[wellsy]

I'm Gary from Queensland where the floods have just been. I'm T2, diagnosed 2 yes ago. Taking Metformin 1000 after each meal. Exercise almost everyday and eat low carb high protein. Before and after meals BG is reasonable 6-7 mmol/l but each morning - out of bed BG (fasting) is up around 9. Anyone have similar readings or can give me a clue?
Gary.

[dano]

Welcome to the Forum, Gary!

There are a couple of things that could be going on. The first is called "Pre-Dawn Phenomena". Secondly, it could be that exercise (ie a thirty minute walk), after your evening meal, would help. There is a lot of info concerning this in the T2 "Blood Sugar 101" thread. You may want to have a conversation with your doctor, as well.

[emlore]

Hey Danny, Can you explain what pre-dawn phenomena is? I've noticed that my morning glucose read is sometimes higher than what it is during the day. Sometimes it goes up during the night instead of down. Is this because of the type of carb I'm eating at night?

[judyannreed]

My doctor called it glucogenesis. That my body makes it's own sugar after the nightlong fast. He suggested that I eat a little protein just before bed to give it something to work on.

[dano]

Here you go dawn phenomena.

[wellsy]

Thanks Dano, I have been checking the net on the Dawn Phenonomen and done some readings at 2, 3 and 4am and my BG steadily increased from 6 to 8.2. Did read somewhere that alcohol or glass of wine at bedtime can help. Am giving that a go.

[adrianconnelly]

Hi Wellsy. This used to happen to me so I found out some more about it from my doctor and the RPA hospital diabetes unit in Sydney.

Judy is correct, except it's called Gluconeogenesis - gluco (sugar), neo (new), genesis (origin). As I understand it, it's the process the body goes through to get a fresh supply of sugar that it previously stored in your liver when it can't get sugar from food you've eaten because there's none left. This occurs notably during the overnight fasting process, but can also occur at other times. It's why sometimes after you've taken a BG reading and then haven't eaten a thing, the next reading actually goes up.

I make it a habit of eating either 2 Vita-Weat biscuits OR a tub of NO-FAT yoghurt (Nestle or Forme brand) about 10.30 or 11pm (ie one serve of carb). It gives the body just a little carb to work on during the night. My out-of-bed readings are consistently under 6 mmol/L, but I also am on a basal insulin each day as well as the metformin (1000mg at each meal) and diamicron (120mg daily).

So you might want to also talk to your doctor about the possibility of adding a small daily insulin dose to supplement your meds. Dosage and timing will be important here, and I wouldn't presume to be dogmatic about it. I can only stress that constant and attentive monitoring of your BG levels will pay handsome dividends. I neglected mine for quite a while but have now taken them more seriously and am now throttling them big time.

I'm not sure where you are in Qld, but I recently attended two half-day sessions at the RPA hospital here in Sydney and they went right through the metabolic process and explained just how diabetes affects those processes, what foods to eat and avoid and how to read the food packaging labels so you can carefully monitor your carb, fat, salt etc intakes. I'm sure there's a similar service through the dieticians at your local hosp. I thoroughly recommend it, and it's either free or bulk-billed under Medicare.

Hope the floods didn't cause you any grief. We've all been thinking of you guys. Good luck.

Adrian

[wellsy]

Adrian, thanks for your advice. I'm also on the same Metformin dosage as yourself and was on Diamicron until I changed my diet to low Carb, started exercising and lost 10kg. Dropped the Diamicron without any marked changes to BG. Still on 1000mg Metformin 3 times day and my weight loss has slowed. BG is ok at all other times. Will try your tip of having some Carb before bed and will check with my Dr next week. Excuse my ignorance but I suppose the basal insulin is being injected. How did you feel starting that? If I can get the morning "out of bed" bit right then will feel I have done goodly.
Floods didn't directly affect me but I do feel sorry for those who thought they were insured only to find out the wording on their policy meant they were not. Once again thank you for making the effort to reply, it is greatly appreciated.
Wellsy

[adrianconnelly]

Hi Gary

Yes, it's a daily injection. I was a bit depressed at first, I confess. I'd hoped it would never come to that, but having been on it now for over a year, I sure wish I'd been on it earlier. It has made the daily struggle to keep the sugars at a reasonable level just that much easier. I started on 10 units of Lantus at first and had to increase it by 5 units per day until my out-of-bed reading was better than 7 mmol/L.

A year ago the meds alone ceased to work sufficiently and I was getting readings of 15-plus. That's just dreadful, and the constant high sugar levels caused soft-tissue damage in my left foot that resulted in a permanent injury (known as Charcot's Arthropathy) whereby some of the bones no longer line up properly and lengthy walking risks further injury. A corrective operation involves 9 months of non-weight bearing convalesence and carries an 80% risk of failure anyway. The softer option was to get specially made shoes that properly support my foot but they are expensive, ugly and cumbersome. I look like Gumby when I wear them and exercise options are therefore limited for me and weight loss is a real struggle because I can't do any weight-bearing heavy exercise.

On the bright side, I guess I could live without a foot if the ultimate injury happened but I can't/won't live without a liver, kidneys or my eyesight which are the other big risks areas, so I can't complain at all if that's the effect it's had. And I did get the big consolation prize - a disabled parking permit - so it's not a total disaster.

I now take 60 'units' of insulin per day (which is only about 20 mls of fluid) at about 6pm.

The needles are very fine and less than 1cm long. I just gently grab some flesh on my tummy, shove the very fine needle in and press the syringe plunger. It all takes only seconds and doesn't hurt a bit. I found that taking it in the evening was best for me. I'm usually at home at that hour and it's just before the onset of the o/night fasting period where it will be of most benefit so it's a good time.

Hope I haven't bored you too much with all this rabbiting on, but I just don't want anyone to neglect their diabetes the way I did. Big, big mistake - and constant vigilance in keeping the sugars low is the key.

Regards
Adrian

Originally Posted by wellsy

I suppose the basal insulin is being injected. How did you feel starting that?
Wellsy

[wellsy]

Adrian,

You said
"I just don't want anyone to neglect their diabetes the way I did"
By neglecting, did you mean not taking your medicines as you should have or not monitoring your levels?
Sorry to hear about your foot, I get some numbness at times and a feeling like I have something sticking to the sole. Oh well, part and parcel I suppose.
Take care!
Gary.