I’m going to post a couple charts from the last two days. If you have some time… Take a look.
Just a quick background story. I’ve been following the Dr. Richard K. Bernstein diet, for a while, but I’m losing weight too fast to continue and need to add some more food in. Here is my weekend experiment.
Yesterday. I ate a cinnamon roll and experienced exactly what should have happened. I spiked to 200+. Then something weird happened. I decided that we should have pizza (I know, I fell off the rocker). So, we had pizza, not only was it pizza, but it was Chicago deep dish pizza. Arriving home, I was surprised to find my BG dropping. It dropped to 138. See chart.
Why does it work when pressured? It was like I could feel the insulin working. I guess this is just diabetes, but for some reason… I had in my head that my charts should look like a three camel humps. Sometimes… I just think my body just sets a level.
This is a classic reactive low pattern for a T2. Insulin production for a T2
Starts out slowly and then kicks into over production which causes lower BG as a reaction to a spike at then end of the cycle.
Simply your body over reacts to the massive dose of carbs and over compensates by producing more insulin than needed plus it puts out insulin longer than needed, thus the
This is not unusual for a T2. But There is a belief that the a pancreas that is overproducing insulin can “burnout” and stop producing insulin.
In my opinion a measured intake of carbohydrates balanced against insulin production is a better approach, but. I am not a medical doctor just a well controlled T2.
Now morning high numbers are totally attributed to your liver dumping glucose.
Not anything to do with your insulin production. The so called “dawn phenomenon
Metformin is suppose to help control you liver leaking glucose.
Believe me… I’ve tried. I’ve eaten more greens than roger rabbit. I’ve went to 6/12/12 on the carbs for a balanced diet. Dropped from A1C of 10.2 to 6.2, but I can’t beat the dawn phenomenon, I’ve even tried waking up at 3am to drink a protein shake. To no avail. On the Metformin, I take 500ER twice a day. I actually had better numbers not taking Metfromin, but promised the Endo I would run it out.
I’m really just working on a strategy to gain some weight back.
When did you take the metformin?
Metformin reduces the glucose dump from liver, so best when that corresponds to food digestion causing rise,but no net rise.
Pizza can have a lot of fat that slows does digestion, and delays BG rise. But might have sugar in sauce, or other toppings.
MM1
I take the Metformin first thing in the morning and before bed. I’m thinking of adjusting the Metformin at night to be with supper. Honestly though, a while back, I stopped the metformin for two weeks and my numbers were actually better.
For the ten years under T2D medication, I plotted my BGs vs. time curves occasionally and they were three camel humps similar to yours. The peaks were around 1.5 to 2 hours after meals. Later on, my Endo added long acting insulin with other medication, then added short acting insulin at meal times and stopped medication. Unfortunately, I did not know that the “preservation” of the insulin production beta cells was the utmost important in the T2D treatment. It resulted in my beta cells “burn out” after 30 years of T2D.
@T2Tom explained your curves very well. Metformin slows the release of BG from liver and it works better at the meal time. Anyway, consider take fasting C-Peptide and BG tests to understand your beta cell insulin production capacity as compared to the normal person at this point. Follow up with another fasting C-Peptide and BG tests later, after trying weight loss (the most effective), diet, exercise, medication, etc. whatever the program you like. You would have better understanding about beta cells insulin production status.
T2D starts from lacking of sufficient first response insulin after many years in pre-diabetes stage, therefore, BG peaks after meals. The remaining functional beta cells produce insulin to take BG entering body cells, hence BG drops. If BG stays high, the brain continues to signal beta cells to release more insulin to meet the demand, without knowing that BG could not be lower due to BG/insulin resistance in entering body cells, not because of insufficient insulin production from beta cells. At the end, beta cells were burn out and insulin injection becomes necessary.
Lower body weight, take low carb meals (<20 carb/day per some doctors) and exercise are important to preserve beta cell insulin production function. If beta cells are preserved, you have better chance not requiring insulin injection later.
Thanks for the well written response. I’m guessing my post should have been worded better. I’ve had my Fasting C-Peptide and Insulin tests completed. 10.9 on Insulin and 1.89 on the insulin (Both Mid normal). However, it seems like it works when it wants. No real pattern. The morning dump, I can shoot up to 300 without eating or I can eat and it shoots up to 300.
As for the weight loss. I really can’t lose much more. I started at a lean 187lbs and weigh in at 158lbs as of last night. Working on a low carb diet and my metabolism doesn’t match well.
Your statement below is what puzzles me. I was diagnosed at 10.2 A1C, so for sure I have been diabetic for a while. Who knows how long. Because I’m slim, they tested me for Anti-bodies, they came back negative after three months after diagnosis. What puzzles me, is sometimes… I can do nothing and it works just fine and other times… nothing zip zilch. I’m attaching today’s chart. Morning Protein Shake, Normal Lunch, and 1 slice of that left over pizza for dinner (not two like the chart before). You can see… it hasn’t responded like the other day. (The evening spike the night before was a small cutie orange).
I guess the question is: am I insulin resistant or insulin insufficient?
T2D starts from lacking of sufficient first response insulin after many years in pre-diabetes stage, therefore, BG peaks after meals. The remaining functional beta cells produce insulin to take BG entering body cells, hence BG drops. If BG stays high, the brain continues to signal beta cells to release more insulin to meet the demand, without knowing that BG could not be lower due to BG/insulin resistance in entering body cells, not because of insufficient insulin production from beta cells. At the end, beta cells were burn out and insulin injection becomes necessary._
One thread in this forum leads to an article published in April edition of Diabetes 2009 by ADA. This paper describes the possible causes of insulin resistance and the relationship to beta-cell failure. Its review of pathophysiology of T2D indicates the complexity of the carb metabolism in human body. You may want to review the “Implications for Therapy” section and discuss with your Endo for an effective treatment in your specific situation. Here is the link to this paper.
Let’s get to your question: “…am I insulin resistant or insulin insufficient?”
If you have a lean body, the excess fat cells related insulin resistance factors, such as, fat muscles, liver, intestine, pancreas, etc. may not be the primary causes. The other factors could be in the insulin releasing ”control” mechanism in the brain, or the deterioration of insulin production beta-cells for whatever the reason, i.e. LADA progression. I will consider 1) reduce carb in-take in each meal to lower the peak BG (<120 or 160?), and 2) use proper medication as suggested in the ADA article and your Endo, in hope of preserving the remaining insulin production beta-cells, 3) monitor the BG changes to determine the best course of action, 4) relax and enjoy your daily activities.
for the longest time I had no PP problem. but FBGL got dox interested and he put me on 500 MG metformin. well he dropped out of o’care so I dropped insurance and bought metformin from india. he wasn’t the greatest and I could tell from research that I was gonna diet and exercise and maybe or maybe not take metformin for at least the next year.
the point of all this is 500 MG of metformin taking at bedtime for nearly 6 months has done NOTHING for my FBGL. now inexplicably AIC and FBGL are going up past pre- diagnosis levels when I did NOT restrict carbs or diet of take Metformin.
500 mg of metformin is often not enough to have much effect. Note that 500 Mg is actually a much higher amount, more than most people can lift. Also, medicines from India are often far from pure.
