Why Are My Fasting Blood Sugars So High?

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Welcome back to another episode of the Diabetes Digital Podcast.

We’re so excited to have you here.

Now, if you have diabetes and your fasting readings are consistently over target.

And that is typically over 130 for most people with diabetes.

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Then this episode is for you.

Welcome to the Diabetes Digital Podcast.

I’m Wendy.

And I’m Jess, and we’re best friends, registered dietitians and diabetes educators.

Through our telehealth platform, Diabetes digital.co, we offer accessible and personalized virtual nutrition counseling for people with diabetes and pre diabetes.

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Visit diabetesdigital.co That’s Co to book your first appointment.

We accept insurance and offer affordable self pay options.

Now let’s get into today’s episode.

Now for those who maybe are newly diagnosed or or people who are supporting a loved one with diabetes.

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Fasting plasma glucose levels are determined by taking a blood sample from participants who have fasted for at least 8 hours.

And this can be in the form of a finger stick, which people will often do to check their blood sugars in the morning.

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So typically, folks will fast overnight for 8 hours and they’ll get that fasting blood glucose reading.

So fasting blood sugar levels can be a key indicator of how well your diabetes is being managed.

But when those numbers consistently rise, it can be super concerning.

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And so today we’re going to explore possible reasons behind those elevated fasting blood sugars.

Now I know what you’re thinking, that it’s all food, right?

That’s a typical misconception that folks have that anytime they’re fasting is elevated, it’s 100% going to be food.

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And that’s not the case.

Fasting blood sugars can be influenced by so many different factors, including diet, yes, but also physical activity, medication and also your overall health.

Yeah, so just mention food and carbohydrate needs are different for everyone.

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So you know, it’s really important to just notice what the trends are for you, and especially if you’re consistently waking up with elevated fasting.

The first thing I would recommend is monitoring your blood sugars after you eat.

So two hours after you have your dinner and then before you go to bed, and then again when you wake up.

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And then maybe do that for a week just to see if there’s any trends.

If you can make any connections based on the foods that you were eating, you could keep a food log and then make any associations that way because it’s really variable.

Some people don’t really like having heavy dinners, and so you know, for the most part we do recommend having anywhere from three to four servings minimum per meal of carbohydrates, but you might decide to distribute that differently based on what your preferences are.

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Maybe for dinner, you know you want to keep it light.

You want like a lighter snack.

I know that that’s really big.

In certain cultures, like where I’m from, people don’t really eat dinner.

And so you want to adjust based on that.

If you’re noticing that your your meals are for dinner and you’re having, you know, maybe 6 to 8 servings of carbohydrates per meal and then you’re making associations based on that, that the fastings are peaking, then what you can do is make adjustments.

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It’s always good to experiment, make adjustments and see if it helps your fastings and you know really like you know what’s best, you know what’s going on with your body.

And so I think that that is going to be a really good place to start.

But I don’t recommend, you know, like just following these food plans that are like, oh, this is going to help you get your fastings down because your body is different, your needs are different.

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If you’re on medication, that influences things.

So, you know, I just want you to take all of that into account.

Also, one thing I want to add because you mentioned like 3 to 4 servings or six or eight, and I think people might think that that’s like 6 or 8 plates of pasta.

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But just to put into context what one serving is.

So let’s say I’m having lunch and I’m having a tuna fish sandwich with a piece of fruit.

A small piece of fruit that is 3 servings, right?

Because each piece of bread is 1 serving plus the fruit is a 3rd serving.

Depending upon the size of the fruit or what fruit it is, it might even be two servings.

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So keep that in mind that it’s not that hard to hit those three to four servings.

I mean, even a cup of rice is 3 servings.

So yeah, just to put that in a little bit more context.

And I also mentioned medication, which is a really important aspect to consider.

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So if you’re skipping doses or if you’re adjusting your own insulin dosing based on, you know, what you’re eating, if you’re like, oh, I’m not really going to eat that much, so I’m adjusting my dose, all of that could impact your fastings as well.

So again, just keep track of everything, Talk to your provider so that you can make those associations.

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If you’re forgetting to take your medication, I find it helpful to set an alarm, especially if you’re on different types of medication and you could talk to your doctor about this.

