Morning numbers High

Hi All, brand new to this TUdiabetes org site.

I was diagnosed T2 in late August. I am on metformin twice a day and Glimipride once per day. I am having problems with the Glimipride. When I take it in the morning I have lows in the lower 50’s and I really have to watch a two hour window after I take it. I can treat it and my numbers are fine after that the rest of the day. During the night though they creep back up to 130-150. I have tried going off the Glimpirde and my overall control during the day is worse with higher numbers. I have tried it at smaller doses too and still have higher numbers. Exercise helps and I watch my diet closely but these Hypo events are the most concerning to me. Anyone have similar problems?

Hi Pualy, I was diagnosed a little over a year ago. I too was struggling with the high morning numbers. I convinced my MD to get me into and endo, I walked in and told him I wanted to try Lantus., That was about 2 1/2 months ago. After finding the correct dosage I am currently experiencing morning numbers in 82 - 98 range, once in a while the are 120 but mostly in the 82-90 range. I also take 500 mg Metformin twice a day.

Opps sorry about mispelling your name Pauly, thats my bad.

Thanks Jim, thats kinda the thinking I was doing. Glimipride its ok as a drug but recent studies show that it can have beta cell destruction on the long term and one should probably not be on it for the long haul, at least that is what I got from a worker at Dr Bernsteins clinic. Their clinic also told me that some of the generic Metformin is not quite as effective as the original from the manufacturer which is interesting too. I know my insurance would love to pay for the real MC-Coy when my state requires generic be used.

As to my numbers they are even higher on another meter I have. I test with two meters at times. These meters are sorta creepy to and are not hard science but I guess better than the alternative and not having them. I average the two and that is likely the number. This morning on wake up again I was at 133. It is funny how the body can make glucose even when it doesnt have any sugars or carbs. I will explore a samll dose of lantus. What time do you take ur lantus?

Well, let me tell you. I’ve had high morning numbers forever. It is called Dawn Phenomenon. I call it Darn Phenomenon. Search through the forums, you will find tons of information on it. To a certain degree it is a natural process that helps you wake up, but is often dysfunctional in diabetics. There are various things people do to treat the situation, I won’t go into them here, but you will find lots of info in the forums.

Glimepiride is a modern sulfonylurea, a drug which pushes your pancreas to continuously pump out insulin. When used in moderation, it can help diabetics with their fasting blood sugar levels. I believe (and Bernstein believes) that it is used far to much to compensate for insulin resistance and to cover the carbs in meals, stressing your remaining beta cells and accelerating your decline. Personally, I’ll not take a sulfonylurea.

I commend you on the exercise and diet, those are the first line of treatment. What surprises me is that in my view, the drug Metformin should be a first medication choice for type 2s. Even the society of clinical endochronologists has metformin first on it’s list in its latest guidelines (see page 19, I’d encourage you to discuss metformin with your doctor. This is particularly appropriate if you are dealing with daily lows while on a low dose of Glimepiride. Should you not be on a low dose of Glimepiride, then you may be able to split your dose and actually be able to stack it with more at night and less in the morning. Again, discuss dosing with your doctor.

Hi BSC, I am on Metformin 500mg twice a day. Do have a little gut problems for about 5 minutes then it passes so yes that was thrown at me first and is working doing its job. Not crazy about the gut problems but since it only lasts a few minutes I can tolerate it for now. The dosing may need to be adjusted here. I think I am getting too much “squeeze” on the pancreas with the Glimipride, especially in the morning when I take it and have a low, sometimes Hypoglycemic levels in the 50’s in the morning after I take it. I will be meeting with a Endo next week to review all of this and look at options, Thanks for the great reply. The morning Dawn is certainly upon me as you say.

I was waking up at 140 myself for a while. Someone told me that I should have a protein snack at night because that seems to help. I was eating toast with jelly and milk for a night snack. So I had two slices of wheat bread with peanut butter and this morning I woke up at 96. It may be a fluke but I will try it again and see what happends. From what someone told me is that proteins help with the dawn effect. So i am doing some carbs and protein to see if it will impact the numbers

Your morning numbers sound just like mine were. The doctor started me on a very low dose of lantus. Increasing it 1 unit a week. After I newness settled in I begain increasing and have found the perfect dose for my body. Right now I split the dose 32 at =night and 22 mid morning. Of course I dont know how the doc is going to feel about this dosage, but the numbers dont lie.