 Hello guys, this is dr. Ergen and today we are going to talk about why my blood sugar is high in the morning Stay tuned Okay, so I get this question all the time So some in my in one of the videos that I said typically the best blood sugars are in the morning and some people said Oh, no, my blood sugar goes up during the day of my blood sugar goes down during the day I'm sorry, so they say my blood sugar is actually higher in the morning than the later time of today well That is true for some people again. That depends on what is going on with your body. So I Said this because most of the time people go on medications like metformin or Orlanthus or anything like that and they end up with the blood sugar Being okay in the morning because those medications work at night and they don't eat anything during the day during the night hopefully hopefully But here's the thing, you know when When you start your day You start eating, right? So typically you expect your blood sugar to go higher now. Why? blood sugars are high in the morning sometimes higher than the night before so Again, that depends on what you're taking during the day if you're taking for example like Gallipoli That is commonly prescribed medication not my favorite, but it's commonly prescribed and that medication works For a while and then it wears off And then this medication makes your body make insulin, right? So Gallipoli produces insulin and that helps with your meals and so forth, but then it wears off and then at night Your body still needs insulin. So insulin is not just necessary For the food your body needs insulin anyways So even if you're eating no carbs whatsoever You still need insulin because your liver will make glucose. You have to have glucose in your system So yes, you don't eat carbs. Good for you. There's some keto people there. They're crazy about it. It's fine but Even if they're trying to say sometimes that if you're a keto diet, you have no diabetes That's not true. A lot of people will still have diabetes even a keto diet In my practice, I have a lot of them So I don't know the people talk about their own experiences, but that doesn't reflect just the population so Yes, keto diet if you're gonna keto your diabetes will dramatically improve if you can stay on it great stay on it But you have to be medically supervised. I don't recommend anybody to watch a YouTube video and go on a keto diet So we're gonna make a big keto video with diabetes Make sure that you watch that video. It's gonna come up soon Even if you don't eat carbs you have to make Glucose in your body and for that glucose to be transported to the cells you still need insulin now What happens is your liver is the biggest depot of sugar? so when you're not having carbs your liver normally stores the carbs that you have eaten previously and After 8 to 12 hours that depot runs out So normally liver gives us sugar to the body to make sure that you sugar keeps going in the body and And then if there's no sugar the liver makes just sugar That's that you have to have certain blood sugar even if it is down to 80 that blood sugar has to be maintained, right? so But like any other organ in the body liver is insulin resistant, especially in type 2 diabetics now in type 2 diabetes your liver is insulin resistant and the insulin is the Hormone that tells liver how much sugar to make So even if you have enough insulin in a lot of insulin not enough a lot of insulin in your body Sometimes doctor check insulin levels Which doesn't mean anything actually because the amount of insulin doesn't necessarily tell you if the insulin is doing the job Or not or you know you have to really check the insulin resistance not just the insulin But anyways, so even if you have a lot of insulin in your body That insulin may not be enough for your liver and your liver may think that you need blood sugar So Insulin is like a break on your liver that tells your liver. Okay. We don't need much of glucose You know, I'm here calm down Now sometimes liver doesn't listen just because of the insulin resistance. So as a result your liver keep making blood sugar at night That's why you guys wake up with a high blood sugar in the morning. That is the answer now. How do you get rid of the Blood sugar high blood sugar in the morning. Let's talk about that Okay, so there are a couple of ways you can do this So number one as we discussed if delivered insulin resistant, what should you do? You should basically Reduce the insulin resistance, right? There are a couple ways to do that The for example a medication called metformin or piagolita zone. These are two relatively inexpensive medications Can do that. There are some herbal medications that can do that as well in a similar way so Or or you just basically make yourself insulin sensitive by age or size and more Try so go for a two mile walk if you're not walking at all go for a mile or two Like in the late afternoon when the weather is not hot I'm from Florida, so it's always hot here But this will always go later in the day or whenever it's best for you. Just go at a time that's comfortable That exercise will have an effect for the next 24 hours. Isn't that amazing? So just exercise some right now and you can still see the