What Is Fasting Hyperglycemia?

Fasting hyperglycemia is an elevated level of fasting blood glucose level that occurs after 8 hours of not consuming any food.


Normal Blood Sugar Level in the fasting state:

  • 70-99 mg/dL: Normal
  • 100-125 mg/dL: Prediabetes
  • 126mg/dl and above: Diabetes (two consecutive tests)

When your morning high blood sugar level is always higher than the recommended level, the result could be a sign of fasting hyperglycemia.


How Blood Sugar Changes Overnight?

Even when you are not eating, your body will still maintain a normal level of sugar in the blood overnight.


What Happens During Sleep:

  • The stored glucose is discharged by the liver.
  • There is an increase in hormones such as cortisol and growth hormone.
  • There is a natural decrease in the insulin levels.

In diabetics or insulin-resistant individuals, the body might fail to produce insulin to overcome the release of glucose, thus causing upsurge of blood sugar in the morning.


Common Causes of Fasting Hyperglycemia


Dawn Phenomenon

The Dawn phenomenon is a normal increase of blood sugar in the early part of the morning that is brought about by changes in hormones (typically, between 2 and 8 am).


Lack of Evening Insulin or Drug

Failure to administer adequate insulin or other forms of diabetes drugs at night may lead to an increase in the level of glucose in the night.


Late-Night Snacking

Snack Kick-Tart snacks can increase the level of fasting blood glucose before going to sleep.


Insulin Resistance

Inability to utilize insulin efficiently by the body helps in increasing the Fasting blood glucose levels in the morning.


Stress and Poor Sleep

Stress hormones enhance the production of glucose.

Nobody should be surprised by the fact that the causes of fasting hyperglycemia are to be understood in order to know what management approach should be chosen.


Fasting Hyperglycemia vs Somogyi Effect

The Dawn phenomenon is confused with the Somogyi effect by many individuals.


Dawn Phenomenon:

  • Slow increase in blood sugar at night.
  • No nighttime hypoglycemia

Somogyi Effect:

  • The blood sugar level is too low at night.
  • Excess is compensated by making the body release glucose.
  • High fasting blood sugar results.

Diagnosing between the two may involve checking the level of blood glucose at 2-3 am.


Symptoms of High Morning Blood Sugar

There are symptoms that may not be noticed by some, and the potential symptoms include:


  • Increased thirst
  • Frequent urination
  • Fatigue
  • Blurred vision
  • Headaches
  • Dry mouth

Incidences of high persistent fasting blood sugar can increase symptoms in the long run.


Read More: High Blood Pressure - Hypertension


Risk Factors

You might also be at risk because you:


  • Have type 1 or type 2 diabetes
  • Have insulin resistance
  •  Are overweight or obese
  • Lead a sedentary lifestyle
  • Eat high-carb food in the evening.
  • Experience chronic stress

It can also be caused by genetics and hormonal imbalances.


Diagnosis and Monitoring

Diagnosis will entail the determination of fasting levels of blood glucose by:


  • Fasting plasma glucose test
  • HbA1c test
  • Continuous glucose monitoring (CGM).

A diary of blood sugar levels will aid in uncovering trends and either the Dawn phenomenon of Somogyi effect.


Treatment and Management Strategies

Management is aimed at controlling the level of glucose overnight.


Medical Strategies:

  • Vary the timing or dosage of insulin.
  • Recommend long-acting insulin.
  • Change oral diabetes drugs.
  • Apply continuous glucose monitoring.

Lifestyle Strategies:

  • Eat balanced evening meals
  • Avoid late-night sweet food items.
  • Exercise regularly
  • Have regular sleeping habits.

Change of medication should be consulted with a healthcare provider.


Dietary Tips to Control Fasting Blood Sugar

Nutrition is very important in the management of fasting hyperglycemia.


Helpful Tips:

  • Choose high-fiber foods
  • Eat lean protein at dinner.
  • Minimize refined carbohydrates.
  • Eat desserts low in sugar before going to bed.
  • Stay hydrated
  • You can have a snack of a small protein based snack when recommended.

An evening meal helps to maintain a stable level of glucose at night.


Possible Complications if Untreated

Long term fasting hyperglycemia may result in severe complications such as:


  • Cardiovascular disease
  • Kidney damage
  • Nerve damage (neuropathy)
  • Eye problems (retinopathy)
  • High vulnerability to infections.

Glucose is also needed to be maintained at the Normal fasting blood sugar range, which minimizes the health risks in the long run.


Conclusion

A hyperglycemia that is observed during fasting is not uncommon particularly among patients who are either diabetic or insulin resistant. To control the difference between the Dawn effect and the Somogyi effect, one has to be aware of the difference between the two phenomena. Monitoring the amount of sugar in the blood, adjusting the medications where necessary, and adopting healthy lifestyle habits will assist the individual to control high level of fasting blood sugar and reduce the risk of complications. The early intervention and frequent observation is critical in controlling glucose in the long-term.


Please book an appointment with the best Endocrinologist in Lahore, Karachi, Islamabad, and all major cities of Pakistan through InstaCare, or call our helpline at 03171777509 to find a verified doctor for your disease.