Diabetes Self-Management Blog

Do you eat breakfast? If you don’t, you’re not alone. A poll done a couple of years ago by ABC News revealed that four out of ten people don’t eat breakfast. Not surprisingly, older adults and seniors are more likely to eat breakfast than younger adults, mostly because of time; according to this poll, only 53% of adults ages 18 to 34 eat breakfast, whereas about 83% of people over the age of 65 eat breakfast regularly.

It’s not uncommon for dietitians to hear patients say, “If I eat breakfast, I’m hungry all day.” Likewise, many people skip breakfast in an effort to lose weight. Some people with diabetes don’t eat breakfast because they wake up with high blood glucose readings in the morning. What are your reasons for not eating breakfast?

I probably don’t have to tell you that breakfast is one of the more important—if not the most important—meals of the day. Even the name “breakfast” implies that you’re breaking the long overnight fast with a nourishing meal to help you face the day. Why is eating breakfast such a big deal? Well, research shows that people who do eat breakfast are more likely to:

  • Reach and maintain a healthy weight
  • Have better strength and endurance
  • Have lower blood cholesterol levels
  • Eat more nutritiously during the rest of the day
  • Focus and be more productive during the day

In fact, data from the National Weight Control Registry, an ongoing study of over 5,000 people who have lost weight and maintained a weight loss of at least 30 pounds for one year or more, shows that one key factor for these people’s success is that almost all eat breakfast. One theory is that eating breakfast kick-starts your metabolism, helping your body start burning food for fuel.

Eating breakfast may also lower the risk of developing Type 2 diabetes by 35% to 50%, according to some studies. Why? People who are at risk for diabetes tend to have what we call insulin resistance syndrome (or metabolic syndrome), a combination of high insulin and glucose levels in the blood, high blood pressure, abnormal blood lipids (such as cholesterol and triglycerides), and too much abdominal fat. This combination of factors paves the way for diabetes. The majority of people who have insulin resistance syndrome tend to be overweight and therefore often skip breakfast in an effort to lose weight, setting themselves up for overeating later in the day or at night and making not-so-healthy food choices.

What if you already have diabetes? Well, eating breakfast won’t make your diabetes go away, of course, but it’s still important to eat something in the morning. If you typically forgo breakfast because your fasting glucose levels are high in the morning, it’s time to take stock of the situation and address the real issue of why they’re high. Typical reasons include: eating too much after supper (probably because you don’t eat breakfast!) or not enough diabetes medicine, whether you take pills or insulin.

Insulin users commonly take basal, or long-acting, insulin at bedtime, whether that’s glargine (brand name Lantus), detemir (Levemir), or NPH. High fasting blood glucose readings in the morning can indicate that the basal dose may not be high enough. Likewise, people who take diabetes pills may need a higher dose. If you suspect that this is the case, talk to your physician or diabetes educator. Bring a log of your blood glucose readings as well as a record of your food intake. Work on getting your fasting readings off to a good start, which will make it easier to control your blood glucose for the rest of the day. And because your body needs fuel to jump-start the day, you can then start eating breakfast without fear that your blood glucose levels will go sky-high.

Some people just aren’t hungry first thing in the morning. That’s understandable, but still not a good enough excuse to run on empty until lunchtime. Wait two to three hours after waking and then eat something, even if you have to bring it to work or school with you. This applies to folks who are running late in the morning—pack something the night before or stash some breakfast bars in your car, purse, or briefcase for a breakfast on the go.

Next week: breakfast ideas!

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Getting Off to a Good Start with Breakfast: Part 1
Getting Off to a Good Start with Breakfast: Part 2


Comments
  1. How timely. I just wrote an entry on my blog this morning about how important breakfast is to getting myself healthy:.One thing I believe has really helped me is eating breakfast every morning. I used to not eat for several hours after getting up. Now, I eat a bowl of cereal everyday. Gets things started right, I think.

    It seems to me that I have more energy and I feel better when I eat breakfast. Yes, I have been fighting those morning blood sugar readings but I finally said to myself: Those readings are in the past I’m on to the rest of the day.

    You are right when I eat breakfast, I am less likely to overeat the rest of the day. Plus, my body gets used to expecting the cereal and it adjusts and says hoorah with me!

    Thanks for the article.

    Posted by Priscilla |
  2. You forgot to mention Dawn Syndrome. If someone’s numbers are high in the morning, it could be because they went low in the night and their liver is dumping glucogen into their bloodstream. Eating breakfast will stop the glucogen dump. If you are worried about too many carbs because you are already too high, eat proteins (eggs or egg substitute, cottage cheese, or a piece of grilled chicken left over from supper!)

    Posted by Ephrenia |
  3. Thanks Ephrenia. Actually, the dawn phenomenon is a rise in glucose levels in the early morning hours, usually due to a surge in certain hormones, such as cortisol and growth hormone. These hormones are responsible for raising glucose levels. The way to avoid this is to ensure an adequate medicine dose (insulin or pills), typically at bedtime. However, it’s possible for people to go low (i.e., become hypoglycemic) overnight and then rebound, which means that they wake up with high fasting glucose levels (called the Somogyi effect). This is more likely to happen in insulin users or in people who use sulfonylureas. The key to avoiding this is to either decrease the evening insulin or medicine dose, and/or eat a small bedtime snack, for example. Also, while I like your suggestion of eating a higher protein breakfast in the case of high morning glucose levels, it’s important to eat some carbohydrate if you take mealtime insulin.

