Keeping diabetes in good control
Getting the highs can be a great feeling after a run or a vigorous walk. But if you have diabetes, having a high glucose reading in the morning when you get up is not so great. It means that your glucose has been high during the night while you are sleeping, and that will impact the 3-month hemoglobin A1C reading. If it continues to stay high, there can be damage to certain organs, like eyes and kidneys, and it may affect the circulation to your feet.
What are the glucose goals for someone with diabetes? In general this should be determined between you and your primary care doctor. The American Diabetes Association suggests these readings:
- Fasting Glucose– less than 120-130 mg/dl
- 1-2 hours after eating – less than 180 mg/dl
- Bedtime – less than 140 mg/dl
If your readings are higher, then it is time to troubleshoot to figure out a solution. These are the common reasons that morning glucose readings run high:
The dinner meal
- Eaten too close to bedtime
- Eating a large serving of the carbohydrate foods such as pasta, potatoes, rice, corn, legumes and lima beans
- Eating rich dessert right after dinner
- Skipping a bedtime snack completely, so the liver releases glucose while you are sleeping, resulting in a high morning number.
- Excessive nibbling on processed carbohydrates right before bed – chips and dip, snack crackers and pretzels, and cookies and ice cream.
It is important to keep your glucose levels in the goal range that you and your doctor decide is best for the management of your diabetes. Generally it is recommended that A1C readings be 7.0 or less.
Strategies to lower the morning glucose reading to less than 130 mg/dl:
- Healthy dinner at least 4 hours from bedtime. Include: lean protein such as fish, poultry and pork tenderloin, half of your plate can be non-starchy vegetables such as cabbage, carrots, greens, green beans, squash and broccoli, fill one-quarter of your plate with a fist-size scoop of starch – sweet and white potatoes, legumes, corn, brown and wild rice, barley or pasta
- Eat a small healthy protein-containing evening snack within one to two hours from bedtime. It should provide 15-20 grams of carbohydrate. Great ideas include: regular or Greek yogurt, whole-grain crackers with 2% cheese and 4-5 crackers, 2 tablespoons hummus and assorted raw veggies, sugar-free pudding cup, cottage cheese with light-packed peach slices
Recipes to help keep glucose levels well-controlled throughout the day:
About the Author
Rita Smith is a Registered Dietitian and Certified Diabetes Educator. She's been working in the field of nutrition and disease prevention for more than 35 years and currently works at Martha Jefferson Hospital in Charlottesville, Va. Each week, Rita provides nutrition counseling to clients who have a variety of disorders or diseases including high cholesterol, high blood pressure, diabetes, celiac disease, irritable bowel syndrome, gastroparesis and weight management. For these clients, food choices can help them manage their health problems.