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Message: <blockquote data-quote="KeithSimpson001" data-source="post: 1210712" data-attributes="member: 306511"><p>There are a lot of factors but one that rarely gets mentioned is that when you haven't eaten for 8 hours [first thing in the morning] alpha cells in the pancreas are producing more glucogen than they would at other times of the day because when you eat, hormones are released by the stomach that suppresses alpha cell glucogen production for up to 8 hours after eating. Glucogen causes the liver to release glucose & so the more glucogen, the more glucose that is released by the liver. On top of that, adrenalin [morning boost] also causes extra glucose to be dumped by the liver in the morning. Of course all this extra glucose is only significant if as a type 2 you are unable to produce enough extra basal insulin to control what the liver is releasing.  In my experience most GP's have insufficient knowledge where diabetes is concerned & indeed even specialists focus on what is usually the problem in their experience, rather than scientifically attempting to diagnose the extent that insulin production has been impaired in type 2 patients. You will be told that Metformin & exercise will both help reduce insulin resistance & they both do BUT with high fasting levels because of insufficient insulin [not resistance], these can only help after having broken that fast & raised glucose levels to the point that bolus insulin is produced.</p></blockquote><p></p>

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