Doing everything I'm suppose to but for some reason lately my BS is running around 130 in AM. It use to be 100 or less. Some mornings its ok but others not so good. Any idea's?
We need a bit more information, Dee! Are you referring to your fasting blood sugar? Are you Type 1 or Type 2? Do you take long-acting insulin? How much and when do you take it?
Yep - I'm with Zoe. This question just can't be answered unless we have more information.
Ruth
I'm type 2. Two years now. A1C is 5.6 take 10 units of Lantus at night before bed. Usually don't eat after 9 PM. except drink water through the night. Take metforim with meals. And take Victoza at 8 PM with snack. I've been having some restless nights so may be that is the reason for it being higher in the mornings. If I sleep late on Sat. morning its usually around 90. But if I get up early its higher. Ive been told it should be between 90 and 120. I'm 62. Does this help.
Yes. But it does lead to other questions...lol. You have only been diagnosed Type 2 for two years and you are on insulin. That is a bit unusual. How long have you been on insulin? Is there a chance that you're not, in fact Type 2, but Type 1? Have you been tested for antibodies? Are you overweight? Do you have another autoimmune disease like Thyroid? 10 units Lantus is much more a typical Type 1 dose than Type 2.
All those more complex issues aside: 130 is a bit high for fasting, though not extremely. You might try raising your Lantus by one unit and see how that works for a few days. How are your other "in between" blood sugars, like more than 3 hours after meals and at bedtime?
Hi Dee, It sound like dawn phenomenon to me. My guess is the Lantus at bedtime is supposed to be taking care of it but is not. The dawn phenomenon is the liver releasing glucose it the morning to give you energy to start the day. In people with D this causes unwanted bs rise. After a while bs will go back down as happens when you sleep in.
130 is not extremely bad but the lower the fasting bs the better. Most T1's are used to adjusting their insulin but because your T2 I can understand if your uncomfortable doing so, a call to you doctor might be a good idea. He may want to change your Lantus at bedtime or maybe increase the metformin if your not already taking the max dose.
By the way Dee most folks here would love to have a 5.6 A1C so you must be doing something right
Gary
Hi Zoe, For Dee to be on insulin after only 2 years is a bit unusal. It sounds like she has an agressive doctor which I think is a good thing. She has a 5.6 A1c if she is LADA will they be so good at this point. I don't know much about LADA onset so I'm going to defer to your expertise in that field.
Thanks, Gary. LADA isn't characterized by a high or low A1C in particular, unless, of course, her numbers are starting to rise because she is making less insulin now. My numbers were very stable for 15 months (on oral meds) until they started to rise. That can happen anywhere from a couple months to a couple years, but if the rise just started her A1C would not yet reflect it.
Good resources for understanding insulin are "Using Insulin" by Walsh and "Think Like a Pancreas" by Scheiner.
Generally you increase your basal insulin to reach your morning target. Often, we need more insulin overnight to combat the Darn Phenomenon (DP). Unfortunately, if you increase your basal too much, you will have hypos at other times of the day, so you need to use some care with adjustments.
I am type 2 as well and have also been on insulin for 2 years. I was switched to Levemir a year ago from NPH. With NPH I was better able to control my DP because I was able to take a larger shot overnight. Not so much with Levemir. And I struggle with sleep problems which really cause bad DP. So when I awake high I will correct the high, taking a dose of rapid acting insulin to restore a normal blood sugar. I've also found that doing this with my breakfast also helps. For some reason, not eating in the morning makes my morning blood sugars even worse.
Thanks Gary. I think you might be on to something about the D because I do have a restless night most nights because of my legs hurting and that could be the reason for the higher BS. I just worry about the numbers being high because my Endo Dr. keeps close track on it and it worries me that she will put me on another med. I just feel like I take too much now. I've also wondered if maybe its a new medicine I take at night now. Its a beta blocker that my family Dr. has me take along with my blood pressure meds. I take it at night before going to bed and it seems like it started happening then too. This is all a guessing game I know but I want to be informed with this desease and stay of top of it. I appreciate your thoughts.
Thanks Brian I will check these resources. Where can I find them? I want to learn all I can about this desease and have tried to be on top of it as much as I can. When I was first told I had diabetes I had an A1C of 14.3 and on six shots a day of insulin. In two years I have gotten it down to 5.6 now. My Endo is very happy with me, except I need to lose more weight. Ugh!! She has been reducing the Lantus for about six months now and I am now on the 10 units at bedtime. She said at my last visit that if I lose some more weight she will take me off it completely and I will just be on the oral meds. I also take thyroid meds, blood pressure meds, and have gall bladder issues that they are saying I may need surgery for. (gall bladder sludge). So I have several issues going on most of the time. Thanks for your imput.
