I am type 2 diabetic. My glucose is 200 or 220 in the morning when I get up. I sometimes have a protein snack at bedtime. I eat a healthy dinner. I dont know why it is so high only in the morning. It gradually goes down to about 120 to 140 at noon then stays lower all day. I am not eating the wrong things. Can you please tell me why this is? I am taking four 500 mg Metformin, two 5 mg glyburide, and one 25 mg Januvia daily.

Amy Campbell


It’s actually common for people to wake up with higher blood glucose readings in the morning. This can occur for a number of reasons, but one of the main reasons is that insulin resistance increases during the overnight hours due to the release of certain hormones, such as cortisol. As a result, blood glucose levels increase. This is a condition called the “dawn phenomenon.” Other reasons for high morning blood glucose include rebounding from a low blood glucose overnight, and eating too much carbohydrate at dinner or at a bedtime snack. You may first want to rule out hypoglycemia in the middle of the night by setting your alarm and checking your blood glucose at, say, 3 am. Then, double check that you’re not overdoing the carbs at dinner (generally, 45 to 60 grams is a goal to aim for). However, in the event that you may be experiencing this dawn phenomenon, talk to your physician about your options. You may need to increase your dose of glyburide in the evening. If that isn’t sufficient to lower your fasting glucose, bedtime insulin is another option.