Dietitian Nutritionist role in correcting morning blood sugar highs in Type 1 Diabetes
A nutrition education and information campaign is held annually in March, focusing attention on the importance of making informed food choices and developing sound eating and physical activity habits. One of the dietitian Nutritionist role is preventing glucose spikes in the morning
Blood sugar levels tend to naturally rise in the morning for some people with diabetes. This is even though the patients do everything right: including counting carbs, taking insulin as prescribed, and monitoring blood sugar four times a day. Dietitian Nutritionists support is critical to help manage morning blood sugar highs in Type 1 diabetics in these circumstances.
Morning glucose increases (hyperglycemia) can be caused by 3 factors; the first (and most likely) cause is incorrect insulin administration. Carbohydrate intake that isn’t matched with bolus insulin dosing; this usually occurs because the patient is underreporting her carbohydrate intake, administering her insulin incorrectly, or using expired insulin.
The second likely cause is biological Dawn Effect. In the early hours of the morning, cortisol and growth hormone signal the liver to boost the production of glucose, which provides energy that helps you wake up. If there isn’t enough insulin to counteract the resistance, the result is morning hyperglycemia
To identify the exact cause, you need to work with a Dietitian Nutritionists to gather the appropriate data and facilitate the sharing of this data with healthcare provider to identify the causes of these spikes and recommend ways to treat them.
One action (among others that the Dietitian Nutritionists recommend) is to track blood glucose levels overnight. To get the full picture of what’s happening overnight, patients should test their blood sugar levels before bed, at least twice during the night (2 AM and 4 AM work well), and in the morning before breakfast. Patients should present the test results to the doctor who’s managing their diabetes. They shouldn’t attempt to adjust their own basal insulin dosing, as that could be detrimental to their health. Dietitian Nutritionists have a number of other recommendations they can make to manage these (and other related) conditions.
Author is Consultant Nutritionist, HOD Clinical Nutrition, Shifa International Hospital, and Advisor to Islamabad Chapter of Pakistan Nutrition and Dietetics Society