High levels of glucose in the morning | Keto

Hi guys,

Started Keto dietupon diagnose of type 2, 5 months ago. Now I have stopped metformin, my morning glucose levels go to 150 - 180 giving me a rough start of the day. How does this translate to my Keto diet, having max 10gr of Carbs each meal (max).

Last night I went to bed with 104, woke up with 162 and no food in between.

Cheers, Marcel

When was your last meal? Protein can take 5 hours to digest and even longer with the fat slowing it down, so if you went to bed before the protein got done processing then you could be high from that. Have you tried waking up in the middle of the night and testing your BG? If your BG is fine in the middle of the night then it might be dawn phenomenon.

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There is something called dawn phenomenon or DP. This is a release of hormones in preparation of waking up for the day and boosts your Bg level. In some people it is a lot more significant than in others. Usually it happens between about 5 and 6 am, but it can happen anytime.

Some people also/or get something called feet on the floor FOTF, which causes your BG to rise right after you wake up and get out of bed.

Both of these also cause insulin resistance for a few hours after you have woken up.


Have you actually stopped taking Metformin in the belief that a keto diet is a substitute for drugs? The answers you have received are all correct, but you need to take Metformin together with the keto diet to get good numbers.
If straight Metformin upsets your stomach, please ask your doctor to prescribe extended release Metformin which is a much kinder drug.


I did indeed. We have this program in the Netherlands to cut out medicine by adapting lifestyle. Meeting the criteria I am very positive about the results on long term. Working with private doctor and a specialised assistant of a professor of the main Dutch diabetes hospital. So short term I need to search for the right changes…

I agree with pastel painter. Just because you are doing keto does not mean no meds.protein can increase blood sugars also. Nancy50


The other thing is exercise which makes a tremendous difference to the numbers you get. This should be in your programme from the hospital.

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I used to use Metformin but had to stop due to stomach issues. I found stopping had near 0 effect but I do use Ozempic which helps some. I then tried Keto and it had a big effect at first so I even had to stop insulin at times, but then almost none on my glucose levels which tend to run high afternoons and night but lower in morning. I use a pump to adjust insulin basal rates up and down over a 4 to 1 variation to compensate. Every day is different.
I could not handle this without CGMS. With it I have been able to keep A1C under 5.5% during all these changes in meds and diet.

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@jhe6, if your BG rises during the afternoon and evening, I would suspect the amount of carbs.

@Marcel_Nagtegaal I found my fasting blood glucose was the last number to come good. Keep the low carb going. I would continue with the metformin. It may be one of the better drugs.
google : metformin longevity trial

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If you do low carb high fat keto diet, then you will be able to skip meals and not get hungry. Try eating OMAD (One meal a day) at noon and see if your morning glucose is better. I think you will find big improvement if you do that. IF (intermittent fasting) should make a big difference.

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I do 1 meal a day alternating with 2 a day currently. Some days are full keto except I find I have to eat 30 carbs/day min or I might get hypo’s in the night.

None of this affects my basal needs going up and down over 3 to 5 day cycles!

I didn’t realise you were on insulin and low carb. Have you tried splitting the basal dose to bedtime and breakfast?
Have you started on a bolus and corrections yet?

Years ago I did have to split my bolus morning and night but It got way more complicated so I had to buy a pump.

I have variable bolus now in about 4 time slots/day but the longer 3 or 5 day variations I have to adjust for. At least my C-Peptide also varied and finally got low enough sometimes for Medicare coverage.