My pre-breakfast morning reading is always between 150 and 175, even when I haven’t had anything overly carby the night before. What gives? During the workday my BG is within the ADA range, sometimes even sneaking below 100. My PCP has me on diet/exercise for now and Lipitor for high cholesterol. I was dxed in early July. No family history of diabetes, 37-yrs-old, BMI at dx was 29. Weight was concentrated in abdomen (OK, fine, I look pregnant and I’m a guy!).
Josh
Twitter: J_Berkman
Diabetes/Health Justice Blog: www.thebigprick.squarespace.com
At night your liver is pushing glucose out into your body so your morning readings will almost always be higher.
Thanks Jeroen.
Why does the liver do this? What is an acceptable morning range? I was under the impression that your morning pre-prandial BG should be the lowest.
Morning fasting should be under 100.
Lowest BG is between 2-4 AM. As part of the normal waking cycle, the liver releases glycogen to raise BG. Of course, diabetics don’t have a way to lower it to normal on our own, or regulate how much glycogen is released.
What are your readings after meals? ADA range is high.
You should insist that your doctor run tests to properly diagnose you. Too many adults are misdiagnosed Type 2 based on age &/or weight. I was diagnosed Type 1 at 53 with no history of diabetes in my family. The tests needed are C-peptide (to measure how much insulin is produced) & GAD antibodies (to determine if your pancreas is under autoimmune attack). You could be LADA (latent autoimmune diabetes adult). LADA have some insulin of their own & can for years. Keeping BG as close to normal as possible prevents burn out of your beta cells for any diabetic.
The liver does this because it thinks you are low on fuel. Do you have a protein + carb snack at bedtime? For many people, this will help. Metformin also can help with this problem because it prevents the liver from pumping out so much glucose.
Agree with Gerri, you need more help to get these fasting overnight readings down. So get back into your PCP ASAP.
These readings are far to high and you need to address it as you are doing damage to your body at these elevated sugar levels. You likely are peeing alot at night too with this high of BG.
He/she probably will start you on Metformin first.
What do you suggest is a good pre-bed snack? Usually, I have a glass of red wine (read it’s good for you) w celery and peanut butter.
Thanks Pauly. My PCP wants to see how I do w diet and excercise for three months. He feels that weight loss will help my BG #s.
It seems a little odd that you PCP wants to hold off on meds for your diabetes but already has you on cholesterol meds. Personally the numbers seem high, for me, very high. There are is a lot of info missing for anyone to to really provide much feedback other than some very general suggestions. In a nutshell, the best way to get your fasting BG down is to get your BG down before you go to bed and to do that in the shortest amount of time is to increase exercise and decrease carbs, both considerably. Next, throw away the ADA standards as they will keep you much higher than you need to be.
The weight loss may very help you BG, but there is not saying how much it will help and then there is question, how long will it take for you to get there? In my case, just for an example, at dx i weighed 230 pounds, fasting BG was 280 and my a1c was 11. Now i am 170, fasting BG is 85 and a1c is 5.0. sounds great right? but if i don’t follow a low carb diet, my BG skyrockets (went to 200 in heartbeat on 1 piece of bread the other night). The point is, diet and exercise wont necessarily fix all the problems. Everything you do will help, but its very possible that a number of treatments will be necessary for the long haul (diet, exercise, oral and possibly insulin).
Best advise i can give is take control. Set your targets, your fasting numbers, where you want to be 1 hour and 2 hour postprandial and then do whatever you need to get there. As Gerri mentioned you may want to talk to talk to your doctor about additional tests to make sure you are properly dx’d. Read, read read. I would start with Bloodsugar101 (book or online).
Thanks. I’ve been following a low carb diet and evaluating what carbs in moderation I can tolerate. I’ve also upped my excercise to 40 min of intense cardio 4 times per week as well as weights 2-3x per week. At my 3-month follow up, PCP plans to do a more detailed workup. I also think that Metformin is in my future. But I’m going to make sure he rules out LADA, b/c I don’t want to waste precious time w oral meds, if it’s insulin I really need.
Ruling out LADA will be good and as Gerri mentioned, the c-peptide and GAD tests should help there. you may need to push your doc on that as most assume you to be T2 unless you end up in DKA and figure even if you are LADA, the treatment plan will be the same (start with diet and exercise, move to orals as the disease progresses and then ultimately insulin as the pancreas sputters out). of course, for those with the disease, its easier knowing what possibly may come down the road by getting a more detailed dx early. as i mentioned, the key is setting your targets and then working with, or pushing if needed, your doctor to work with you on the right treatment plan to meet those targets.
Good luck and welcome to TuD!!
Good plan, J, & also please get a referral to an endo. It can take months to get an endo appt. Waiting three months until you see your PCP again isn’t in your best interest.
Here’s a link to the site Bubbaluv mentioned www.bloodsugar101.com. It’s excellent.
If you have the antibody tests, make sure you get the whole panel. GAD is just one of several antibodies you could have. Oral meds could actually be damaging if you have LADA.
You may just need time, you were diagnosed only last month. It took me a half a year to get my my morning fasting numbers below 150 mg/dl. And then it was only after ditching the ADA diet and going low carb that I was able to hit my blood sugar targets. You may just need to give things some time, you have made a great deal of progress for just one month. Remember, this is a marathon, not a sprint.
Thanks, bsc. This is all very new to me. I’m trying to absorb as much as I can and the encouragement helps. Last night I went to bed w a BG of 110. When I woke up and tested at 7 a.m. I was close to 170. Since my daytime numbers are fairly decent <140 2 hrs after meals and and between 96 and 115 fasting, I don’t think I’m LADA. I trust my doc and will follow his lead at this point, though I wasn’t impressed with the DE in the practice. She seems to swear by ADA. I guess the good folks at TuDiabetes will be my de-facto DE. I’m open to Metformin if it can help reduce my risk of complications. My MIL was on dialysis and had a below-knee amputation a few years before she died at age 60. I don’t want to put my wife through that sort of trauma again. I’m doing my part (no more than 15G of carbs per meal) and excercise. I’ve lost 9 lbs since dx, and everyday.