I'm a Newby to this forum, but have been diagnosed Type 2 for almost ten years. My former Dr. had me just do a fasting test every day, and my AIC's were tickety boo: according to him I was a model patient. I've been going to a new Dr. since relocating, this one claims to be a diabetes specialist. Again just daily fasting test, and this fellow told me not to worry as long as numbers are less than 180. He has not been happy with my last two AIC's.
Started testing six times per day, and found that my levels soared after meals, and didn't come down till next morning. Tried high Glycemic diet, and this seemed to make things worse! Read here about the low carb regime; began having meals with as close to 0 carbs as I can. The spiking settled down immediately, but my fasting numbers started coming as high as 220! It seems that two hrs. after my evening meal and a 40 minute walk I'm about 150; somtimes it is still in that range when I go 'jammies & nppies', and sometimes much higher; with one exception it has been very high every morning for the last two weeks that I've been doing the low carb routine.
Not sure what is going on here, nor what to do about it. Any and all advice would be appreciated.
Hi James. Welcome to TuD. I have the same problem with the fasting numbers so I rarely fast for long. I eat small snacks throughout the day which usually works well. I'm not sure where you are in Canada... here in Ontario we have had a time change this week and I'm having trouble bringing the numbers down. I'm pretty sure that I will get it fixed soon but it will take a week or so. I also have trouble when I have to fast for a blood test... takes days to get back to normal. Could either of these problems be affecting you right now? Many on TuD have problems with the morning numbers. There are 2 reasons for this. The first is the Smogyi effect which means you go low overnight and your liver dumps sugar to compensate. The second is the Dawn Phenomenon which means that the liver gives you a rush of sugar just before you wake up. You have to test during the night to see which it is. You can check the search at the top of the TuD homepage for the Dawn Phenomenon to see how everyone deals with it. There is good info on Google too. If you haven't been to Bloodsugar101.com, I would highly recommend it as she addresses many of these problems. Stay well. Cheers! Joanne
I'm currently in Saskatoon, and was born and raised in the Collingwood, On. area. I can see what you are saying about the sugar going higher in both scenarios, and mine seems to be going up in the late evening, and/or during the night. Odd, I don't think it was doing this before. Mine was quite high this morning, it came down considerably two hours after I had a large breakfast and a long walk. Now it is time for my evening meal and it is higher than it was when I first tested this morning! I have only had eggs, onions & mushrooms today. I could try the many small meals during the day but I wouldn't be happy about it. Thank you for your reply.
Hi James and welcome. I'm a Type 1, but shouldn't be shocked about the ignorance of your doctors, because we get the same thing, maybe a little less as they would have to be insane to tell us to only test once a day. Testing only once a day, however, is only marginally less insane for a Type 2. Your numbers, as you realize are too high. It's great that you are eating virtually no carbs and seeing less spiking, but how long can you keep that up?
Bottom line, you are working really hard and you are to be commended for that, but it looks like you've reached the point where diet and exercise are not enough. I would strongly suggest you talk with your doctor about starting you either on oral meds or insulin. You need some "assistance" in getting those numbers down because otherwise you will put yourself in line for complications. Sit down with the "diabetes specialist" and ask him what he recommends. There is no shame at all in needing more help controlling your numbers. Ten years on diet and exercise is great.
Hi Peetie; I've a bad habbit of just two meals per day/no snacks. last night when I checked before bed, and it was so high, I had a spoonfull of p-butter and a piece of old chedder, and it was higher this morning.
Hello Zoe; I am taking two 500 mg metformin twice per day. My BS was a little too high before I switched to this low carb experiment, now it's just too weird, (and too high). My morning reading was twice what it should be, but, two hours after breakfast it was down by 3 to about 9. When I checked it before dinner it was 12.4, then, after three hours and a long walk I just tested at 7.4. For dinner I had the same as for breakfast; three eggs, two mushrooms, one slice of onion. Maybe I have to either eat more often, or throw in a little bit of carbs.
Being a scot, does that mean you can stand in a hammock and play golf?
