First of all a big thanks to everyone that posts on this forum - just a great source of information and help.
I was wondering if any of you had any comments on my situation. It's been almost 4 years since my diagnosis and I take no medications. I exercise quite a bit and I decided to stop eating carbs and see how it went. My last A1C last month was 5.5. I have had seven A1C tests and the range has been from 5.2 - 5.8 - but my glucose readings are almost never below 100. I wake up between 108-120 almost every day and then stay there or a little higher all day. I try to do some exercise after I eat to burn off the extra glucose. I never go low - the only time I can get below 100 is if I "carb up" (eating some carbs before exercise) and if I do it right I will drop below 100 after I am finished. It is very tricky to hit it right. As a newbie diabetic I thought that hard exercise would be great for glucose readings but I found I going way up (140-170 range) if I didn't eat some carbs especially before strenuous exercise. I can't eat any bread or potatoes or sweets or I shoot straight up so I try to avoid them entirely. I eat a lot of eggs, cheese, nuts, chicken, and meat and if that's going to be the end of me so be it since that's well over 90% of my diet, lol.
I wondered if anyone had any exercise suggestions regarding my situation. I still get surprised by my meter quite often by being a lot higher or lower than I thought I would be when I test after exercise. I wonder if I should be taking Metformin to try to spend some time under 100. Does anybody take Metformin only at night? Thanks
My doctor wants me to take all my metformin pills after my evening meal, works for me, I get no side effects. I am T2 and take no other medication for diabetes. Am I right in assuming you are T2 and not taking metformin in addition to insulin?
Your A1c is 5.2-5.8 and you are worried about being above a hundred. Not to mention that you say you are steady 100-130 let's say.
Now I ain't no doctor but personally if I were your doctor I would kiss you on the lips.
That is GREAT control!!! Your A1c is better than most non-diabetics.
Enjoy the ride my friend and keep checking your BG readings. But if my endo told me that he wanted me to start taking ANY medication for diabetes I would tell him or her to take a hike.
There are two major factors that can lead you to run constantly high. First, low carb diets often result in a situation where much of the blood glucose is coming from protein in your diet. And protein is digested over 3-5 hrs which can result in being a tad higher all throughout the day. It is also true that many people with diabetes have a defect which makes their blood sugar "setpoint" too high. This can cause you to run higher than normal blood sugars.
Overall, I would not worry too much about the fasting numbers. As long as your blood sugar is consistently below 140 mg/dl and you maintain an A1c in the 5% range, many of us would consider you a poster child of control.
Hello Brian, this "setpoint" is worth to investigate. What if this level is a result of high insulin resistance? The beta cells are trying to get the level down but they can only keep it slightly elevated. I am asking because additional meds like Metformin might be helpful then to relief the Beta cells. I know that "Glucotoxosis" usually starts at higher levels. On the other hand stress from slightly elevated numbers and resistance might have a smililar effect on a different time scale. My point is that the higher "setpoint" might be a justification for additional meds to preserve the current state of the beta cells. Would the c-peptide test provide the information about the current insulin resistance / over-insulinazation (in lack of a better word)?
The only setpoint defect I've heard of in diabetes is one of the MODY mutations. Is one of the eight defects found in T2 a setpoint issue? If it is, how do meds help that? Wouldn't the person's body just spend all its time trying to bring it back up?
Holger, keep in mind that a state of homeostasis of normal BG profiles can exist under extreme beta cell stress, basically the "end-point" for a T2 before BG can no longer be controlled naturally. A person can have significant insulin resistance, but still normal natural BG control, as long as the pancreas can keep up.
So, this may not be a "set point" issue; it could be hyperinsulinemia, just not bad enough yet to uncover the cause.
Really, a better test for diabetes would be checking serum insulin levels over two hours after a glucose challenge. Measuring glucose only gives an indication something's wrong when it's been wrong for probably years.
Thanks to all for the informative responses. I appreciated reading you thoughts as I am still deciding what to do. I am pleased with my numbers but as you guys hit on I wonder if my pancreas is burning out because I always am above 100 - still undecided about whether to try a dose of met at bedtime to see what would happen. And Pole, all my Dr. does is give me hell about taking statins lol, even though my numbers (161 total, 101 LDL) aren't that bad except my HDL which has been crummy for years before diabetes (32). I'm not as interested in statins as I am in the Met based on what I read here and elsewhere.
