Not understanding my glucose test results.

[queenbee01]

🙂Morning all, Not been around for a couple of weeks, it's been busy at the B and B.
I'm getting confused about my Glucose meter readings. In the last month I have swapped over from using urine testing strips to Glucose Meter readings. I am a Type 2 diabetic taking Metformin and Sitagliptin. In an effort to gain greater control over my BS, I decided to ditch the urine test strips. Since then I have been testing on fasting, 1 hour after a main meal, then 2 hours after a main meal, then once before I retire for the day.

My evening meals are about 50grams of protien with a small mixed salad.

For some weird reason, no matter how low my last meter reading is the night before, my Bs after fasting are always around 10.-10.7 (my nutritionist told me it was because my liver, during the night releases insulin into my blood stream because of the 8 hour period fasting. Apparently this does not happen to everyone.) and apparently my liver is doing this to keep me going because it goes in to fight or flight mode because it does not know when I will eat again.) She suggested taking my medication as soon as I rise and delaying eating breakfast until my blood sugars start to fall to around 6 or 7.

I tried this yesterday. Up at 5.30am blood sugar was 10.7, by 9am it had fallen to 9.8 but by 9.30 it had risen to 9.8. Then I ate scrambled egg on a slice of rye bread with no margarine or butter. 1 hour after my blood sugar had gone up to 10.1 and two hours after it had come down to 7.9
I ate my breakfast when I did because I did not want my BS to start rising again.

I've tried reducing the portion size of my evening meal and not eating any carbohydrates after 3pm but it does not seem to make a blind bit of difference, by BS after fasting is always higher than the last blood test taken the night before.

Secondly, you all go on about maintaining your BS at around 6 -7. How do you do this? is it a constant 6-7 or do you get minor fluctuations through out the day? My Bs readings go up and down all day long, rarely higher than 10.4 and never lower than 5.

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[mcdonagh47]

🙂



For some weird reason, no matter how low my last meter reading is the night before, my Bs after fasting are always around 10.-10.7
I tried this yesterday.
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Its the DP - Dawn Phenomenon ( sometimes called a Liver Dump), a common occurrence in most people but can be troublesome to T2s.
Many ways of cheating the DP have been tried - basically a small snack of long acting glucose (i.e. protein and fat) is needed before bedtime so that the Liver is fooled into "thinking" no extra glucose is needed at dawn..
But some people have a fierce DP that runs on into mid morning which makes breakfast essential in order to turn off the Liver
Check out these links ...

http://www.mayoclinic.com/health/dawn-effect/AN01213

http://www.diabetes.co.uk/blood-glucose/dawn-phenomenon.html

David Mendosa ( a major T2 blogger) has also investigated ways of dealing with the DP ...
http://www.mendosa.com/blog/?p=232

 

[DeusXM]

What you need to do is train your body to not do the fight or flight mechanism. There's several ways of doing this.

*Make sure you eat breakfast and don't wait. If you wait around, your body will 'learn' that you don't eat in the mornings, and will 'helpfully' release glucose to ensure you have energy. You can retrain your body to not do this by getting a carb hit first thing. This will take a couple of weeks.

*If you are already eating a carby breakfast, it might be you simply need more food to fool your body that it isn't starving. Switch to something low-carb, high-fat and healthy, like an omelette. Again, this will take a couple of weeks.

*There's also a fun option. Distract your liver. Your liver has a lot of jobs to do and is very good at getting its priorities right. Consuming a small amount of alcohol before going to bed (say, a good glass of red wine) keeps your liver occupied on getting rid of the alcohol and leaves it too busy to worry about chucking out some 'just-in-case' glucose.

Secondly, you all go on about maintaining your BS at around 6 -7. How do you do this? is it a constant 6-7 or do you get minor fluctuations through out the day? My Bs readings go up and down all day long, rarely higher than 10.4 and never lower than 5.

This is a matter of some debate. Firstly, BGs should actually be in the 4-6 range, but 6-7 isn't bad. Your BGs WILL also fluctuate as well, depending on how recently you ate - which is where the debate comes in. There is a school of thought that says non-Ds never have BGs over 7 even 45 minutes after eating a carby meal, and that this is what we should aim for. I'm not convinced by this. But generally you should expect your BGs to be higher for 1 to 2 hours after eating, although really these should never go as high as 10 at any point.

But yes, your BGs will fluctuate throughout the day - your body is an analogue system with lots of variables, while your BG meter is a 'best guesser' with a 20% margin of error.

 

[Vicsetter]

The reason you test at 1hr and again at 2hrs is to see what the food has done to your glucose levels. It looks like you shouldn't be eating the Rye bread. It is difficult when you are on pills alone to control what is going on to your body. I work to the targets of : fasting (pre meal) 4-7 and +2 hrs of 5-10. and try and better those figures. If you hit a mealtime with a BG level of say 8 then you will have to re-consider what you are going to eat. I find a lot of meals with some carb content will add 3 to your BG level and you will struggle to get it down so your next meal is within target. It may even take a couple of days to get over a 'naughty meal'. I also find that my morning fasting level is roughly the same or slightly higher than my evening bedtime level. What you have to do is try and get your bed time level down so your morning one isn't so high and this probably means cutting down on your evening meal carb content.

Whatever you do don't beat yourself up over it, getting readings between 5 and 10 means you are really trying hard and succeeding and I doubt your nurse/GP will worry about it, but will wait for your HBa1c which should be quite good.

 

[MeganN]

I get liver dump too had an agonising week of it 2 weeks ago. It ruins my mid morning results.
On a day when I'm at a good level I either have a sandwich for breakfast or 2 ices of toast with a boiled egg. I use the purple nimble bread as its the lowest carb content bread per slice that I have found, only 8g per slice.
If my readings are high I normally have some sugar free jelly and a glass of milk but am now going to experiment with protein shakes.

Good luck. Unfortunately all you can do is keep experimenting as none of us is a text book case. X

 

[queenbee01]

Thank you Mcdonagh47

Thank you for the links. have read all three and found them interesting. I might try the vinegar idea, though my partner would be jumping through hoops if he knew I could drink a small glass of wine after my evening meal. (having almost given up drinking the stuff!) and Cheese, now they're talking, I cut out eating cheese in my diet because I LOVED CHEESE and had the will power of a whelk when it came to how much of it I ate. because it was all or nothing I decided to stop eating it. Don't know if I dare to start eating it because I don't want to go down this road. 🙂

Its the DP - Dawn Phenomenon ( sometimes called a Liver Dump), a common occurrence in most people but can be troublesome to T2s.
Many ways of cheating the DP have been tried - basically a small snack of long acting glucose (i.e. protein and fat) is needed before bedtime so that the Liver is fooled into "thinking" no extra glucose is needed at dawn..
But some people have a fierce DP that runs on into mid morning which makes breakfast essential in order to turn off the Liver
Check out these links ...

http://www.mayoclinic.com/health/dawn-effect/AN01213

http://www.diabetes.co.uk/blood-glucose/dawn-phenomenon.html

David Mendosa ( a major T2 blogger) has also investigated ways of dealing with the DP ...
http://www.mendosa.com/blog/?p=232

 

[Tezzz]

I found the later I eat in the evening the higher my waking BG. I was 7.0 today after a late shift at W.

I try not to eat after 8pm if I can help it. Perhaps you may find that eating earlier would help you.