You can cluster them together.

So let’s say that you have a morning set of medications that you take and then you have an evening set of medications that you take and you cluster them together.

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So it’s not like you’re taking all these medications throughout different parts of the day, just trying to talk to your providers, see what is the easiest way for you to remember to take things.

And then pill boxes are also a really good tool that you can order online.

And that way you can categorize them each day knowing you know what you need to take, especially if you’re also taking supplements and things like that.

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It just helps to keep things a little more consistent.

And then I also wanted to mention physical activity, because physical activity does help to maintain your blood sugars at a healthy range.

And the recommendations from the American Diabetes Association are 150 minutes a week.

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So that can look different based on whatever your preferences are.

So let’s say you want to do an hour workout two to three times a week, or you want to break it up and you want to do 30 minutes five days a week.

However you prefer.

Whatever activity you prefer, I think it’s good to have a combination of cardio and strength training just so you’re engaging your muscles and you’re also getting your heart rate up.

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But you know the most important thing is that you’re enjoying yourself and that this is something that you’re going to be able to sustain over a long period of time.

So keep that in mind when you’re thinking about OK, you know, like do I want to suffer through a gym workout or do I prefer to go on a leisurely walk or do, like a YouTube dance workout or, you know, whatever it is that you’re into do?

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You have any YouTube channels you like?

Yeah, actually there’s one that I really enjoy.

It’s called and a Fitness.

And these two black girls, I think they’re from the DMV area and I love it because they’re not like typical fitness aesthetic.

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Like they’re they’re really curvy and they’re all about embracing that.

And their workouts are just so lit, like they have afrobeats, they have reggaeton, they have fun hip hop, they have soca, they have everything.

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It’s so good.

Yeah.

And I’m such a fan that because they have like you know, like you can donate or whatever and I’d be sending them memo payments and.

Oh wow.

When?

They do their workouts because it’s so much fun.

Yeah, I love the workouts.

And they’re twins, too.

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Wow, have I seen them.

I may have actually.

Actually, I think I have seen them online.

That’s a good reminder to go back to them.

But there’s so many good free workouts on YouTube and people often overlook it.

And and also at all levels, like I’ve been doing a lot of 40 plus workouts and they’re just a little more gentle on the body.

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We can include some of our favorite YouTube workout stations in the show notes.

But yeah, if you have any, please let us know because I’m always looking for new channels.

OK.

So in addition to all of those things, there are a couple other factors that might impact your blood sugars, one of them being stress.

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I can’t stress that enough.

Like how big of an impact stress has on your blood sugar and why?

Because people are always very confused about this.

What happens is stress triggers the release of stress hormones like cortisol and hormones like cortisol can raise your blood sugar levels.

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So that’s why it’s so important to manage your stress throughout the day.

Good stress management techniques might include medication, not well sometimes medication but also I was going to say meditation.

One of my favorite meditation apps is called Insight Timer.

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I also love this woman on YouTube who does a particular type of meditation called Yoga Nidra.

And if you just Google Yoga Nidra with Ali, she’ll pop up.

I think she lives in Hawaii.

She’s on just, yeah, very relaxed vibes all the time.

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You hear her nature in the background, like she’s either in the rainforest or on a beach and there’s waves and all this stuff.

So I love yoga nidra because it really helps you to connect with your body.

And I find that great for managing my stress throughout the day.

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So whatever it is for you that you find helpful, just make sure to incorporate those techniques.

And I’ve even seen first hand like when I’ve tracked my blood sugar with ACGM, which is a continuous glucose monitor.

On the days that I’ve had a lot of stress and just working really hard and not taking breaks, my blood sugar is more elevated than on the days that I meditate and I’m a little more relaxed.

9:23
Yeah.

Another thing that can impact your blood sugar is illness, and many people with diabetes know the concept of sick days.

That’s something that you will often talk about with your dietitian or your doctor how you’re going to navigate sick days.

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And the reason why this is important is because illness or infection can lead to increase insulin resistance and higher blood sugars as the body fights infection.

So when you get sick with things like the cold or the flu, the illness and stress from it can cause your body to release hormones that raise your blood sugar levels and make it harder to keep that blood sugar at Target range.

