Well followed u with my GP today 3 wks post diagnosis, went in with a spreadsheet of my numbers and three research papers. Ha! Yep, I am that patient :).
Any way, she’s pleased and I told her the recommendations of the AACE and she told me that was great for my goal. So we are square there and no insulin right now. Numbers are getting better. Found out my retinas are bleeding from the eye specialist, which I saw after reading the info here. The GP was shocked by that considering they lost my blood work for 3 months and there are obvious complications that could have been avoided. She understands I’m serious about getting this under control and accepting only the best results and team to get me there.
But I cannot get my AM numbers down. My waking is bouncing between 120 and 150. I would love any input on working this down. I added a low carb high protein late night snack. Any advice? Mornings are rough wondering if exercise in the am wil help. Thx everyone!
Amber - Your waking numbers between 120-150 are not bad numbers. Optimal would be less than 100 but that's not always possible. Is there a reason that you added a late night snack? I am not a T2D, so I can't help with treatment advice. I do know that exercise is a good thing for all diabetics. I read recently that for T2Ds, exercise starting 1/2 hour after eating helps a lot with post meal blood glucose readings.
The best thing that you could do for yourself as a newly diagnosed T2 is to learn how different kinds of meals affect your blood glucose. It would be a good idea to test your BG just before eating and then 2 & 4 hours later. Write down your numbers and consider whether that particular meal was good for you or not. This is sometimes referred to as "eating to your meter." Your meter will tell what is OK to eat and what drives your BG too high. In general it's good to shoot for less than 140 at 2 hours post meal and around 100 or less after 4 hours.
What you are experiencing is called the Dawn Phenomenon (DP). Personally I call it the Darn Phenomenon. There are different opinions on why it occurs, I've come to believe it primarily occurs because our bodies naturally clear out circulating insulin early in the morning and it causes things to go haywire. As diabetics, we often don't produce or release enough insulin. So in the morning when we have a normal cortisol rise to help us wake up, the resulting release of glucose from our livers (which is normally controlled by insulin) is unregulated. And for some of us, it can be a little like a runaway train. And while you might think exercise or not eating in the morning will help, it will often make your body scream louder to release blood sugar and then you will be even higher before lunch.
Before I started insulin two years ago I was in much the same situation as you, and as Terry says, your numbers are not all that bad. I never found a satisfactory solution. In fact, even with insulin I still don't have a full solution and still have numbers mostly in the range you describe. There are a whole variety of suggestions, I'm sure others have some. Here are the ones I found helpful and some others that I didn't find helpful (although everyone is different):
Taking all my metformin right before bed (all 2.6grams)
Drinking red wine before bed
Not helpful
Eating snacks before bed, of any kind
Improving my overall blood sugar control
Eating more carbs or less carbs overall
Exercise (strength training makes DP worse the next night and AM exercise makes it worse).
So even after all that and having started insulin more than two years ago and all the things I've done, my morning numbers are no better than yours. We do the best we can, I may not be able to "fix" my DP, but I can manage it and I can make sure it doesn't get out of control.
Ugh. Well, I guess it is a figure it out as you go deal. I am testing like mad right now, as Terry suggested to learn what happens when I eat.
The gp recommended a late night snack to try and help with the am numbers. Not sure why but seems to help a bit.
Bryan your input on exercise, is that just your experience or a diabetic fact?
I also thought about taking my last med dose just before sleep. Seems a reasonable thing to try to hold them down. I know they are not terrible #s but they make me FEEL terrible and lethargic, grumpy. I seem so sensitive to ANY rises right now…my body seems to react to the littlest things
A
I don't think there is any "diabetic fact." There is information and there is Your Diabetes May Vary (YDMV).
Dr. Bernstein recommends not exercising in the morning as the added stress from exercise will often make your DP worse. He talks about this in his book "Diabetes Solution." I found this happens, but everyone is different. Strength training is known to increase growth hormone which surges overnight and growth hormone is known to be an antagonist to insulin (it works against insulin). I can give you more references if you are interested.
Dawn phen is a result of excessive glucose release by the liver that starts seriously at 3:00am and gets worse.
Liver signalling is also a culprit and since liver works on inverse of blood level of insulin; the lower the actual insulin, the liver thinks it needs to pound in more glucose till it sees higher insulin levels.
I agree with brian that the items that do not work in fact do not work.
For some; some shots of a basil insulin - increase pump releases at these late time 3:00am through 5:00 am my be beneficial.
for me only metformin and I take 2 doses - one of 500mg at 10:00 pm and another at 12:00am midnight will arrest the liver monkey shines from 12:30 am through 5:30 am. My liver does not signal properly on the insulin so under any condition where liver is asked to add glucose; it wants to add the whole liver buffer. The size of 500mg metformin can be too small for some and may need increasing to 750mg.
