and flaky that no amount of lotion will hydrate it. No amount of water can quench my thirst, and my mouth feels like the Sahara Desert. With one hand on the water cooler, and the other hand on the bathroom door, I guzzled down what I could until the feeling hit that I wasn’t going to be able to wait any longer. I was out of regular insulin, and I had taken my long acting insulin. I was not so patiently waiting for it to kick in. This morning was not starting out so well. I’d have to tackle the reports in my current brain fog. I did have a doctor’s appoin Continue reading >>
6 Things To Do If Your Blood Sugar Is Too High
Grapefruit also has a low glycemic index (GI), around 25, which means it doesn't raise blood sugar as quickly or as much as high-GI foods like white bagel (72) or even a banana (48) or watermelon (72). (The highest GI score is 100.) A 2006 study published in the Journal of Medicinal Food, found that people who ate grapefruit (juice or half a fruit) before a meal had a lower spike in insulin two hours later than those taking a placebo, and fresh grapefruit was associated with less insulin resistance. All 91 patients in the 12-week study were obese, but they did not necessarily have type 2 diabetes. While the results are promising in those without diabetes, blood-sugar reactions to food can vary widely, so if you have been diagnosed with type 2 diabetes, test your blood sugar after eating grapefruit to make sure it can be part of your healthy eating plan. Getty Images Blood sugar is a tricky little beast. Yes, you can get a high reading if you throw caution to the wind and eat several slices of cake at a wedding. The problem is that you can also have a high blood sugar reading if you follow every rule in the type 2 diabetes handbook. That's because it's not just food that affects blood sugar. You could have a cold coming on, or stress may have temporarily boosted your blood sugar. The reading could be wrong, and you need to repeat it. Or it could mean that your medicine is no longer working, and it's time to try a new one. The point is, it's the pattern that matters, not a single reading. Whatever you do, don't feel bad or guilty if you have a high blood sugar reading. A 2004 study found that blood sugar monitoring often amplifies feelings of being a "success" or "failure" at diabetes, and when readings are consistently high, it can trigger feelings of anxiety or self-bla Continue reading >>
Blood Glucose Levels High In Morning & Low After Eating
You may be puzzled by a high blood glucose reading in the morning despite going to bed with a good reading the night before. Or your postmeal blood glucose may be lower than the reading before you ate. Unusual blood glucose fluctuation can be frustrating for diabetics and is affected by many factors. Keeping a good record of your diet, medication and blood glucose can often help you solve the mystery. Video of the Day If you consistently wake up with higher blood glucose levels despite being compliant with your meal plan, this could be a condition known as the dawn phenomenon, states the American Diabetes Association. Dawn phenomenon is a a sudden rise of blood glucose levels 10 to 20 milligrams per deciliter in the early morning between 2:00 and 8:00 a.m. It is caused by an increased release of hormones such as cortisol, glucagon and epinephrine while your body is preparing to wake up. These hormones increase insulin resistance and stimulate your liver to release glucose, causing blood glucose levels to rise. Insufficient insulin or medication, excessive carbohydrate snacks at bedtime or high-fat meals at dinner may also cause blood glucose to be elevated in the morning. To rule out if your high blood glucose is due to dawn phenomenon, your endocrinologist may ask you to eat a low-fat, carbohydrate-controlled dinner, maintain your usual physical activities and check your blood glucose around 2 or 3 a.m. for several days. Your doctor will help you determine if you have dawn phenomenon and adjust your medications accordingly. If the fluctuation is due to food, your dietitian may alter your meal plan and may suggest that you skip a bedtime snack or change the type of snack to a lean protein, modify your dinner or add some light exercise after dinner. When you wake up with Continue reading >>
Controlling The Dawn Phenomenon
Do you wake up with a blood glucose level that’s higher than when you went to bed? You might wonder how this could be. Is this “dawn phenomenon” serious, and what can you do about it? Our reader Mishelle commented here, “I don’t eat [much] during the day. [I take metformin morning and night.] My blood sugar is still too high in the morning…sometimes 125–140ish.” How can Mishelle’s glucose levels go up if she didn’t eat anything? She probably has a mild case of dawn phenomenon. Her glucose is going up from sources other than digested food. Some of it is produced by the liver from stored starch and fatty acids. Livers that produce too much glucose are one of the main ways diabetes causes high blood glucose levels. Other organs also produce small amounts of glucose. This is called “gluconeogenesis” for you science freaks out there. Organs do this to keep blood glucose from going too low at night or other times of not eating. From about 2 AM to 8 AM, most people’s bodies produce hormones, including cortisol, glucagon, and epinephrine. All these hormones increase insulin resistance and tell the liver to make more glucose. The idea is to get you enough glucose to get out of bed and start the day. The whole process is apparently started by growth hormones. Everyone has a dawn phenomenon. Otherwise they’d be too weak to get breakfast. But in people without diabetes, insulin levels also increase to handle the extra glucose. People with diabetes can’t increase insulin levels that much, so their early morning blood glucose levels can rise dramatically. Experts disagree on how many people have a dawn phenomenon. Estimates range from 3% to 50% of Type 2s and from 25% to 50% of Type 1s. Is dawn phenomenon a serious problem? It can be serious. According t Continue reading >>
Why Do I Have High Blood Sugar Levels In The Morning?
