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Letter from the Editor, #736: High Blood Sugar Mystery

Jul 4, 2014

Can you all help me with a couple of things?

I know from experience that many of our readers are very physically active and health conscious. In talking with some of my colleagues, many select lower carb regimens to follow. This often leads us to take on long bouts of physical activity without consuming glucose or carbohydrates before starting the activity.

Over the past three weeks I have had about half a dozen fellow road cycle riders come to me concerning their A1c values. None of these riders are overweight and none of them have diabetes and they were either in their late 30’s or early 40’s, but they are concerned because they are seeing high fasting readings of 120-140 mg/dl frequently. They also have indicated that the highest they get 2 hours after a meal is often lower than their fasting readings. Four of them had A1c values done and they were 5.7 to 5.8. Each of them wanted to know why they were getting these readings.

I am looking to see what you, our readers, might feel the problem is. I proposed that their low carbohydrate consumption on these long rides was causing the liver to supply most of the energy source needed. This long term need for glucose could be creating a "dawn phenomenon" effect and this could be the reason their fasting readings were high. If you have an idea about what is causing these high readings and if my theory might be plausible then please let me know by replying to me at

If you are a medical professional in the Orlando area and you would like to attend the AADE meeting on August 6-9, we are looking for a few volunteers to work in our booth. In exchange for your time, we will provide you with a pass for the conference at no charge.


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Dave Joffe, Editor-in-chief