Vägen till blodsockervärde 6.0 mmol/L på morgonen


Fasting Normal Range Blood Sugar Levels. <100mg/dl in the U.S.< 6.1 mmol/L in Canada
Acceptable Fasting Sugars with Diabetes 90-130 mg/dl in the US4-7 mmol/l in Canada

13 tips for getting there

1. Decrease your bedtime blood sugars if they are mostly over 130 mg/dL or 7 mmol/L. This is one of the most underused but effective methods. (Mostly I think because many people only check their blood in the morning). Many of the people with diabetes that I see have high fasting numbers because they go to bed with high numbers that are no-where near normal range blood sugar levels. Perhaps the problem is starting with the evening snack or with supper. If so, check out the solutions for lowering your results before bedtime.
back to solutions list2. Add a small bedtime snack When you are not eating, your liver makes and leaks sugar (fuel) to the bloodstream. You always need some fuel on board. Sort of like a pilot light on the furnace. During the night you need the fuel to keep your heart beating, your blood warm, your dreams vivid and, well . . . whatever else you do in bed at night (ahem).
Sometimes the liver gets too excited overnight – particularly with type 2 diabetics – and releases too much sugar. Some people can tell their livers to ”back off and quit making so much sugar” by eating a small amount of carbohydrate (starch, fruit, milk or yogurt) before bed. This doesn’t work for everyone. Some people it makes no difference, others go higher in the morning and yup, some go lower in the morning. Experiment.
back to solutions list3. Try a smaller bedtime snack. If you have a snack before bed, consider making it smaller if it’s too big. Did you know a bagel is equal to 3-4 bread and can easily raise you above normal range blood sugar levels? A store bought muffin can be 4 bread (some are more!!). I often see people who feel that a bedtime snack should include all 4 food groups and might have a sandwich with milk and fruit. Healthy choices but for many people, a snack of 1- 2 bread or a piece of fruit (or 15-30 g carb) is ample. Check to see how much carb you are eating at night. (total carbohydrate on label minus grams of fiber).
Some people speak with their educators about getting rid of the night-time snack. If you are eating it to avoid hypoglycemia, you might want to talk to your educator or doctor. Nowadays, as much as possible, the medication is worked around people’s eating habits, not vice versa.
back to solutions list4. Eat a healthier bedtime snack What can I say? Sometimes junk for snacks leads to junk for fasting levels. Not always but I know people who can pinpoint the nights they ate nachos, chips or pizza solely by their finger poke reading the next morning. Hmmm. .. it seems to work like that for my readings too. I have a harder time guessing how much insulin to give with junk food –probably because I’m not paying attention to the portions. But hey, switching to a healthier snack has other perks even if it doesn’t help you achieve normal range blood sugar levels. For example, it could help with weight loss – did you know that 8-10 lb weight loss very often leads to lower numbers when blood sugar testing? Cutting out 2 tsp of fat a day (1 piece of bologna or 10 chips)leads to 10 lb weight loss in a year.
A healthier snack might be one that is lower in fat or higher in fibre or lower in glycemic index (eg. A slow releasing carb food like oatmeal). Okay, while I’m yabbering, how about a snack that also has antioxidants to protect your blood vessels (if you have diabetes or impaired glucose tolerance you are 4-6 times more likely to have a stroke or heart attack than someone without these conditions -sorry to sneak that ugly fact in on you). What would this perfect snack be? Well, colorful fruits and veggies of course! Okay .. . OKAY! I can’t help myself, I’m a dietitian too you know. Sometimes I just can’t keep my focus to getting normal range blood sugar levels.
back to solutions list5. Try a consistent size bedtime snack. If your morning readings vary greatly from day to day then look at your bedtime snack. Do you vary the size of it? You might want to try a bedtime snack that is similar in carbohydrate content from night to night. Eg. Always having a set number of grams of carb like 30g. Or always having a set range or budget of carb like 20-30 grams. Or, similar in the number of carb food servings . . . like 2 carbohydrate food servings per night. Or similar in the amount of starch, fruit,milk every night – like always 1 bread and 1 cup of milk. These are all the same things really, just different ways of getting there. Discuss with you dietitian if you feel that consistent size bedtime snacks are something that would help you get fasting normal range blood sugar levels more consistently.
back to solutions list6. Add evening exercise or any activity (hubba, hubba). Even a stroll can be helpful if you’re not up (oops, wrong descriptor) for any ”hubba hubba”. But really, it doesn’t need to be stuff that breaks a sweat to help you reach normal range blood sugar levels. Read this story.