    Posted by acampbell |
  4. I am a T2 and my BG is closest to normal (6.1) in the a.m. only if I eat a snack about 3 a.m. I tried no meal after 6 p.m. I get 7.2 next morning. I tried a snack at bettime..still 7.2+ in the morning. I tried no medication at night same result, medication and snack at bedtime still 7.2*. I am within range at 3 a.m. whats happening here? Can anyone explain?

    Posted by juds |
  5. Hi juds,
    Many people with Type 2 diabetes (and even some with Type 1 diabetes) experience insulin resistance in the early morning hours. This happens due to the body’s release of hormones that cause your liver to release glucose, thus raising blood glucose levels. It’s very likely that when you eat a snack at 3 am, your pancreas is stimulated to release insulin and your liver shuts down glucose production; hence, your fasting glucose is lower. Since your fasting glucose is at the high end of normal on days when you don’t eat a 3 AM snack, you might talk to your provider about possibly changing your diabetes medication. Metformin or even some bedtime long-acting insulin can help. You could also try eating something called an Extend bar at bedtime; this product can help stabilize blood glucose levels (go to for more info). Finally, take note of your HbA1c level - if it’s at your target (usually less than 7% for most people), you’re doing well with your treatment plan.

    Posted by acampbell |
  6. I’ve been a type2 diabetic for 16 years and just recently asked about Byetta.I’ve been using Byetta for 5 months and have lost 55 lbs. It has helped tremendously also in conroling my #’s. A1C previously was 7,most recent results 6.2.I feel more energetic and find myself exercising almost daily. My husband and I ride our bike 3.5 miles a day, and I find myself wanting more. It.s great!!

    Posted by EJBritt |
  7. I used to skip my breakfast and lunch i will finally eat before 4 pm. between my job and my 2 kids the stress that i have is too much to take. I found out that im diabetic when im in the waiting room before my surgery for ovarian cyst.
    I lost 40 lbs. since then and eat breakfast everyday. Now i eat six times a day, and actually really help me to regulate my blood glucose.

    Bing

    Posted by bing |
  8. i’dlike to receive a free newsletter

    Posted by EDWARD KLINGLER |
  9. I am not sure what is going on. BS in the morning are extremely elevated anywhere between 140-165. I’ve tried snacking before bed and not eating anything. I am very concerned but all my dr can say is lose weight. I am on metaformin 1000 daily and glyride 10 mgs daily. Been diabetic for 12 years.

    Posted by PAT |
  10. Hi Pat,

    Your morning blood sugars aren’t extremely high, but they’re higher than the target range for most people in the morning (which is 70 to 130). Since you’ve had diabetes for 12 years, what likely is happening is that your diabetes has changed, meaning that you probably need more medicine. Losing weight may help a bit, but you should talk to your doctor about increasing your dose of metformin.

    Posted by acampbell |
  11. There are a bunch of issues here and none of them have fast answers.

    1. Yes one needs breakfast - no argument.

    2. Dawn phenon is not necessarily controlled by morning meds. Only met stopped my liver while injected insulin - no effect.

    3. Digestion time on meds can vay from one to a couple of hours to 2.5 for met so in am the world is dead for a couple of hours and out of whack. Only injected insulin is fast.

    4. For me the only thing that works is to stick to early wake-up snack of some nuts and then for breakfast eat proteins and low glycemic to keep glucose boost to min as liver stumbles up.
    Shoot the cereal and carbs as they muck every thing up when meds not up.

    5. By mid morning, meds up and liver stopped on its dawn rampage and then things far better and by lunch eat a balanced diet carbs et all.

    6. In am cream in coffee, coffeemate and carbs will really whack a body that has been shut down all night,

    While breakfast is the most important meal, for those who are liver challanged - oversized releases and dawn effect running amuck, careful meal planning and tight carbs control is crucial in am as liver calms down and meds come up to speed so as not to hammer BG way higher than wanted or needed.

    FYI: I wake up at 5:00 am and BG is 130.
    By 5:30 last night 12:00am met pill wears off at 5:30am and I inject 3 units of humalog lispro and I watch my liver hammer my bg up to 150 and stabalize. I take my normal am meds at 6:10 am and breakfast at 7:00 am (low glycemic and proteins) 300 calories.

    My bg sticks around 145 to 155 all morning till lunch time.

    Posted by jim snell |
  12. I have type 2 diabetes and I was doing well for awhile. Now I find that everything sends my blood sugar up. It’s kind of depressing. Anyway, I am on 1000 mg’s of Metforman but, it gives me constant diarrhea and has inflamed my stomach. I am not sure what the doctor is going to give me now. I don’t know what to eat for BK. I am not a BK eater, but, I guess I am going to have to start eating it. I guess I better get to the nutritionist like the doctor told me to, so I can ask what to eat and when.

    Posted by BCedrone |
  13. Hi BCedrone,

    There are many options in terms of medicines that your doctor can try. Try not to get discouraged about your blood glucose levels. I think meeting with a dietitian is a good idea, as he will give you some suggestions for breakfast that appeal to you. You don’t have to necessarily eat “traditional” breakfast foods, either. Try having some fruit with peanut butter, or yogurt, or an egg with some whole-grain toast. There are a lot of options!

    Posted by acampbell |

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