Some people experience very high blood sugar levels in the morning. But what implications does this have for a person's health? There are two main causes of high blood sugar in the morning, the dawn phenomenon and the Somogyi effect This article explores these two causes of high blood sugar levels in the morning. It also discusses what risk factors may cause people to experience them and gives practical advice around how to better manage blood sugar levels. Contents of this article: The dawn phenomenon The dawn phenomenon has to do with natural body changes that occur during the sleep cycle: Midnight - 3 a.m. While most people are sleeping, their body has little need for insulin. During this period, however, any insulin that may have been taken during the evening causes the blood sugar levels to drop off drastically. Between 3 - 8 a.m. The body automatically begins to dish out stored sugar (glucose) in preparation for the upcoming day. In addition, hormones that actively reduce the body's sensitivity to insulin are also being released. During this time period, counter-regulatory hormones are being released. This can interfere with insulin, which may lead to a rise in blood sugar. These include growth hormones, such as: cortisol glucagon epinephrine These events are all happening simultaneously as bedtime levels of insulin are beginning to taper off. Each of these events ultimately plays a part in causing blood sugar levels to rise at "dawn" or in the morning. Who the dawn phenomenon affects Although people with diabetes are generally more aware of the dawn phenomenon, it actually happens to everyone. However, it affects people with or without diabetes differently. Typically, people who do not have diabetes tend not to notice these high blood sugar levels in the morning. Continue reading >>
How To Fix High Morning Blood Sugars (dawn Phenomenon)
There are various possible causes of a high blood sugar level in the morning: The Dawn Phenomenon which is a natural rise in blood sugar due to a surge of hormones secreted at night which trigger your liver to dump sugar into your blood to help prepare you for the day. Having high blood sugar from the night before which continue through the night into the morning. Reactive hyperglycemia which is also called the Somogyi Effect. This is when a low blood sugar in the middle of the night triggers your liver to dump sugar into your blood in an attempt to stabilize your blood sugar. Why Are My Blood Sugars High in the Morning? There is a simple strategy for diagnosing the source of high blood sugars in the morning. Test your blood sugar before bed. Test your blood sugar in the middle of the night. Test your blood sugar in the morning. It takes a little bit of effort, but you only need to do it a few times to diagnose the issue. TheSomogyi Effect is less common than the Dawn Phenomenon, according to an article published by The Polish Journal of Endocrinology. To diagnose either of these phenomena, scientists recommend checking blood sugar levels for several nights specifically between 3 a.m and 5 a.m. or using a continuous glucose monitoring system (CGM). Many healthcare practitioners are now offering the use of a loan CGM for a few days which can be helpful to observe nighttime blood sugar activity. How to Fix High Blood Sugars in the Morning The Dawn Phenomenon refers to a surge of hormones excreted by your body in the early morning hours. These hormones rise each night around the same time to prepare your body to wake. Basically, your body is starting the engine, releasing some fuel, and prepping to go for the day. The Dawn Phenomenon occurs in all humans regardless of whet Continue reading >>
Why Is My Fasting Blood Sugar High In The Morning?
People often wonder the reasons for the high level of blood glucose when they wake up early in the morning. There can be several reasons for the same. This article deals with the topic “Why is My Fasting Blood Sugar High in the Morning?” so, join in for this article and read on: What is Fasting Glucose? Fasting blood glucose is the level of blood glucose that you have when you check it early in the morning before eating anything. It is usually high and there are two main reasons to explain the same. The following phenomena are responsible for the high levels of fasting blood glucose in the morning: What is the Dawn Phenomenon? There is a host of changes that take place in the body while we are sleeping. These changes are known as the “Dawn Phenomenon.” One of the reasons for high blood glucose levels when we wake up in the morning is this dawn phenomenon. 3 A.M is the time when our body is experiencing the soundest sleep. Hence, around this time the body hardly needs any insulin. Whatever insulin is taken by the body in the evening leads to a sharp loss in the level of blood glucose at this time. As a result, between 3 A.M to 8 A.M, the body is slowly getting more and more resistant to the hormone insulin and the stored glucose of our body is being used for the release of some energy. When all the above things are taking place, the insulin you must have taken at bedtime is also getting used up in the process. All these are responsible for the increase in the level of blood glucose early in the morning when you wake up. What is the Somogyi Effect? Another reason for the high level of blood glucose in the mornings is the Somogyi effect as described for the first time by the famous researcher, Michael Somogyi. This effect is also known as the rebound effect due to Continue reading >>