Bedtime 120-140/am 200-240

@john2002 Hello John, and welcome to Mayo Connect. We are a community of patients and caregivers, living with a wide variety of conditions, and helping each other in our journeys.

I do not have diabetes, but my husband has lived with and managed Type II diabetes for 30 years. A few years ago, he was struggling with the same situation after having good control for a long time. Here are a few things he learned.

First, his meds were no longer "quite enough" - he and his doc experimented for a while and settled on a different set of medications, which worked great again - for a few years. Then the same thing happened, and he added a Trulicity injection once a week (after a trial on insulin which wasn't good for him.)

Second, our retirement lifestyle changed a bit, and our meals were not as routinely scheduled. Evening meals especially were not at a set time, and set off the high AM sugars. His A1C, though, still remained quite acceptable, though a bit higher. So again, some adjustment.

Now, he has a high protein, moderate fat snack in late evening when he takes his meds (sometime between 9-11 pm) Examples: a serving of pistachios, a tablespoon of peanut butter, a low-sugar protein shake, a small protein bar... This has solved the problem.

Have you and your doctor tried adjusting or changing medication? How is your A1C?
Sue

@john2002, hello. Have been type 2 diabetic many years, fairly well controlled now with short acting insulin before or right after meals based on carb count for the meal and long-acting insulin at bedtime after an evening snack despite also having renal disease and gastroparesis. In the past I frequently experienced what my dr. called Dawn Syndrome. As glucose levels fall during the night, it's normal for the liver to make glucose to get the body ready for morning but sometimes with diabetes the liver overdoes it, especially if bedtime sugar levels are low.
The dawn phenomenon: What can you do? - Mayo Clinic https://www.mayoclinic.org › dawn-effect › faq-20057937.

Although this might not apply to you, since I have gastroparesis, sometimes slow food absorption delays glucose getting into my bloodstream. Therefore early morning my body thinks I need glucose so the liver makes some, raising morning fasting levels.

Also, you might want to ask your doctor about it.

Hope this helps.

@john2002 I’m Cheryl jumping in to add my 2 cents worth. I’m 47+ years diabetic (all types, believe it or not) and also have CKD, gastroparesis and diverticulitis. @sueinmn and @kamama94 are spot on with their recommendations. There is another freaky thing related to the Dawn Phenomenon called the Somogyi Effect. You could ask your provider about that. One thing I’d like to emphasize is that with these diagnoses there isn’t a one & done fix. With time the condition will morph and the treatment will require adjustment and fine tuning. My thoughts and prayers are with you as you and your team work hard at this.