From the Guidelines
No, it is not better for a diabetic patient with morning hyperglycemia to eat carbohydrates to stimulate insulin release. Instead, patients should focus on managing their morning high blood sugar through a combination of medication adjustments, timing of evening meals, and appropriate breakfast choices. For type 1 diabetics, adjusting insulin dosing is crucial—this might involve increasing the morning insulin dose or adjusting the evening/overnight basal insulin, as suggested by the American Diabetes Association 1. For type 2 diabetics, medications like metformin should be taken as prescribed, and in some cases, the healthcare provider might recommend taking certain medications before bedtime rather than in the morning. The morning hyperglycemia often results from the dawn phenomenon (early morning release of hormones that increase blood sugar) or from rebound hyperglycemia following overnight low blood sugar. Adding more carbohydrates when blood sugar is already high would typically worsen the situation rather than improve it, as consuming carbohydrate-containing foods and beverages can increase postmeal blood glucose levels 1. A better breakfast approach would include protein, healthy fats, and limited complex carbohydrates to prevent further blood sugar spikes while providing necessary nutrition, in line with the nutrition therapy recommendations for the management of adults with diabetes 1.
Some key considerations for managing morning hyperglycemia include:
- Adjusting medication dosing and timing, particularly for type 1 diabetics 1
- Choosing appropriate breakfast foods that are nutrient-dense and low in added sugars, saturated fats, and sodium 1
- Considering the individual's overall eating pattern and lifestyle, including physical activity levels and other health goals 1
- Monitoring blood glucose levels and adjusting the treatment plan as needed to achieve optimal glycemic control 1
By prioritizing these strategies, diabetic patients with morning hyperglycemia can better manage their blood sugar levels and reduce the risk of complications, ultimately improving their quality of life and reducing morbidity and mortality.
From the Research
Morning Hyperglycemia in Diabetic Patients
- Morning hyperglycemia is a common issue in diabetic patients, and various strategies have been proposed to manage it, including eating carbohydrates to stimulate insulin release 2, 3, 4, 5, 6.
Effect of Carbohydrate Intake on Insulin Release
- Research suggests that consuming carbohydrates can stimulate insulin release, but the effect on blood glucose control is not always clear 3, 5.
- A study found that adding whey to meals with rapidly digested and absorbed carbohydrates stimulated insulin release and reduced postprandial blood glucose excursion in type 2 diabetic subjects 3.
- However, another study found that combining carbohydrate with protein elevated postprandial insulin levels but did not improve glucose response in type 2 diabetic subjects 5.
Impact of Different Types of Carbohydrates
- The type of carbohydrate consumed can affect blood glucose control, with slowly digestible carbohydrates potentially having a more beneficial effect 2, 4.
- A study found that a bedtime meal providing uncooked cornstarch improved breakfast tolerance the next morning, while a bedtime meal of white bread did not have the same effect 2.
- Another study found that a low-carbohydrate breakfast improved glucose control in people with type 2 diabetes compared to a low-fat control breakfast 4.