Hi Zoe,
Yes, I am overweight. I need to lose 50 pounds. I am 62 years old and My Grandmother and her sisters on my Dad's side had diabetes. I had an A1C of 14.3 when I first was told I had it. I was started on six shots a day of Lantus and humalog (100 units on sliding scale). I take Nateglinide 120 MG once before every meal, metformin (four at night 500 MG). My Endo started me on Victoza about six months ago and it worked good at first, lowering the blood sugar and I did lose some weight from it but that stopped too. But she tells me to stay on it. I have other issues, thyroid, high blood pressure, breathing problems, two time breast cancer survivor and not am having gall bladder issues. (gall bladder sludge). So lots of things going on but I try to stay on top of it. I was told I was Type 2 from the beginning. Not sure if I've been tested for antibodies. What would that do? I will try raising the Lantus and see how that works.
Thanks so much for your advice.
Dee.
I can see why your doctor has been so aggressive, You started with some pretty high numbers for a T2. You and you doc have done a excellent job in bringing things under control.
Although I feel that your doctor is correct in typing you as T2 it would not hurt to ask about LADA. LADA is often overlooked in us more seasoned folks. Zoe is a prime example, she was treated as a T2 for sometime before getting a correct diagnosis.
They say that the only thing that's constant is change and that's especially true for diabetes. The most important thing is to recognize it and make the necessary adjustments, you seem to be doing a good job at that.
Gary
Click on the links in my post and it will take you to amazon where you can buy the books. They also might be available in your public library. I have to tell you, many of us suffer from DP. I never found anything that really got my morning blood sugars down except insulin (well except drinking like 5 glasses of wine at bedtime). I think it is great that you have made such progress. Perhaps you can think about "managing" your morning numbers. Try the eating thing. Try eating just eggs. Perhaps waking a 130 mg/dl can be tolerated as long as you get down to a normal fasting (70-110 mg/dl) soon after waking.
That extra information helps, Dee, because it makes you sound more like a type 2, especially the humalog dose. But oddly, your Lantus dose is quite low for a Type 2, so that might in fact be the problem. The only reason, btw, I questioned your Type is that I was misdiagnosed as type 2 at age 58, when in fact I'm Type 1; many of us are, as doctors assume someone our age is automatically type 2.
Sounds like you have dealt with a lot. Glad you're here - this is a great place to get support and info.
Ah, I should have read all the new posts first! Now I see why you are on such a low dose of Lantus. I'm of the "if it's not broken, don't fix it school". That's very likely why your numbers are going up in the morning, your Lantus has been reduced too low.
I don't know, Dee, the thyroid makes me wonder still about your type (yes, I know I'm contradicting myself). You could be a Type 1 with insulin resistance.the reasons I say this are you have another autoimmune condition (thyroid) and you so obviously respond to insulin. It wouldn't hurt to be tested. The testing would include a c-peptide - this tells you how much insulin your body makes - Type 2's make lots of insulin, they just can't use it very well due to insulin resistance, Type 1's make very little. The other tests are for antibodies and are definitive of type. Type 1's have antibodies because it is an autoimmune condition, Type 2's do not. The most important antibody is GAD65 which is indicative of LADA (slow onset type 1), but a full panel is best. I'm not convinced you're type 1 (with some people it's very clear!) but if you were than the oral meds would be a waste of time and staying on insulin would be the way to go.
I second the vote on the books. Using Insulin by John Walsh is my bible.
Thank you Shawnmarie. I did question that to my Family Dr. when he put me on it but he didn't seem concerened. He also just started me on another med that is called Lipofen that is suppose to help get my triglisorides lower and my good Cholestrol higher. I was reading the info that came with it and it said you shouldn't take it with a beta blocker. I hate taking all these pills. There are times that I can tell my sugar is low and sometimes I am shocked to find it is low also. So that could be the reason behind that. Thanks for the info.
Thank you Gary. When I found out I had it I decided I would treat it just like I did the breast cancer. I give it my all and pray for the best outcome. I know some people who have it and just gave into it and have a lot of health issues. I spend a lot of time with Dr's but if that is what it takes to stay healthy I will do it. I appreciate everyone's imput, it really helps. I will ask about the LADA and she says.
Dee
Ok. Thanks. I will work on that. I've gotten lots of good information on this question.
Dee