Not a Doctor but:
I would eat regular meals every couple of hours. Staging longer means that liver needs to bang in when BG drops sub-70 and it may be adding way too much glucose shooting BG way up. This why infrequent fingerprick tests while getting some data do nor give you trend data.
One item I banged into was liver - in that: as gut empties down and if you eat snack at right time nibbling, liver can do glucose add even when BG is 140 thru 200 shooting BG skyward.
Also early am Dawn effect may need checking to see if liver is bad boy whacking one skyward to 200 plus. Check at 3:00am and every hour to see what is going on.
I hate to say this but you may need to agressively check doing multipe frequent caveman checks to get view of what is happening if you do not have cgms.
Guess and intuition while helpful do not rule out hard data as clue to issue.
When my Dr. became alarmed at my A1C my levels were reasonable fasting, but upon testing multiple times daily, peaked after meals & plateaued through untill evening. Two weeks ago I began this low carb diet plan, and eliminated as many carbs as possible thinking that I'd begin re-inserting them into my meal plan after my numbers were satisfactorlly regularized. Immediately I noticed the apres meal numbers quit peaking, however, at the same time my fasting numbers became quite high, beginning to rise between meals, and in the evening after my last meal. I'll give you my numberssince noon yesterday; I had just two meals yesterday, each the same as breakfast today: 3 eggs, slice onion, two/three mushrooms.
12:13 pm 9.4 (3 hrs apres meal, with 45 min exercise.) 5:24 pm 12.00
8:19 pm 7.4 (3 hrs apres meal, with 45 min exercise.)
9:51 pm 9.4 (snack - thmb size peice of cheddar)
11:53 pm 9.6
6:59 am 11.2
10:56 am 8.6 (3 hrs apres meal, with 45 min exercise.)
I'm 195 lbs consistantly, which neither myself or my Dr. feels is overwieght.
I'm descended from a long line my dear Mother once listened to. My ancestors came from the northern Highlands apx 200 years ago, and had been 'encouraged' to emmigrate from the southern half of what still is call Southerland country. A couple hundred years prior to that that half had been the land of Clan Mackay; due to unfortunate circumstances of a financial nature, that land then fell under the title of Sutherland. My Mother's surname was Mclaughlin.
Welcome to Tudiabetes. It is a great support group. Lots of doctors don't believe in a lot of testing for Type 2's. My doctor told me to test 2 x per weeek. I am glad I did not listen. When I read Blood Sugar 101, I learned about Eating to your meter. That mean you pick your bg goal and design your meals around your 2 hour number. At first my bgs were in the 180-200 range but now they are more like 100-120 range. I know what spikes me and what doesn't. I don't know why doctors don't tell patients to do this, it is so simple. Also if you have been a Type 2 for 10 years you may have progressed to being insulin insufficient. It seems you are taking a small amount of metformin. I had to raise mine to 2550 before I saw fastings close to 100. Even with that, I am sure at some point I will have to go to a long acting basal insulin to provide me the insulin that my pancreas is no longer making. I also eat very low carb, usually around 10-15 per meal, less at breakfast.
Been Canadian so long I forgot about hammock, but, I can make love in a canoe! This soaring BS, (and, between you & I, it isBS), long after a meal just started with this low carb thing, so, I will have a lunch of yogurt and bran at 1:00 and see what happens. Will keep the 3:00 am test in mind, but, what is 'caveman' testing? I'd heard of 'caveman dating', but I can't see how I can gain insight into my BS by hitting someone on the noggin with a club!
Some things that have worked for me. I take my my night time dose of met right before I go to bed. If my BS is high in the morning it stinks all day. I also eat a piece of cheese, some almonds or a bit of sausage before bed. I have to eat something high fat or my BS is high in the morning. I think this must be because I bottom out overnight and have my liver dump but I'm not sure since when I have tried testing every hour I find that my BS just goes higher and higher overnight.
I eat about 6 times a day. I seem to do better like that. I think if I get too low then my liver dumps.
I started low carbing and it took a few days but my BS did go down some. Sadly, if I look at a piece of bread it goes up. My dr. is afraid to put me on anything besides met because I often get down into the 90s during the day. He's afraid that if he gives me anything stronger that I will go hypo too often. But, that may be what you need, something besides met.
