Reasons for a high fasting blood sugar with Type 2 Diabetes and what to do about it

Do you start the night with a pretty good starting value and overnight, the blood sugar rises even though you’re unaware of having emptied your entire fridge throughout the night?

So, how do these high fasting values come about?

If you have Type 2 Diabetes, you probably have a bit of extra fat around mid section. Physicians call it abdominal fat. If that fat accumulates in our liver cells, they become less sensitive to the hormone insulin. And this is exactly where the problem lies.

Sugar release from the liver

Usually, our liver releases a few grams of sugar, depending on body weight, per hour, into our blood to stabilize the blood sugar when we’re not eating. Insulin is normally released when the blood glucose values are high to suppress the release of sugar as it wouldn’t actually be needed if the blood sugar is already high. Since people with Type 2 Diabetes often have insulin resistance, which means that the insulin can no longer work properly, the liver releases much more sugar into the blood than needed. All this sugar would then have to be transported to the muscle cells and consumed with the help of insulin. As these cells don’t have a high need for sugar, particularly in the night while sleeping, it’s accumulated in the blood and this results in high blood sugar values in the morning.

Additionally, various hormones (growth hormones, adrenaline, cortisol & glucagon) play a trick on us. They’re the opponents to the hormone insulin and to really get you going in the morning, these hormones are produced in the second half of the night.

That’s why we need more insulin to transport the sugar into the cells in the early morning hours than for example at noon. Therefore, a breakfast with less fast carbs and a little bit more protein can help reduce the increase of  blood sugar values. The beloved white wheat roll with strawberry jam is therefore, rather, something better off saved for special days. ?

Sleep quality can affect your blood sugar

But there are some other factors that affect our blood sugar values in the morning. The duration and quality of our night sleep, for example.

Those who sleep less than 6 hours or sleep badly often have more of the stress hormone cortisol in their blood which causes the liver to release an extra portion of sugar. 

What can I do about high blood glucose values in the morning?

Let’s start with the little helpers:

• Sleep well and enough - which is unfortunately easier said than done ?

• If it’s possible, try to eat your dinner 4 hours before going to sleep. This has the advantage that most of the meal is digested when you go to sleep and your blood sugar doesn’t increase throughout the night. 

• Going for a walk after dinner can help to make the cells more sensitive to the effects of insulin. The muscles simply consume more sugar then, which prevents it from being accumulated and converted into fat.

• There are also some diabetes medications that can help: An important active agent is metformin. It works for about 12 hours and can suppress the unchecked sugar release of the liver. In case of high fasting blood sugar values, it’s ideal to take it later in the evening and many people take it twice per day to see these great effects all day long. You can discuss with your attending physician, if this is an option for you at all. 

• Of course, insulin also lowers the fasting values and is for some people with Type 2 Diabetes indispensable. But be careful! Insulin is not the solution for the problem itself, it just lowers the high blood sugar and even that is often not working properly because of the high insulin resistance. Remember: Insulin is our fat storage hormone, so the more we inject, the more fat we tend to store. And I hardly know anyone who doesn’t like the idea of getting slim while sleeping.