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Now, having diabetes doesn’t make you more likely to get the colder flu, but it does raise your chances of just getting sicker than the average person.

So make sure that you have a plan for these sick days ahead of time to help you manage your diabetes.

That will make additional complications less likely.

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Also, as we had mentioned in previous episodes, make sure you’re getting enough water, especially if you’re having a sick day, because even small sips of water are going to help you stay more hydrated.

We also are big fans of things like the flu shot, especially for for everybody really, but especially for people with diabetes, because this will help make getting the flu less likely for you, which is a good thing if you have diabetes because again, that can increase your risk of having your blood sugars above target.

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Now, having said all this, we’ve provided a few reasons why your blood sugar may be elevated, especially in the morning, and you might be doing everything, quote, UN quote, right and still your blood sugar is elevated.

And that just might mean that you need to make a change to your medications, right?

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So this is when we loop in our medical provider and you might say that you’re looking at your diet, you’re you’re having physical activity in your lifestyle regularly, you are reducing stress and still your blood Sugar’s high.

This is when you call in the doctor, and it might mean we need to layer in another medication or introduce a medication to your diabetes regimen.

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Yeah, and there’s always weird things happening in the body.

You might have heard of the Dawn phenomena or the Somogyi effect.

These are two occurrences that can also happen.

The Dawn phenomenon is where your body releases hormones like cortisol in the early morning, and so you’re getting increased insulin resistance and higher blood sugar levels.

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And this is where you want to look in your provider, because you might have to make an adjustment to your medication.

I think it’s helpful if you think you might be experiencing this.

Keep track of your blood sugars before you go to bed, and then also keep track of your blood sugars when you’re waking up to see like you know are things looking pretty good before you go to bed.

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And then without any explanation, you know when you wake up, they’re over 130 because you might be able to make an association there, especially if you’re not snacking at night.

You know there’s really no reason why you should be getting elevation, so that’s something to consider.

And then the Somogyi effect is when your blood sugar levels actually drop during the night, or when whenever it is that you’re sleeping.

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And so your body counteracts that.

It’s almost like a defense mechanism.

And so it releases hormones to bring it back up.

And the next thing you know, you’re waking up and your blood sugars are above target.

And with that, again, you know you want to check your blood sugars at night.

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You can check it in the middle of the night, or it might be helpful.

If you have ACGM, that might be even better because you don’t have to necessarily wake up.

It’ll just automatically kind of register your numbers throughout the night and then you can kind of see what the patterns are and then make any adjustments with your medication or your food choices based on that.

13:12
Yeah, and a couple of strategies that you can try.

Some takeaways are a bedtime snack.

That’s one of dietitian’s favorite things to recommend to clients who are experiencing elevated fasting blood sugars, especially when something like the Dawn phenomenon or the Simoji effect is happening.

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Because if we consume a small balanced snack before bedtime, it can help prevent that night time hypoglycemia and subsequent rebound hyperglycemia.

One thing I want to point out is it is a good idea to opt for snacks that contain complex carbohydrates.

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So that might be things like a piece of fruit or a piece of whole wheat bread and a protein and or fat to help provide sustained energy overnight.

So an example of a snack might be some whole grain crackers with peanut butter or half a banana with peanut butter and just check to see like how that impacts your blood sugar throughout the night and in the morning.

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And this is the reason why we love CGM, the continuous glucose monitors is because it gives you that data in real time without you having to wake up in the middle of the night to check your blood sugar.

You can just kind of see what happened the next morning.

So again, in addition to a bedtime snack, you want to make sure that you’re monitoring your your blood sugar so that you can see where these trends are happening and certain patterns and that can enable you to adjust your management plan accordingly.

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And of course, as we’ve already mentioned before and we’ll continue to say, talk to your provider about adjusting your medications if that is something that needs to happen because sometimes you can do everything in the world and at the end of the day, the medications need to be changed and we don’t recommend you go tweaking those yourself.

15:04
We recommend getting in touch with your medical provider to help you see the full picture and also make those changes accordingly.

All right.

So that wraps our episode.

Thank you so much for tuning in.

Remember that we are always here to support you.

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You can click on our get started form.

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Bye bye.

Thanks for joining us for today’s episode.

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We’ll catch you later.

Bye.