Dear Food Speak: I'm trying to live healthier ever since I got diabetes. I can't understand why my blood sugar in the morning tends to be so high when I've stopped snacking after supper. Can I fix this with diet?



Kudos for all you do to manage your diabetes. People like you are the inspiration behind "A Day in the Life of Diabetes," an initiative by the American Diabetes Association to raise awareness about this chronic disease affecting nearly 26 million Americans.

During American Diabetes Month, the ADA is asking people to submit personal images to the association's Facebook mosaic representing what a day in the life of diabetes means to them. The mosaic includes success stories and was also showcased on NASCAR driver Ryan Reed's race car during a race in Arizona this month.

Your story calls for a look beyond your diet. It sounds like you may be experiencing the dawn phenomenon, a surge of early morning hormones which signals the liver to release stored blood sugar. People with diabetes don't have a normal insulin response to adjust for that, so fasting blood sugars can rise. Insulin is a hormone that controls the transport of sugar in the blood into the body's cells for energy.

Blood sugar monitoring is the best way to confirm the dawn phenomenon. Your doctor may recommend blood sugar checks at bedtime and upon waking for three or more consecutive days so that you can see just how much your blood sugar increases overnight. If your doctor suspects this phenomenon, medicine may be prescribed.

If you take insulin for your diabetes, there may other reasons for high morning blood sugars. It may be that the timing and/or amount of insulin you take is inadequate. Or high morning blood sugars could be a rebound effect from being too low in the middle of the night. If so, then blood sugar would be low around 2 or 3 a.m.

Research has not found a dietary fix for the dawn phenomenon. Still, many health care providers consider a few modifications worth a try. For one, try eating dinner earlier in the evening. You could also try adding a bedtime snack. The belief is that having food in your system overnight tells the liver to hang onto excess blood sugar instead of releasing it and raising blood sugar levels. Try a low-fat, high-fiber food paired with a little protein such as a few whole grain crackers spread with peanut butter or a small bowl of fibrous, low-sugar cereal with low-fat milk.

A nighttime snack can be counterproductive for people who need to lose excess weight. A better option may be to add some physical activity after dinner. Exercise enables your body to use insulin more effectively. It's a benefit that lasts for many hours after exercise so it may help to drive down blood sugar the next morning. While your search to solve your blood sugar problem may cause you stress, it will also likely grant you an appreciation for how individual diabetes management can be.

Courtney Sansonetti is a medical nutrition therapist and certified diabetes educator for Rehabilitation Associates Inc. Her Food Speak column appears monthly. Email your questions to