First, diabetes is not treated or the treatment is not standardized and unreasonable, which leads to poor fasting blood glucose control. For example, the dosage of hypoglycemic agents is insufficient, which leads to poor blood sugar control throughout the day.
Second, eating too much dinner, adding meals before going to bed, or eating dinner too late will lead to high abdominal blood sugar the next day.
Third, after exercise or fasting time is too long, resulting in an increase in fasting blood sugar.
Some patients did exercise at home before fasting blood sugar test, or walked a long way to the hospital for blood sugar test. In fact, fasting exercise or fasting for too long can lead to mild hypoglycemia, which in turn leads to an increase in reactive blood sugar. So the measured blood sugar is relatively high.
Fourth, mental and emotional stimuli such as stress, mental tension, anxiety, insomnia, or acute and chronic infections, cervical spondylosis and other stress factors will lead to an increase in fasting blood sugar.
5. Some patients reduce their drugs by themselves, which leads to an increase in fasting blood sugar. Some patients usually have good blood sugar control, and their fasting blood sugar increases after self-reduction.
Drinking too much at dinner, eating less staple food, and fasting blood sugar increased the next morning.
Seven, Su Mujie phenomenon leads to high fasting blood sugar.
Su Mujie phenomenon refers to short-term hypoglycemia caused by too much hypoglycemic drugs, too little meals or too much exercise, and then the blood sugar rebound increases. This reaction is actually a self-protection regulation of blood sugar balance. When hypoglycemia occurs, in order to maintain blood sugar balance and stability, the secretion of glucagon (such as adrenaline, glucagon, glucocorticoid, growth hormone, etc.). ) through the increase of negative feedback mechanism, promote the transformation of liver glycogen into glucose. At the same time, insulin secretion is also inhibited, which increases blood sugar, thus helping the body to correct hypoglycemia and prevent blood sugar from rising in the body. When the dosage of hypoglycemic drugs (including insulin) is too large or too hungry before meals (or before going to bed), it causes hypoglycemia at night, and then fasting blood sugar rebounds in the morning.
8. "Dawn phenomenon" leads to high fasting blood sugar: "Dawn phenomenon" refers to the situation that diabetic patients gradually increase their blood sugar after dawn every day (about 4:00 ~ 8:00) or need more insulin to offset high blood sugar when blood sugar is well controlled at night and there is no hypoglycemia; At present, although there is no consistent quantitative standard for the "value" of blood sugar increase caused by dawn phenomenon, most scholars believe that blood sugar is normal at night and fasting blood sugar level exceeds normal in the morning, so dawn phenomenon can be considered.
At 1~5 am, the secretion of growth hormone, cortisol, epinephrine, norepinephrine, thyroxine and other hormones that raise blood sugar increased, but the utilization of peripheral glucose and insulin secretion also began to increase correspondingly and accurately, so the blood sugar of healthy people remained stable and normal in the early hours of the morning. Growth hormone, cortisol, epinephrine, norepinephrine, thyroxine and other hormones that raise blood sugar increase at night, but different from healthy people, the anti-hyperglycemia factors such as insulin sensitivity, insulin secretion and peripheral utilization of glucose in diabetic patients decrease or delay, that is, the factors that raise blood sugar exceed the factors that lower blood sugar, which leads to the obvious increase of fasting blood sugar in the morning and the "dawn phenomenon". Studies have shown that the degree of "dawn phenomenon" is closely related to the course of diabetes, the level of blood sugar control and insulin resistance; The longer the course of diabetes, the worse the blood sugar control, the lower the insulin sensitivity, and the greater the fluctuation range of "dawn phenomenon", but the smaller the fluctuation range of "dawn phenomenon".
The above eight causes of fasting hyperglycemia can be summarized as three reasons: 1, insufficient use of hypoglycemic agents; 2. Su Mujie phenomenon; 3. "Dawn phenomenon"; But in clinical practice, it is often more complicated, and several factors often appear together. Fasting blood sugar is high, but the reasons are different. Therefore, it is very important to analyze and find out the reasons behind fasting blood glucose. Can't blindly increase hypoglycemic drugs. Only by finding the real reason can we prescribe the right medicine and really control fasting blood sugar. So how do you identify the causes of elevated fasting blood sugar?
Methods: The patients ate dinner in the evening from17 to18, and went to bed around 22 o'clock. Venous plasma glucose was measured at 22: 00, 2: 00, 4: 00 and 6: 00 respectively. According to the measured blood sugar value, analyze the reasons behind the increase of fasting blood sugar;
1, "dawn phenomenon": if there is no hypoglycemia at night, but the blood sugar gradually rises after the early morning, it is "dawn phenomenon";
2. "Sumujie effect": If hypoglycemia occurs at night (