benefit up to 24 hours So your blood sugars will be lower if that exercise is not enough That means that you have to do more but your sugar is definitely will be better than the days that you don't exercise If you see the difference, I think you'll be more willing to do exercise So if you don't have to exercise or exercise exercise is not enough Then we sometimes have to use Pharmaceutical or herbal medications depending on your preference to bring the blood sugar down and that is to improve the insulin sensitivity in your liver Now of course if you lose weight by doing some sort of diet keto diet Or low carb diet low-fat diet doesn't matter You know just do a diet that is good for you that you can manage Some people love keto diet. Some people hate keto diet. So it's it's not just one fits all So and I'm not a I'm not a big supporter of any diet except the Mediterranean diet because that that diet has been studied Multiple times has been proven multiple times to reduce the heart attacks on strokes and to reduce the diabetes as well Keto diet unfortunately doesn't have any studies any long-term studies or short-term studies to prove That it reduced any heart attacks or anything like that. Yeah, it is your sugar, but reducing sugar is not Everything so we have to look at the health in a general fashion Anything that claims Anybody that claims anything about any diet or medicine have to prove that it actually works in many different ways and so forth so Again, we will work with you guys to see what we can do Again, you have to talk with your doctor Possibly preferably an ethnocrinologist and And of course after the discussion you guys make a An informed decision together and you if you need a medication you go for it Of course, you need to understand what you're taking how you are taking the side effects on all that stuff So don't jump on a medication unless you really know the side effects or the Benefits actually most people get hung up on the side effects. So here's what happens people Look on the internet, right? So they find the side effects that are seen one in a 10,000 they say oh, I don't want to take the medication But the benefits are so high They're just going for a blind eye for the benefits and they just get hung up on the very Minor risk sometimes again diabetes is not just a science guys. It is an art So you have to choose your fight. So You want to do exercise and diet you have time for it go for it. We will support you. We will be watching you over I promote always remote patient monitoring and remote patient management because When I am remotely managing you and staying in touch with you. I'm always with you That is not something you get from anybody. You normally go to a doctor. They give you a pill. Good luck. Good luck. Hope it works It's it shouldn't be that way. It shouldn't be that way So if you hear about the medication if you hear about a side effect, you should be able to say hey doc You know, I heard about this. What do you think, you know, is it gonna affect me or you know, should I you know What's my benefit? How much benefit do I have? How much risk do I have right? So Unfortunately trust to doctors is going down And people are skeptical and people actually think that they can just do it themselves It's not a garden work. Okay, so unfortunately medicine is not something that you can just figure it out but It is important to get the right information from the right person and not just from health line calm or web MD calm guys I know who always writes those articles. They're not real doctors They're just a bunch of freelancers to just pick up information from right on left left side put it together and Create a business. That's not where you should be getting your information from But back to the topic, right? Sorry got sidetracked Your liver is responsible We are not playing the blame game here. Yes, you can do dieting better. Yes, you can exercise better Yes, we can support you. Yes, we can tell you how to do it If you want to hear how to do it, you know, some people are just very self-motivated and they don't need it But we can definitely help you with that but also we can guide you through if you need a medication to Convince your liver not to make so much sugar Sometimes, you know, everything fails and we have to go on an insulin again going on an insulin is not a life sentence Don't look at that that way A lot of people are extremely happy that they are on once a day insulin They see a blood sugar is immediately improved Again, diet and exercise is not always Helpful for everybody. So let your doctor decide do your best on your on your end And if your blood sugars are not still coming down in the morning, you have to do something You have to try the pills depending on the situation Again, we are talking about type 2 diabetics Type 1 diabetics, they always have to take insulin. They have to take insulin multiple times a day That's a totally different story And we are occasionally talking about Type 1 diabetes management and the devices they use etc But but what I am talking today is about strictly to about type 2 diabetes So another problem with this high blood sugars we experience in the morning Is sometimes it's just You know eating late or eating