I know a fellow whose fasting readings had been in normal range blood sugar levels for quite some time found his morning levels to suddenly be out of target. We wondered if the exhaustion of the pancreas was finally progressing (as is its nature). However, we learned that he had stopped doing his 10-minute stroll with the dog in the evening. We doubted that 10 minutes would make such a difference to the morning blood test but he was game to resume them and see. His great results surprised even us! We never thought the answer to ”How to lower fasting blood sugars” would be a simple 10-minute evening walk! Yup – everyone is different and you don’t know what works until you try it.
back to solutions list7. Remember to take your diabetic medication. Forgetting these meds, particularly at supper or bedtime can really increase the morning blood sugar testing results. How much can this affect your blood sugar? Read here to learn how it affected some very educated people with diabetes.
We have numerous patients who regularly forget their medication at meals and night-time but remember them first thing in the morning. We often ask the physician to consider a switch to a one-a-day pill or insulin for these people if appropriate (it isn’t always). I’m thinking of someone in particular who this worked absolute wonders for. And this person felt emotionally better because he got rid of the guilt associated with always forgetting the meds.
back to solutions list8. Verify the numbers are really before breakfast tests. And at least 3 hr after food. I know it sounds strange, as breakfast is usually 8 or more hours since you last ate. But, occasionally I see patients who eat carb food at, say, 7:00 am (like a glass of juice to take their blood pressure pill) and then do blood sugar testing at 0900 before they eat breakfast. In this case, the 0900 test is actually a 2 hr after food test. You should consider testing before the 0700 juice, for this example. If you test 2 hr after carb foods (juice,fruit,starch, milk, yogurt) then you want to see those numbers in the diabetic normal range blood sugar level of < 180 mg/dl or 10 mmol/L for after eating.
back to solutions list9. Make sure you’re not getting low during the night. For people on insulin in particular, it’s possible you can have a low during the night – meaning a number lower than normal range blood sugar levels. Some of you may not wake with these overnight lows and in response, your liver panics and dumps out significant fuel later so that you wake with a high reading. This is called the Somogyi effect. To see if this is happening, do blood sugar testing at 0200 hr or 0300 hr. See your doctor if lows are occuring at those time- a number of things can cause this but most notably the diabetes medication. Glargine or Lantus is a newer insulin on the market that can reduce the occurence of overnight lows. Just a reminder,: treat any low glucose reading with a fast acting carbohydrate.
back to solutions list10. Get a better night’s sleep. As a diabetic person, a poor night’s sleep might prevent you from having normal range blood sugar levels in the morning. The sleep problems I see most often include sleep apnea, stress,depression and painful diabetic neuropathy in the feet. Each of these by themselves might also increase glycemia and negatively affect health in other ways.
Fortunately, research has shown some amazing results with improved blood sugars by treating sleep apnea. If you suspect any of these concerns in yourself, please see your family doctor to discuss.
back to solutions list11. Reduce Evening Stress I know I just mentioned it in passing above, but stress management is so critical it is worth mentioning again!! Stress causes the liver to make more sugar (left over from when we were cavemen or women — ok, cave people — so we would have fuel and energy for fight or flight from . . . sabretooth tigers I guess). This same reflex has our body’s making more hormones that work against insulin. Of interest, this stress – whether it be emotional or physical, also has horrid effects on blood pressure and heart health! The well respected Interheart Study clearly showed that stress was one of the 9 factors causing 90% of all heart attacks worldwide I also see many patients who eat more in response to stress- especially at night. This of course can give high blood sugar testing results. However, if the stress is short-lived like a cold you might see elevated morning glucose levels return to normal range blood sugar levels once the cold has cleared up. If you check out Diabetes News and Nuggets you’ll find articles on effects of stress on the body and blood sugars after meals and the great news that relaxating helps lower blood sugars.
Note also that if you are sleeping poorly because of waking to pee frequently, then you might have high sugars during the night and not just the few hours before waking. In this case, do some blood sugar testing to make sure you are not going to bed with high sugars.
back to solutions list12. Eat an earlier breakfast! Yes, you read it right! Occasionally I see people who test at 0700 when they wake and ARE in the normal range blood sugar level. They have nothing to eat at that time, trot off to work and test at 0900 before their breakfast or snack. Then they find their sugars ARE HIGHER than normal range blood sugar levels.
