edthireo

Q:

I have been diagnosed with type 2 diabetes and I decided not to take medications but try diet and exercise. But my morning glucose level before meal is around 140. Is this something to worry about ?

Amy Campbell

A:

For most people with diabetes, the fasting (before breakfast) and pre-meal blood glucose goal is anywhere between 70 and 130 mg/dl. Your goal could be different, so it’s always best to check with your healthcare provider. But, assuming that your fasting glucose target is 70 to 130, you can first try focusing on the types and amounts of food that you eat in the evening. For example, eating a high fat dinner, such as fried chicken, fettucine Alfredo or greasy Chinese food may lead to higher blood glucose hours later. Also, eating too close to bedtime, whether it’s your dinner meal or a snack, can sometimes lead to higher than desired fasting glucose levels. And eating too much carbohydrate, such as crackers, fruit or popcorn, especially later in the evening, can boost fasting blood glucose levels, too. However, another situation may be occurring during the night and into the early morning hours, called the “dawn phenomenon.” This is a common reason that fasting blood glucose readings are high in the morning. The dawn phenomenon is a result of the effects of hormones that cause insulin resistance overnight. The end result? High blood glucose at dawn (hence the name). You can try the meal planning suggestions that I mentioned above, but if your fasting glucose levels continue to increase (and if your A1C rises above 7%), I’d suggest you talk to your provider about the possibility of needing medication.