high-fat food. So what happens when you eat a high-fat food? The absorption is so slow that your blood sugar may be, you know, 150 or 140 when you go to bed But then that pizza that you ate can actually show up way later down the road And then you may wake up with a very high blood sugar So that is something you need to be aware of Eating the dinner early on will definitely help Taking maybe a walk after dinner definitely will help your morning blood sugars And most importantly night eating habits unfortunately is very common People get cravings and they end up getting up. They cannot sleep and they end up eating something Now if you're going to eat something you can try to really have something With a low glycemic index if you're going to eat a carb like an apple Huff and apple I think will be able to curb your appetite Or just stick with your meso-elastic whatever you want to go for That is not you know high in carb or possibly no carb Yogurt may not be a bad You know the snack if you have to if you are not going to be able to sleep without eating But anytime you go eat some crackers or try to drink juice or have Fruits that are high in carbs like melons and stuff. It will definitely increase your blood sugar drastically So you have to be really careful about that So the third problem that can actually really increase your blood sugar Is if you are having a low blood sugar So believe it or not if you are having a low blood sugar In the middle of the night, which typically happens between midnight and three or four o'clock Your body will give a reaction And that's called smorgi effect You're going to have a spike in your blood sugar. So you're basically dipping down That generally happens from taking too much basal insulin You're generally dipped down and then and then your body gives a stress reaction You sometimes wake up and sometimes you don't but then your blood sugar spikes right back up Because your body makes a hormone called glucagon When your blood sugar is going down glucagon goes up So adrenaline goes up so you may be Having a nightmare or something I don't know but you're going to have a lot of turmoil in your hormones when your blood sugar goes down And when that happens you you're going to wake up with a very high blood sugar So when people come up or wake up with High blood sugars We ask them to check their blood sugars at three o'clock in the morning If their blood sugar is three o'clock in the morning Let's say is down to 60 and they wake up with 200 That I know I have to fix that 60 blood sugar before I think about 200 because I know the 200 is the result of 60 Okay, is that clear? now on the other hand if that three o'clock blood sugar, let's say is 180 and then you wake up with 220 Yeah, I know that your blood sugar is steadily going up That is if you don't have a dexcom or freestyle librae You know, these are the tools that really helps a lot for the doctors and for the patient Because if you have a dexcom or libra, just look at it if your blood sugar is dipping down at night Then you know why it's going back up If your blood sugars are steadily going up Then that means that your liver is just making too much sugar your liver is making Or or you're eating something too late or Or you missed your exercise, whatever the reason may be That drives your blood sugar up. You just have to be sometimes playing the detective work As long as you know What really can be causing the high blood sugar And if you identify what is causing the high blood sugar, then you can fix it If it is your liver if it is your insulin resistant No matter what you do your exercise and you eat right you don't eat late You don't eat after midnight, but your blood sugar is still going high in the morning Without having a low at three o'clock in the morning That means that you really need some sort of insulin sensitizer And that will be metformin, pyroglutazone or some herbal medications Or sometimes the long-acting insulins Again, look long-acting insulins could be Lantas could be levemir could be tugeo could be truceba Even could be novelin n or hemelin n Depending on your situation, which is the right medication Of course the insurance covers may play a role All these things we think about Again, you know, when I try to prescribe medication, of course I'm trying to give you the best thing with the most benefit and the least side effects Some people cannot afford their insulins. We help them to get their insulins Free of charge by applying to the pharmaceutical companies There are a lot of ways we can try to help people with their medication prices Even if they have insurance sometimes or Medicare We try to find ways to get the financial help for our patients We cannot just tell them just don't eat anything. It just doesn't work that way guys So I hope that video is useful to you. Please give it a thumbs up and subscribe to our channel So you can be a diabetes pro And guys, I highly recommend for you to go to our website and go to sugarmds.com forward slash diabetes Dash education and you can select a category and you can basically Read and learn as much as you want. That is a free resource for all of you Please utilize it. I share it and let me know if you have any comments or questions