The biggest concern for diabetic patients is blood sugar. Fluctuations in blood sugar are like an invisible giant hand grabbing the patient's heart. High or low blood sugar will affect their mood. When asked what time of day it is most difficult to control blood sugar, many people with diabetes say that it is most difficult to control blood sugar in the morning. So is this situation a coincidence or does it happen for a reason? Today, let’s follow the editor to find out the reasons.
Hormone secretion has circadian rhythm
Jia Kebao, deputy chief physician of the Department of Endocrinology at Beijing Xuanwu Hospital, said that because the secretion of glycemic hormones in the human body, such as growth hormone and epinephrine, begins to increase regularly in the early morning, this is when the body is preparing for a new day of work and life. Normal people can secrete corresponding insulin to keep blood sugar within the normal range, but for diabetic patients with reduced blood sugar regulation ability, it will lead to an increase in blood sugar in the morning. In fact, this is the well-known "dawn phenomenon." Dr. Jia Kebao reminds everyone that if blood sugar rises in the morning due to the dawn phenomenon, you can increase the dosage of basal insulin before going to bed or add metformin before going to bed.
Insufficient basal insulin secretion
Patients who have received insulin treatment should all know that the physiological secretion of insulin in normal humans consists of two parts: basal insulin secretion and mealtime insulin secretion, depending on whether they eat or not. The secretion amounts respectively account for about 50% of the total secretion throughout the day. Basal insulin secretion does not depend on eating. Its function is to prevent glycogen stored in the liver from being decomposed into glucose and released into the blood. It also prevents fatty acids and amino acids from being converted into glucose through the gluconeogenesis pathway and released into the blood. Therefore, although there is no peak in basal insulin secretion, it is very important to regulate fasting hyperglycemia and pre-meal blood sugar. Dr. Jia Kebao said that some diabetic patients, especially those with a longer course of disease, have elevated fasting blood sugar due to insufficient basal insulin secretion.
Dr. Jia Kebao suggested that for patients with insufficient basal insulin secretion, attention should be paid to treatment. Oral hypoglycemic drugs that stimulate insulin secretion, such as sulfonylureas, can be adjusted, or medium and long-acting insulin injections can be selected.
Improper drinking water is also the reason
Deputy Chief Physician Jia Kebao said that some patients eating too much at night is also one of the reasons for the increase in fasting blood sugar. Especially after dinner without proper exercise, it is more likely to cause the blood sugar to increase before breakfast. Many diabetic patients have unreasonable dietary intake mainly because they don’t know how much energy they need to take in every day. For this reason, Dr. Jia Kebao has listed a table so that everyone can calculate how many calories they need every day based on their own situation. Three meals a day can account for 1/3 of daily energy, or breakfast can account for 1/5, and lunch and dinner can each account for 2/5.
