My husband is a diabetic (since last March). He's not on any medicines -- just diet control. His meter readings in the morning, taken 1 hr. after breakfast, is almost always high (180-210). However, his readings in the evening are always normal (140-115). What can he do or what foods should he eat in the mornings to help maintain a more normal readings in the morning?

There are two main reasons that blood sugar levels may be higher in the morning. These are referred to as the “dawn phenomenon” and the “Somogyi effect”. The dawn phenomenon is the result of various changes that occur naturally in the body during sleep. It refers to increased glucose production and insulin resistance (approximately 3am-8am), which are brought on by the release of counterregulatory hormones (including cortisol, epinephrine, and glucagons). So, the release of these hormones to maintain and repair your body actually causes blood glucose to rise during the first hours of the morning. The Somogyi effect, or “rebound hyperglycemia”, can occur as a result of low blood sugar levels overnight. The hypoglycemia triggers the release of counterregulatory hormones, which increase blood glucose. It is thought that the Somogyi effect may be a result of poor diabetes management, however, you mentioned that your husband is not taking insulin so I do not think that this is the problem. Your husband’s doctor may be able to pinpoint further reasons for high morning glucose levels.

What your husband chooses to eat for breakfast can also play a part in the high glucose readings. A breakfast filled with simple sugars (sweetened cereals, doughnuts, pastries etc.) may result in higher than normal blood sugar levels. In addition, increased portion sizes or going back for seconds can also lead to high blood sugar. I would recommend consuming a balanced breakfast consisting of a carbohydrate, fat, and protein. If he is in a hurry in the morning, try plain yogurt mixed with almonds, high fiber cereal/milk with berries or a few slices of whole grain toast with almond butter. For a more leisurely morning meal, consume scrambled eggs with avocado and vegetables, whole grain French toast topped with ricotta cheese and light syrup, or a breakfast smoothie made with yogurt, fruit, wheat germ and nuts. Finally, make sure your husband is watching portion sizes during dinnertime and choosing a balanced meal. If he eats a snack before bed, make sure it contains a healthy protein source in addition to a high fiber carbohydrate (half of a turkey sandwich on whole grain bread or hard boiled eggs with a glass of milk).

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