Why do most diabetics worry about the morning fasting blood sugar being high?-Written by Dr. Harold Gunatillake

FRCS, MBBS, AM (Sing), FICS (US) FIACS (US)

Fasting blood sugar is a test done on your early morning wake up time check, or when you visit the collecting centres to give blood for biochemical screening, fasting for 12 hours.

Fasting blood sugar is more diagnostic to check whether you have excess blood sugar. That would be the routine
test your doctor will request on your annual blood check, sometimes with the HbA1C test If it is on the high side your doctor refers you for a random plasma glucose test or oral glucose tolerance test. The oral glucose tolerance test is the gold standard for diagnosing type 2 diabetes.

If your fasting level is higher than 126 mg/L (7 mmol/L) you have diabetes.
So, lets go back to the fasting blood sugar test (fasting for 12 hours) and its significance in diagnosis and control of diabetes. After diagnosing diabetes, a fasting blood sugar level is not required as it takes you no where in your management of diabetes.

But you will do a fasting blood sugar level test at home spontaneously whether your doctor requests you to do or not, for your own curiosity.

And then, you worry about it when its above the normal range, on most days.
This early morning jump of sugar level do occur between 2 and 8 a.m. Normally, whether you are a diabetic or not, due to hormonal changes in your body, there is a boost on your blood sugar in the early hours of the morning.
The hormones that are involved are growth hormone, cortisol, glucagon and epinephrine. They all raise your blood sugar level.
Normally in a non-diabetic more insulin is manufactured to control this increase level of blood sugar. In a diabetic, since your body does not respond to insulin, your morning blood sugar will be raised, even if you are controlled with medication and a strict diet.
Please read again and again and understand the situation, and not worry about this high morning reading.
In the first place do not do a fasting blood sugar level test, with your own monitor at home, when you are a proved diabetic.
This natural boost is necessary to give enough energy to get up and start the day.
In addition to the above natural boost of blood sugar in the morning, there may be other factors that cause this rise.
You didn’t have enough insulin the night before. Or you may have forgotten to take your tablets the night before
Or you may have gone to dinner to a friend’s or a restaurant and broken all the rules, including an extra drink of wine. If you are concerned about your raised fasting blood sugar, do an early morning brisk walk for one hour daily (aprox.8,000 steps), your blood sugar will come down below the normal range, you would be thirsty and hungry and your breakfast would be most rewarding and pleasurable.

For daily management of your blood sugar, it is more feasible to do a random blood sugar at about 4pm, and that should read between 7- 8mmol/L.
If you walk about 3-4 hours with short breaks daily, your insulin resistance will drop, and you may need minimal medication or no medication.
Hope this article is useful.

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