Q: I have had Type 2 diabetes since 2005. My doctor has me taking a combination of metformin and glibenclamide (a sulfonylurea). Until a few weeks ago, my fasting blood sugar was always around 100 mg/dl. Now it rises overnight, and I wake up as high as 200 mg/dl even with nothing to eat after dinner. Why is this happening? What can I do about it?
A: With Type 2 diabetes, the pancreas gradually loses the ability to produce insulin over the course of time. Insulin may also start to work less effectively, particularly in people who gain weight, exercise less, experience more stress or develop other health problems.
In your case, since you are not eating at night, your blood sugar is likely rising overnight because your liver is producing more glucose than your pancreas can handle. You’re just not making enough insulin on your own, at least during the night. There are many options for fixing this, ranging from lifestyle changes (dietary modifications, increasing physical activity) to adding new medical treatments (oral or injectable medications) to simple dosage adjustments.
Your health-care team can make adjustments to your diabetes treatment plan based on specific/individual needs. See your physician regularly and communicate between appointments if you suspect that adjustments may be in order. Of course, it helps to have plenty of blood sugar values to share. Without data, it will be difficult for your health-care team to diagnose the problem and figure out the best possible solutions.
Want to learn more about blood sugar levels that rise overnight? Read “The Dawn Phenomenon and Somogyi Effect: What You Can Do” and “Controlling the Dawn Phenomenon.”