If this is you, then your liver is to blame for this as it is dumping out sugar to fuel the day. The good thing is that the first 0700 test was in target so for most of the hours during the night you probably had healthy blood sugars. The high is only happening for two or less hours (hopefully) between 0700 and 0900 hrs. This might have minimal effect on overall glycemic control. But, to beat this, you can try the small carbohydrate food (like 4 ounces of juice; a cup of milk; a few crackers) at 0700 to see if it “shuts the liver off” to keep you in normal range blood sugar levels for the morning. Or you could have an earlier breakfast. Alternatively, you might need a change in medication dose or timing or type.
back to solutions list13. Consider Insulin Pump Therapy. If you take multiple daily injections of insulin or insulin with most meals, insulin pump therapy might be something to consider. It particularly helps people with their basal insulin needs over night so greatly improves fasting sugars. Don’t know what basal insulin is? Or why it’s so important in everyone for achieving normal range blood sugar levels in the morning? See this article on insulin pumps and basal.
back to solutions list14. See your doctor or health educator for medication adjustment. Are you are doing everything you can and still can’t reach close to normal range blood sugar levels in the morning? Then it’s time to talk with your doctor or diabetes educator. First off, maybe your sugars are only rising shortly before you wake up. In this case, your A1c might be fine. Keep an eye on it in 3 months to see where it is going. However, if you are rising earlier in the night, then your A1c might be reflecting this and be higher than it was last time.You might need the addition of more medicine or a different medicine to help you achieve near normal range blood sugar levels. For example, metformin or glucophage is a very commonly prescribed inexpensive pill that asks the liver to stop making so much sugar. It is often prescribed at bedtime. Intermediate or long acting insulin (like NPH, N or Glargine) are often prescribed at night to work with the fuel that the liver is making. Insulin can be a very effective way for how to lower fasting blood sugar levels. And now, in the U.S. there is the release of Byetta – an injectable hormone that has shown great results in lowering blood sugar without the hassles of low blood sugars.
Sometimes people need medicine to cover the carbohydrate from their bedtime snack. Meaning their morning readings are fine if they don’t eat a bedtime snack but. . . they want this snack! Quality of life and choice takes priority. So, sometimes fast acting medications like Gluconorm, Starlix or rapid insulins like Humalog or Novorapid are added at bedtime. Professionals have differing opinions about this so discuss with your health care team for theirs.
It is not a failure to start pills or insulin any more than it is failure to use hair dye to cover gray hair. Your pancreas is likely growing older faster than you are and needs help to achieve near normal range blood sugar levels. Remember, high blood sugars do damage and can affect your future. Your dreams. Your time with the people you most want to be with. Suppose a medicine could you keep all that?
Someone recently told me: “It’s hard work. But I prefer hard work to complications.” You get normal or near normal range blood sugar levels because ”U-ACT” to solve them via any number of various ways. Seeing your MD is acting. It is proactive to say “I can’t fix it. My body needs help. I’ll go see someone.”
back to solutions listBRAVO!
You made it through this page. Even if you don’t try any of these solutions you are better informed about what your doctor or diabetes educator might suggest next to help you reach near normal range blood sugar levels. So? Did you see something that you want to try or discuss with your doctor educator? Got something planned? Now ask yourself on a scale of 1 to 10, how confident do you feel that you can meet your new goal?
If you answered 8, 9, or 10 well congratulations! Research shows that your chances are better at succeeding than if you’d answered 7 or less on the confidence scale. This of course does not mean that it will decrease your blood sugar testing results into normal range blood sugar levels. You will have to test and analyze and fine -tune to see if it does. Remember the steps to U-ACT!
If you answered 7, or less on the confidence scale, well, maybe the goal you’ve set for getting into normal range blood sugar levels isn’t right for you. Or maybe it is too big a goal. Make it smaller. Remember SMART goals (Small and specific, measurable, acceptable, realistic, time frame).
You can also try a different strategy every day to help get your fasting numbers into normal range blood sugar levels – but to avoid frustrating yourself, keep good records. That way, you can see which of the things work to put you into normal range blood sugar levels and which don’t.

Källa: http://www.diabetes-blood-sugar-solutions.com/normal-range-blood-sugar-levels.html#1


VD: QMI Quality Management Training Institute

Publicerat i Diabetes


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