Here is my situation...
Type II taking Victoza... I have pretty good control. Going tomorrow for a check up and will have my A1C checked at this time.
ANYHOW... the question.
Last night my BS at bedtime (9pm) was 119. I thought that was pretty good. Last night around 1:40am I woke up freezing. I got up and went to the bathroom and checked my BS. It was 134. This morning I took it and it went up to 140. I have been waking up lately during the night freezing cold however, I can go back to sleep fairly quickly. Last night was the first time I checked my BS.
I have a hard time with my morning fasting numbers. They are pretty much consistently 120s-130s. Daytime control is tight. I eat fairly low carb.
I don't know that to do about the morning fastings. I don't know if my nightly waking up has anything to do with my morning bs readings. I am thinking they might. ANY SUGGESTIONS? I have read about Dawn Phenomenon and also the Symogi affect... I just don't know.
Looking for ideas.
I think many of us struggle with Darn Phenomenon (DP). I don't believe that this is about the Somogyi effect. In fact, your waking up and finding that you were high overnight pretty much rules it out. The Somogyi is about a harsh enough low that you get a rebound high.
Bernstein believes that mostly happens because our bodies naturally remove insulin overnight. We are diabetic, so we don't produce enough insulin to counteract that and when you factor in the natural hormone release in the morning we have DP.
There are lots of suggestions on how one might reduce DP. You could have a snack (of various kinds) before bed. you could drink some red wine, you could stack all your metformin in a single dose at night, etc. I never found anything that reliably helped my DP except insulin. So you just need to adjust. One thing I found was that it was important for me to eat first thing in the morning, and that would reset my system and often let my blood sugars normalize. If I fasted all morning, thinking that fasting would drop my blood sugar, it just would not work. So I always eat breakfast.
Thanks BSC... I do make sure to eat first thing in the morning and do have good BS readings all day long. I am on straight Victoza. Metformin stopped working for me. My A1C wasn't in a good enough spot for my Dr. to be happy. At that time it was 6.7 up from 5.8 a year earlier. During the day my BS is pretty good if I am eating low carb and healthy which I have been trying to do big time. I am hoping that my having good control during the day will counteract the DP. Its just frustrating. I am not a wine drinker so will try a snack before bed. It is hard for me to train myself to do that since my Dr believes nothing after 6pm eaten and I have trained myself to live that way. I appreciate your input.
I am taking metformin and Victoza so this might not apply to you. Before I started Victoza like you and bsc I needed to eat right when I got up or my blood sugar would slowly continue to rise throughout the morning. If I take my metformin and Victoza right when I get up and delay eating for an hour or more, often my post prandial will be lower than expected. Perhaps waiting enables my meds to kick in? You might try testing when you get up, give yourself your shot, wait before eating and test again just to see if it works for you. Unfortunately I am often rushed in the morning and must take meds and eat right away so I can get to work on time. The other thing I do is eat almost no carbs for breakfast, my current favorite is bacon and eggs, < 2g of carbs.
Dawn phenom is one of the most frustrating parts of this condition because often nothing really works. I haven't drank in years, but last year my fasting numbers were rising and having read about the red wine trick I tried it, it had zero effect on me:(
Thanks BadMoon for your reply.
I do eat first thing in the morning... I also have Thyroid disease so I take that first and an hour later I have breakfast. I typically take my BS upon waking up first thing. I give myself my injection in the evening. I tried switching to the morning to see if that made a difference for the better and it was worse actually so i switched back to evening. I don't know. I will try the nighttime snack and see what happens.
119? 134? 140? Those are all quite fine by my standards -- not high, not low -- perfectly within reasonable boundaries, I think (on the topside of normal, sure, but certainly nothing at all to be 'worried' about in any way). Do you really think a 140 is high? I get it that there's folks on here who keep really (REALLY) tight control, and while that's certainly laudable would your endo ever say that a 140 is high? Mine would not.
Maybe I'm just different -- I've been dealing with this way too long on my own without the input of a public internet forum like this... Were those my numbers I wouldn't even bat an eyelid, and I keep pretty good control (latest A1c was 6.7 two weeks ago).
I see an internist for my diabetes and an endo for my thyroid. My internist is actually harder on me than my endo. He says its because she (the endo) sees people with much higher A1Cs and therefore doesn't see 6.7 as bad. He (my internist) likes it down near 6.
Do I think 140 for fasting is high... I do... but that's what I've been taught. I am not "worried" I am concerned with working toward getting it lower. I don't think that's unreasonable.
I appreciate the difficulties T1's have in matching insulin doses to food exercise etc. Additionally insulin caused lows are always a concern for insulin users. But we have to be careful about comparing T1 and T2. For starters neither Brigitte nor I take any insulin, if our fasting is 140 we are guaranteed to go much higher even eating a low carb meal.
According to the American College of Endocrinologists any reading over 140 causes damage. So I would think that although an endo would think a post prandial of 140 was fine a fasting of 140 is not so fine. Brigitte's and mine's goal to keep a lid on fasting numbers is an entirely rational choice. Here is a review of studies supporting the position if you would like to read any further about this topic.
Interesting. I had a discussion with my endo a week ago about low A1cs (anything 6 and under). He distrusts them a fair bit as he thinks they come from a fair amount of hypos, which he thinks are no bueno. He'd rather I ride a bit high than shoot for really low A1cs and risk having a bunch of reactions just to glean that low A1c from. A different approach maybe. And everyone is different, right?
I do admire your desire to be really strict about your numbers. Sorry if I painted you as worried -- perhaps I was reading that into your OP when you said you were "having a hard time" with your morning numbers. I thought that indicated you were worried about something having to do with them, when apparently you are not at all worried about them. That's good.
Typically the Somogyi Effect (which I have been dealing with since having to pee on strips to get my BS from the night prior...) involves numbers that range from <50 to >200, not 119 to 140. Good luck getting your control even tighter than it already is.
And good luck with your doc visit!
Thanks for the clarification. You are absolutely right -- T1 and T2 are very different -- like calling bronchitis and pneumonia the same thing because they both affect the lungs I have always said -- and I should take stock of that before replying to any posting here. My head was wrapped around her "140" number. You've explained it in very clear terms for me. Thanks.
Thanks Michael! I will keep you all posted on my appointment tomorrow!
Well said BadMoon... I wouldn't have been able to put what you said into words but you are right.
You bet. And as a result of what BadMoon wrote below, I think you can simply ignore my postings to your thread. You're dealing with a very different beast than I am. :)