14/09/2026

MONDAY | SEPT 14, 2026

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High blood sugar in the morning? H ERE is a puzzle that confuses almost every newly diagnosed patient and quietly torments you cheated in the night. It is one of the most common patterns in diabetes and it is pure physiology, not a moral failure or a sign of weak willpower. O N D D I A B E

standard the world over. It is the pronunciation of vowels which often differ in different parts of the English- speaking world. For example, the Americans pronounce “hot” as “hart” whereas in British English, it is pronounced as “hort”. Nearer to home, Sabahans and Sarawakians pronounce “ay” as “eh”. So, cake is pronounced as “kehk” and KK – as in Kota Kinabalu – as Keh Keh. The difference in the articulation of vowels gives rise to different accents. Basically, there are two differing sound values – the sounds of symbols, both consonant and vowel – American and British. If we are teaching the British curriculum, then we should teach the received pronunciation – also known as BBC English, Oxford English or far back – sound values, and if we are teaching the American curriculum, then we should be teaching the American sound values. It will be helpful for teachers, especially new teachers, to familiarise themselves with the International Phonetic Chart which comes in the British and American versions. The chart actually guides teachers in the correct pronunciation of English language sounds. A point to remember is that this chart is not for students but for teachers. What is the phonetic chart? As mentioned earlier, the English alphabet has 26 letters or symbols. But these symbols produce 44 sounds which cannot be adequately and accurately represented by the keep you supplied until morning. On top of that, in the early hours before you wake, your body sends out a surge of “get ready for the day” hormones – cortisol chief among them. These hormones nudge the liver to release even more sugar, preparing you for the activities of the day ahead. In a person without diabetes, the pancreas responds with a small increase in insulin, allowing the extra glucose to be stored and keeping the morning blood sugar reading within the normal range. This natural early-morning rise in blood sugar has a medical name: the dawn phenomenon. It occurs in everyone but most people don’t notice it because their insulin response keeps the rise in check. Why diabetes exposes it In diabetes, that quiet balancing act fails. The liver still faithfully does its night shift and the dawn hormones still fire on schedule – but there is not enough working insulin to soak up the extra sugar they release. So the sugar accumulates in the blood instead of being stored away and you wake to a higher reading despite an empty stomach. The fasting number is high not because of what you ate last night but because of what your liver released while you slept, with no insulin there to balance the books. What this means for you First, stop punishing yourself for a high morning reading as though

timing and type of medication, your evening meals and sleep and, if necessary, make a small adjustment to smooth out the overall picture. The point is not to chase a perfect number every single dawn but to make sure a persistent trend is understood and managed. The bottom line The dawn phenomenon is a normal hormonal rhythm that becomes more noticeable in diabetes: before waking, cortisol, growth hormone and adrenaline signal the liver to release glucose, but insufficient or ineffective insulin allows fasting blood sugar to rise. Persistently high morning glucose is, therefore, more than a number – it can push HbA1c higher and signal an imbalance involving liver glucose output, evening meals and medication timing. Rather than blaming yourself or last night’s dinner, treat the morning reading as useful information that can help identify what needs to be adjusted. Dr Eason Chang is a physician and diabetes and metabolic health educator. He is the founder of DREC Healthcare Academy Sdn Bhd, which promotes diabetes prevention, management and reversal through sustainable lifestyle and nutrition interventions. The information provided is for

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MANY of my Diploma in Tesol (teaching English to speakers of other languages) students ask me this question: “How do we teach correct pronunciation?” And this is almost always a concern for inexperienced English language teachers as well. My response has been consistent. If I wanted to speak the Korean language like a native, I would try to imitate a Korean because Koreans are the custodians of the Korean language. Similarly, if I aspired to speak French like a native, I would try to imitate a French. But when it comes to the English language, whom do I imitate? The British? The Americans? The Australians? The New Zealanders? All of them are categorised as native English speakers but they do not speak English the same way. Each has its own distinct pronunciation pattern, especially the vowels, although the pronunciation of consonants is quite standard, the exception perhaps being “t”. Before we look at consonants and vowels, perhaps we should first look at the sounds of the English language. The English alphabet has 26 letters or symbols but these symbols produce a total of 44 sounds. In all, the 21 consonant letters or symbols give us just 24 sounds. Vowels are trickier. The five vowel symbols give us a total of 20 sounds – 12 monophthongs and eight diphthongs. As mentioned earlier, the pronunciation of consonants is quite some of them. You go to bed with a decent sugar reading. You eat nothing at all through the night. You wake up, test before breakfast and the number is higher than when you went to sleep. How can sugar go up when you have not eaten a thing? It feels like the body is playing a cruel trick on you or like you must have done something wrong. Well, you did not. There is a clear and well-established reason for it. Understanding that reason will help stop you from blaming it on last night’s dinner and something breakfast never caused – and prevent you from feeling like a failure over a number you are not responsible for. Your liver works the night shift Most people think of the liver as simply as a filter that cleanses the blood. But it is much more than that. It also serves as the body’s sugar storehouse, quietly working the night shift while you sleep to help keep your blood sugar levels stable. Through the night, your body still needs a steady trickle of fuel to keep your heart beating, your lungs breathing and your brain ticking. Since you are not eating, that fuel has to come from somewhere – so the liver releases stored sugar into the blood, in careful amounts, to

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Second, inform your doctor if your mornings are consistently your highest readings of the day. This is useful information – it can point to how your liver, your medication and their timing are interacting and it is something treatment can specifically target. A high fasting number is a clue, not a disappointment. Reassuring truth Your body is not sabotaging you at dawn. It is doing exactly what it was beautifully designed to do – keeping you fuelled and ready through the night – but without enough insulin to keep the accounts balanced while it does. Once you understand the quiet night shift your liver works on your behalf, that mysterious morning number stops being a source of frustration and becomes one more thing you can understand, discuss with your doctor and manage. Knowledge turns a scary number into a workable one. A single high morning reading now and then is nothing to lose sleep over. But if your fasting numbers are consistently your highest of the day, week after week, that pattern is worth bringing to your next appointment rather than quietly worrying about it at home. Your doctor can review the

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“The point is not to chase a perfect number every single dawn but to make sure a persistent trend is understood and managed rather than silently blamed on yourself.

reference only. Comments: letters@thesundaily.com

The accent is on clarity, not pronunciation

COMMENT by Sanny Sandhu

It is more important for teachers to guide students in pronouncing clearly without worrying about accents. Clarity in pronunciation will go a long way in minimising miscommunication. – AMIRUL SYAFIQ/THESUN

small town and capital of Kelantan, approximately 200km from Kota Bharu – I happened to meet two young boys, perhaps eight and 10 years old, conversing in English with an American accent. I asked them if they travelled abroad frequently. They told me they hardly ever had the chance to visit Kota Bharu, let alone travel overseas. So how did they acquire an American accent? They said they watched cartoons on television regularly. In other words, they had

alphabet. This is where the phonetic chart comes in. By using phonetic symbols, the chart shows us the articulation or pronunciation of all the 44 sounds. In closing, it is more important for teachers to guide students in pronouncing clearly without worrying about accents. Clarity in pronunciation will go a long way in minimising miscommunication. Accents can be acquired remarkably quickly through exposure. While I was recently in Gua Musang – a

acquired the accent simply through exposure to American television programmes. As teachers, accents should be the least of our worries. What matters most is clarity, and that is what we should focus on. The accent will follow. Sanny Sandhu is a principal training officer at Asiana Training and Consultancy. He is also a licenced trainer for the London Teacher Training College, UK. Comments: letters@thesundaily.com