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Type 2 Diabetes
March 2003

Q. I am a 52-year-old type 2 diabetic. Can you tell me why the highest sugar I have when I do home monitor is the morning one when I have not eaten for 8-12 hours? It doesn't seem to matter what the evening meal was, it's always the highest test of the day. My A1C test has been 7 or lower the last 3 years.

A. Type 2 diabetes usually occurs in adults, and responds to diet, exercise, and medication. The pancreas still makes insulin but the body tissues become less responsive to the insulin, so blood sugar levels remain high. Control of blood sugar levels within an optimal range is a critical life function, as the brain requires constant glucose supply to function. Other organs such as the liver and muscles can store glucose in the form of glycogen.

These stores become critical during sleep and other periods where food is not supplied. The liver in particular will release its glucose stores to keep blood glucose normal during sleep. So in the morning, your blood glucose can be elevated even though you have not eaten for many hours.

Keeping blood sugar near normal levels will prevent or delay many of the complications of diabetes. The hemoglobin A1C test reflects the level of glucose control, so you seem to be doing well in this regard.



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