Research shows the beta cells of your pancreas are really sensitive to even slight increases in your blood sugar levels. There is also evidence that beta cell dysfunction may commence when your blood sugars spend as little as a few hours over 100 mg/dl (5.5 mmol/l). It has also been found these cells can survive and recover after they are exposed to lower levels… but only if that switch is made before a certain amount of time has passed.

So how do you lower your blood sugar level when it is out of your target range? Some of the strategies you can use to lower your level include:

1. Increase your activity level: exercise acts like an insulin shot… it lowers blood glucose. It has been repeatedly demonstrated that exercising after eating, when your blood sugars are at their highest, will lower these levels. And exercising after breakfast appears to make physical activity later in the day, even more powerful in keeping your blood glucose under control.

2. Drink additional fluids: often dehydration leads to high concentrations of sugar in your bloodstream. Drinking two to three quarts (two to three liters) of sugar free liquids each day helps prevent dehydration. When your blood sugars are high, drinking sugar free liquids helps to dilute it.

3. Eat less carbohydrates at the next meal: a basic guideline is to eliminate carbohydrates, or choose foods with a lower glycemic index until your blood sugar levels return to your target range. If you are working with exchanges, eliminating one starch exchange or fruit exchange, will lower your blood glucose by 30 mg/dl (1.67 mmol/l). If you are overweight or obese, just losing five to ten per cent of your total weight will dramatically lower your levels.

4. Identify infection and illness: high glucose levels make you prone to infection although the upsurge of glucose is part of the healing process.

5. Monitor your blood sugars two hourly: this allows you to treat and make adjustments as early as possible. This will show you whether the steps you are taking are effective in lowering your levels.

Please do not hesitate to contact your health care provider when your blood sugar levels remain higher than 250 mg/dl (13.9 mmol/l) for more than two days.

No-one is entirely sure what causes insulin resistance, although many scientists suspect a genetic defect may be the culprit for both resistance to insulin and type 2 diabetes. However, insulin resistance is an extremely important concept for those with diabetes type 2.

What is known is there are several factors that do contribute to its development:

• obesity with a high proportion of fat in the abdominal cavity and around your internal organs… this is called central obesity. It is as common as a 40 inch waist. It is important for you to understand the effect obesity has on your cells’ insensitivity to insulin because it means that even injected insulin… as is sometimes required with type 2 diabetes… does not work as it should and larger and larger doses are then required
• inappropriate diet is definitely a major contributor… weight gain and obesity are significant causes of type 2 diabetes
• lack of physical activity also contributes to insulin resistance and may also contribute to type 2 diabetes. Inactivity often leads to obesity which compounds the risk.
• a deficiency of vitamins can also contribute to the development of resistance to insulin and type 2 diabetes

Insulin resistance is really a complex phenomenon in which several genetic defects combine with environmental factors. In other words, although family history and genetics play some part in this syndrome, there are more pieces to the puzzle than your family tree.

What really comes into play is diet and how you exist in your environment. However, diet is the most important and what’s more, it is the easiest to change.

The primary treatment for insulin resistance is:

• exercise and
• diet

Low-glycemic index or low-carbohydrate diets have been found to help. Research has shown exercise and diet are nearly twice as effective as metformin at reducing the risk of insulin resistance progressing onto type 2 diabetes

Too much insulin causes low blood sugar levels or hypoglycemia and because this is a life-threatening situation, your body will respond by releasing several insulin antagonists… cortisol and epinephrine from your adrenal glands, growth hormone from the pituitary gland and glucagon from your pancreas. Why… to negate the effects of insulin.

These are very powerful hormones that bring about rapid and powerful elevations in your blood sugar levels and often cause your blood sugars to shoot too high. So then these high levels need to be treated with more insulin which can then cause another plunge in your blood glucose. This will be followed by another compensatory response and even larger doses of insulin.

Now the Dawn Phenomenon is a natural occurring process that occurs during the sleep cycle, where your body starts to work on the compensatory response mentioned above. These hormones fight against your insulin’s attempt to lower your blood sugars, and usually occurs when your insulin dose is wearing off. This results in your high blood sugars in the morning. This occurs in many type 2 diabetics six to ten hours after bedtime.

Many people with type 2 diabetes wake up in the morning with a higher blood sugar level than when they went to bed, although they have not eaten and had their insulin injection or anti-diabetic medication the previous night.

A higher level above 108 mg/dl (6 mmol/l) when you get up in the morning is a common feature of type 2 diabetes and is actually a puzzle to those who experience it.

Events leading to the Somogyi Effect or rebound hyperglycemia are similar to the Dawn Phenomenon… the difference is the cause. In this case your blood glucose has dropped due to taking too much insulin or failing to have a snack before your bedtime.

Checking your blood sugar levels between 2 and 3am on several consecutive nights will give you a clue as to which effect is the cause of your early morning high sugar level. If your level is consistently low the Somogyi Effect is likely to be the cause. This would then indicate your night-time insulin level is too high or your bedtime snack too small. On the other hand, if your level is high between 2 and 3am, the Dawn Phenomenon is more likely the cause.

Do not hesitate to talk to your health care practitioner as you may need to change the time you take your evening insulin so that its peak action occurs when your blood sugar levels start to rise. Bringing your level down aggressively will only worsen the problem by creating hypoglycemia.

Another theory is that you should be less concerned with blood sugar levels that are elevated in the morning unless there is consistent elevation during the day.