Blood Glucose Rises After Breakfast

Question: I am a 50-year-old woman that has been borderline diabetic until 12 years ago when diagnosed. I am taking metformin 1000 twice a day along with Januvia in the morning. I cannot get my readings down in the morning. I am almost positive it is the dawn phenomenon. The problem is that my A1c is always between 6.0 and 6.5 but my morning readings are between 140 and 180. If I get up in the middle of the night they are always under 115. If I get up and my reading is high then eat a light breakfast, blood glucose numbers are then around 300. Don't know what to do, and have been fighting this problem for several years.

Answer: Your A1C is in the target range, but the glucose excursions are an issue. You may need a medicine in the morning to prevent the skyrocketing glucose after breakfast. The risk of starting a drug like Amaryl or Starlix for the morning meal is the risk for the side effect hypoglycemia. If you haven’t already spoken with a registered dietitian about your breakfast content (as carb-controlled meals should only cause less than a 50 mg/dl (2.77 mmol/l) point glucose rise from pre to post meal), that is worth an individualized look.

Thank you for all the questions. My apologies for not being able to answer each and every one, but you can always submit your question through dLife’s Ask an Expert where other CDEs are waiting to answer your diabetes questions.

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NOTE: The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.

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Last Modified Date: November 27, 2012

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