Welcome, everyone here is so supportive and has some great ideas.
I agree with you; after 10 years something has changed in my system, and the switch to ultra low carb has added complications to that change.I have an appointment with my Dr. for Monday, and will have a pretty little chart made up for him outling my menu and the resulting readings. I will also try taking some metformin with a Hi-pro snack before I go to bed.
Thank you for your response Whirlygig; I have never had a low reading; the lowest I've seen was a couple of years ago and it was 4.8, but on the Hi-pro, Lo-carb routine my BS does seem to just keep climbing if I go a long time between meals. I will try your advice and have a snack and pills pre 'jammies & nappies'.
finger prick glucose meter. SOmebody once called it cave man machine.
It stuck with me.
I found myself taking metformin dose 1 hour before meal ( my gut timing) and that stopped it. What I found was bizarre, but as I had cgms and could watch the riots, (before met dose) i found that as BG was dropping due to gut emptying, if I ate a small snack that tried to reverse dropping BG, I would see BG stall flat and liver suddenly bang in with a glucose add cycle booting BG up fast. Body BG pre-issue and checked with fingerprick was 140 thru 200, yet somehow liver was booting in extra glucose for curious reasons. A metformin dose up to strength in blood at time gut was emptying stopped any monkeyshines. For me that meant taking meal dose - one hour before eating meal. I am unclear what extra body sensor was telling liver/brain to bang in more glucose.
this was repeatable and able to duplicate. Met dose late at night before bedtime - 10:00 pm through 12:00am will slow down dawn effect.
Where in du Canada do/did you live? I am from Vancouver BC.
Hi James, It looks like your 1st stage insulin response is impaired. This happens when you no longer make enough insulin to build up insulin stores in your pancreas. Your pancreas is supposed to store insulin for quick release when carbs are ingested but when your insulin production is impaired it is constantly playing catch up and is never able to build up reserves. Eating low carb can help but some of the protein you eat will eventually become glucose and if your insulin production is low enough your BG will stay high for a long time.
It looks to me like insulin injections maybe in your future. Please don't despair, even if you do need to inject it's not the end of the world. Most folks that have crossed that line have found insulin is the best thing that has happened to them, it was for me. Insulin for me is a powerful tool that I have used along with diet and exercise to finally gain control of this monster. Insulin may not be the next step for you but don't let your doctor brush off your current level of control as good enough.
Insulin worked better for me and wish I had been on earlier ( 30 years earlier) as it works way better in conjunction with a working pancreas rather than the oral pill hammers - glyburide , starlix etc.
On another point; if one is on low glycemic diet and cannot lose weight and BG remains high, in my case, liver was being a pain releasing ( throwing back) far too much glucose. I was on solid diet of 1200 calories a day and walking 2 miles a day and could not lose an ounce for 2 years until liver corraled and excess glucose release of liver stopped. Extra insulin did not fix that but metformin did in doses spread around the clock. Once liver stopped, a1c dropped from 13.3 to 6.9 and now 6.4 and health improved dramatically.
As I said, that was my case and yours may be a different set of issues. In my case I initially went to 30 test strips a day and graduated to cgms to watch the feature show 24/7. Ido not recommend unless absolutely necessary due to cost and other issues.
The CGMS has been most helpful wringing out issues , diet and exercise as well as watching and corraling a rascal of a liver.
Thank you for your response and warm welcome. I am seeing my Dr. on Monday, and it will be interesting to see what he has to say; this is the same diabetes specialist who, when I told him two years ago that it seemed to be getting more difficult to get acceptable fasting numbers, told me not to worry as long as they were less than 10 mm/l, or 180 on the other scale. My mother's side of the family was riddled with diabetes, both of her sisters and her one brother had it, and, of course, my mother had it as well. I have three siblings and all of us are diabetic; my older sister was put on insulin two years ago, my younger sister told me this week that her Dr. told her that the time has come for needles. When I was diagnosed the news was hardly a surprise.