I have been working on my diet and trying to eat the right foods. I have not been able to lose any weight. I have type 2 diabetes. My sugar level in the morning can range from 130 to 180. My A1c over the past 6 months is 7.2. I was taking metformin and glimepiride. My doctor just started me on janumet er. My sugar since I started is still high in the morning. The problem is during the day it can drop to the 80s. I don't know what to do. Please help me.

Amy Campbell


It’s common for blood glucose levels to be higher than desired in the morning, as the liver tends to release glucose during the overnight hours. Your diabetes medication should help with this, and hopefully lower your morning blood glucose levels to below 130 (the goal for most people with diabetes is 70 to 130 before meals). It may be that you need an adjustment in your medication. However, it can take a while for your medication to start working, especially since you just started on a new one. Also, be careful of what you might be eating at night. Snacking after dinner, especially on fatty foods, such as potato chips or cheese and crackers, may also lead to higher glucose readings the next morning. If you usually eat a snack, skip it one night and see if that makes a difference in your morning readings. A blood glucose of 80 during the day is not considered to be “low,” so you should not be concerned unless your glucose drops below 70. Fortunately, your A1C level of 7.2 percent is very close to the target A1C for most people with diabetes, which is less than 7 percent. Keep checking your blood glucose and if you don’t see an improvement in your fasting blood glucose after another week or so, let your provider know. In terms of your weight, try keeping a record of your food intake for a few days and then review it and see where you might be able to make some changes. You might also consider meeting with a dietitian for more structure and guidance. Don’t forget that physical activity is the other part of the equation when it comes to weight loss. In fact, guidelines state that people need to be active pretty much every day for about 60 minutes in order to lose and maintain weight. You don’t have to be active for 60 minutes all at once, but the point is that you should try and move as much as you can every day.

March 7, 2013 at 7:48 pm