T Nation

Glucose highest in morning

A couple of months ago a friend’s mother decided to go on the Atkin’s diet because of her high glucose blood level ( > 160). Since then her blood sugar has been steadily dropping and now her average blood sugar is just below 100. But within the last month an interesting thing has been happening. Her morning glucose before breakfast has been higher that any other time of the day. 90 minutes after she eats breakfast, her glucose level has actually decreased. This I could not explain. She usually doesn’t eat anything past 6pm. In my limited knowledge my first thought was that her insulin was getting shut down during the night, thus not allowing her blood glucose to get absorbed into the body’s cells. Would anyone have an idea of what might be going on? Any help would be well appreciate. Thanks.
Brownbear

I certainly don’t have a full handle on it – it’s an interesting thing to be sure – but one aspect that’s probably contributing is that the protein consumed with breakfast is stimulating an insulin release, driving down the existing blood sugar, moreso immediately than the effect of increasing blood sugar from conversion to glucose. At least, that would seem to make sense.

Funny you mention this as I just brought this very topic up on another thread.

In some people, there seems to be a “reverse hypoglycemia” effect that occurs in the morning. I had this very same thing when I used to do cyclical keto diets. I could never register urinary ketones in the morning regardless of what I did, but anytime I would test later in the evening they would always show up. I can’t explain the physiology behind this…I just know it happens in some people.

Yes, I can attest to this as well. In the morning hours after I first wake my blood sugar is always at its highest. I find it hard to eat anything during this time. I actually feel much better if I fast but I know I shouldn’t. And it never fails that around 5-6 hypoglycemia sets in and I get ravenous.

An elevated AM glucose has been described in diabetics and is refered to as the “dawn phenomenon”. The exact cause is not clear, although cortisol which peaks at 6 AM (and would tend to elevate blood sugar levels) may play a role.

Thanks for the reply guys. It does seem plausible that cortisol may be playing a role here. My friend’s mother has been under a little stress lately. Maybe that’s manifesting itself in a higher level of cortisol. She gets blood work done fairly frequently. Maybe she can ask if she can get her cortisol checked (if she doesn’t get it checked already). Again, thanks guys.
Brownbear

I asked my endo’s nurse a similar question just the other day. I didn’t fully understand the answer, but I’ll relate what I can. Overnight fasting glucose is only one part of the entire blood sugar / insulin picture. Apparently during sleep, the liver kicks in (about 4-5am) and starts producing glucose so you can actually wake up. The desired levels for morning fasting glucose are 80-110. The morning glucose levels apparently have very little to do with sugar load response during the day. Morning blood glucose level represents liver function and overall body setpoint due to insulin resistance. Blood glucose levels during the day represent glucose uptake and insulin action. Does that make sense?