Fasting Blood Sugar Changes: Causes, Conditions, and Solutions

Understanding the Fasting Blood Sugar Changes

Many people have high fasting blood sugar, but their postprandial (PP) sugar is normal. This phenomenon is seen by a lot of people in our country. This looks like that if you eat food your sugar will be ok but if you don't eat sugar goes up. This is so confusing for you. So, "Why does this happen?" We will discuss a few more scenarios related to blood sugar to learn more. 

1st condition - Fasting Blood Sugar Level is High but PP is Normal

Some people will find that their fasting blood sugar level is 150 mg/dl but their PP sugar is 140 mg/dl, why does this occur? This might be due to Reactive Hypoglycemia, also called Reactive Hyperinsulinemia. Let’s understand what Reactive Hypoglycemia is. When we eat carbs, they go into the stomach and are converted into sugar. This sugar is released from the stomach to the blood and the pancreas detects it and releases insulin based on the amount of sugar released from the food. Insulin moves sugar from the blood into the cells.

This process happens every time food is consumed. Over time, due to frequent episodes of eating the pancreas starts releasing excess insulin and gets inflamed due to overwork. The anticipation that too much sugar is coming with every episode of eating the pancreas produces way more insulin than required. For instance, if a normal person’s pancreas produces 1 unit of insulin for a particular food, in this person it will produce 3x insulin even though the food is the same. This is reactive hyperinsulinemia. The excess insulin pushes more sugar into the cells, causing the blood sugar level to drop. This is why the fasting blood sugar level was 150 mg/dl, but the PP level dropped to 140 mg/dl.

To overcome this condition we need to give rest to the pancreas by reducing the glucose load of the meal. People also need to reduce their episodes of eating to a maximum of 4 per day. This will help pancreas to release insulin slowly which will help in normalising both fasting blood sugar and PP sugar levels.

2nd Condition - Fasting Blood Sugar Level is Normal but PP is High without Eating Many Carbs

This condition might be the result of a weak pancreas. Due to the continuous state of hyperinsulinemia for several years, the beta cell in the pancreas starts dying. The capacity of the pancreas to release insulin reduces, hence a person's sugar level rises after a meal because the pancreas is not able to produce a sufficient amount of insulin. 

For example, if a normal person’s pancreas produces 10 units of insulin after a particular amount of food then this person’s pancreas produces only 2-3 units of PP insulin. As the glucose load of a meal increases the blood sugar increases more than it should. 

Insulin production can be checked by testing fasting blood sugar and PP insulin levels in the blood. When blood sugar is high then pancreas increases its production of insulin to the maximum to bring the sugar level to normal level, in this state beta cells dies at a faster rate, and managing blood sugar remains high. If someone is having this condition then he should keep his glucose load of a whole day diet below 25 per day and less than 10 glucose load per meal. 

3rd Condition - Random Blood Sugar Level is Normal and HbA1c is Controlled, but Fasting Blood Sugar Level is High

If only your fasting blood sugar level is high, this is known as the Dawn Phenomenon. After fasting for 12 hours or more overnight, fasting blood sugar levels drop, prompting the liver to start producing sugar. Protein and fat are essential, but carbs are not, as glucose can be made from non-carbohydrate sources through gluconeogenesis. This is why fasting blood sugar levels may increase. In this condition, increasing protein intake at dinner can help because protein takes longer to digest, helping to keep blood sugar levels stable.

Tips for Controlling Fasting Blood Sugar Levels

1. Distribute the Glucose Load of meal evenly: Proper glycemic load distribution is important. We recommend following a diet with a glucose load of less than 25 per day. This does not mean consuming low glycemic loads (e.g., 3 or 2) in the morning and at lunch but taking a high glycemic load (e.g., 20) in the evening. Proper distribution is necessary, as shown in the image:
   • Breakfast: 5 GL
   • Lunch: 10 GL
   • Snacks: 3 GL
   • Dinner: 7 GL

Following this pattern can help you manage your glycemic load more effectively. Download the EGL chart to know food products glycemic load.

   2. Avoid Exercising in the Morning:

Do not consume food or exercise within three hours of waking up in the morning. Instead, opt for exercising in the evening rather than in the morning.

Conclusion

Managing blood sugar levels is not a one-size-fits-all approach, as different people experience different patterns of blood sugar fluctuations. Whether it's high fasting levels with normal PP, normal fasting with high PP, or the Dawn Phenomenon, understanding the underlying reasons is key. For those with high fasting and normal PP levels, giving the pancreas rest by reducing carb intake and meal frequency can help. If fasting levels are normal but PP levels are high, it may indicate a weakened pancreas, and adjusting the glycemic load might be necessary. Lastly, for those with the Dawn Phenomenon, increasing protein intake at dinner can help stabilize fasting blood sugar levels.

To manage these conditions effectively, it's important to focus on distributing glycemic load properly throughout the day and adjusting your routine, such as exercising in the evening rather than in the morning. By understanding your body's unique needs and making targeted changes, you can better control your blood sugar levels and maintain overall health.