Blood Glucose Targets

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AnnSebastian

AnnSebastian

Well-Known Member
Relationship to Diabetes
Type 2
Hello. My name is Ann. I was diagnosed with T2 diabetes a few years ago and have been aiming to keep my blood glucose within normal levels ever since. Fell off the wagon recently but now trying to get back on track. Was using an ordinary Jazz bg meter prescribed by my NHS practice - but have just upgraded to the ‘bluetooth’ version so I’m keen to get it right from the start.

I have one question:

I was given targets for ‘fasting’ and ‘post meal’ BG levels. Its relatively easy to keep my ‘post meal’ level below 9ish when I’m trying - but much harder to get my ‘fasting’ BG level below 6ish every time. My BG often increases overnight when I have eaten nothing. I often ‘graze’ rather than eat large meals.


My question is

Which BG level is more important? ‘Fasting’ or ‘Post Meal’ BG level? As long as my overall BG levels stay below 9 whether I’ve eaten or not does that qualify as ‘controlled blood glucose’.
 
PS. I appreciate that anything considered to be ‘Medical Advice’ (which this could well be) might not be allowed via this forum. However - if there are any ‘clinicians’ reading this - any info would be appreciated - and/ or links to information / research papers (‘without prejudice’)
 
AnnSebastian said:
PS. I appreciate that anything considered to be ‘Medical Advice’ (which this could well be) might not be allowed via this forum. However - if there are any ‘clinicians’ reading this - any info would be appreciated - and/ or links to information / research papers (‘without prejudice’)
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This is not a forum for clinicians this a forum of people with Diabetes.
 
Some are or were HCPs Ann and some of us weren't. However you don't have to be medically qualified to know of the effect you have described - because we either have diabetes or eg our child(ren) have it. It's a primaeval effect which human beings have retained, known commonly as 'Dawn Phenomenon'. You go to sleep. A few hours later, your BG level drops. Comes back up a tad until your body starts to get ready to meet the new day when you'll either need to hunt and gather or sally forth to hunt eg the woolly mammoth, either or both of which are needed to feed you and yours, so the liver pumps out some of it stores of glucose to fuel your cells to do those things. It has happened all our lives and we were oblivious! Until we were diagnosed diabetic and started testing our blood glucose and all said one by one - what's all that about then?

Breaking your Fast sorts it out no prob. So - eat something! If you don't normally eat brekkie don't worry - a bit of cheese, half a slice of boiled ham, any sort of egg, bit of left over last night's supper, whatever.
 
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Hi AnnSebastian,
I'm not a doctor, just somebody who has/is reversing their T2 Diabetes. I'm doing it through LCHF and Time Restricted Eating (aka Intermittent Fasting though it's really just skipping Breakfast in my case). Grazing, if you consume any carbohydrates at all in your snacks, can be very bad for Type2 diabetes in my opinion, since carbs raise your Insulin and you need to get that low in order to become less Insulin Resistant.

The Post Meal BG level is the most important one, since this is the only one you yourself can directly affect. However I feel that your target of below 9 mmol/L is rather high. I use a Target on under 8.0 (some are even more strict and use 7.8) which should be low enough to avoid the possibility of Neuopathy or Retinopathy. In addition to that I have a goal of keeping the spike from pre-meal to 2hrs after first bite to be lower than 2.0 mmol/L. Any meal that spikes it more than that I note and won't eat that (or as much ) again.

The Post Meal BG difference from before the meal is purely because of what you eat, but the Fasting BG mostly depends upon how much Glucose your Liver dumps into your bloodstream in order to give you the energy to hunt/gather your breakfast - just like it did for our pre-agriculture ancestors.
 
People are free to ask any questions here @AnnSebastian - but any responses will only be the experiences and ideas of members of the forum, and cannot be relied upon to be accurate, and must not be treated as any form of medical advice.

Diabetes is a highly individual condition, and what works well for one person, may not necessarily be appropriate for anyone else. Plus any member offering their thoughts will not know other details of the circumstances of rhe original poster, which may have significant impact on the appropriateness of any suggestions.

Having said all that, having a forum full of people whose brains you can pick about anything and everything to do with diabetes self-management is a hugely valuable resource, and can be a brilliant source of ideas, tips, strategies and suggestions to pick from and experiment with 🙂
 
trophywench said:
Some are or were HCPs Ann and some of us weren't. However you don't have to be medically qualified to know of the effect you have described - because we either have diabetes or eg our child(ren) have it. It's a primaeval effect which human beings have retained, known commonly as 'Dawn Phenomenon'. You go to sleep. A few hours later, your BG level drops. Comes back up a tad until your body starts to get ready to meet the new day when you'll either need to hunt and gather or sally forth to hunt eg the woolly mammoth, either or both of which are needed to feed you and yours, so the liver pumps out some of it stores of glucose to fuel your cells to do those things. It has happened all our lives and we were oblivious! Until we were diagnosed diabetic and started testing our blood glucose and all said one by one - what's all that about then?

Breaking your Fast sorts it out no prob. So - eat something! If you don't normally eat brekkie don't worry - a bit of cheese, half a slice of boiled ham, any sort of egg, bit of left over last night's supper, whatever.
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Thanks for replying. I understand ‘dawn phenomenon’ I was just trying to decide if its that important as long as my BG stays below my target across the board. Seems more important to me to keep my maximum BS average below my limits. I managed to reduce my insulin needs from 40 units to 30/34 units a day by keeping a close eye on my BS and taking tumeric supplements whenever I knew I had eaten more carbs than I should. It seemed to work. A couple of weeks ago my meter conked out so I fell off the wagon. I’m trying to get back on track and reduce my insulin needs further with lower carb food. But its hard!

Maybe I’ll try eating something small before I test my BG in the mornings?

Ann
 
grovesy said:
This is not a forum for clinicians this a forum of people with Diabetes.
Click to expand...
I know. I use twitter a lot and there are ongoing posts from people giving advice, many of them don’t know what they’re talking about. This is why I always make a point of saying ‘ I’m not a clinician’.
 
everydayupsanddowns said:
People are free to ask any questions here @AnnSebastian - but any responses will only be the experiences and ideas of members of the forum, and cannot be relied upon to be accurate, and must not be treated as any form of medical advice.

Diabetes is a highly individual condition, and what works well for one person, may not necessarily be appropriate for anyone else. Plus any member offering their thoughts will not know other details of the circumstances of rhe original poster, which may have significant impact on the appropriateness of any suggestions.

Having said all that, having a forum full of people whose brains you can pick about anything and everything to do with diabetes self-management is a hugely valuable resource, and can be a brilliant source of ideas, tips, strategies and suggestions to pick from and experiment with 🙂
Click to expand...
Works for me.
 
ianf0ster said:
Hi AnnSebastian,
I'm not a doctor, just somebody who has/is reversing their T2 Diabetes. I'm doing it through LCHF and Time Restricted Eating (aka Intermittent Fasting though it's really just skipping Breakfast in my case). Grazing, if you consume any carbohydrates at all in your snacks, can be very bad for Type2 diabetes in my opinion, since carbs raise your Insulin and you need to get that low in order to become less Insulin Resistant.

The Post Meal BG level is the most important one, since this is the only one you yourself can directly affect. However I feel that your target of below 9 mmol/L is rather high. I use a Target on under 8.0 (some are even more strict and use 7.8) which should be low enough to avoid the possibility of Neuopathy or Retinopathy. In addition to that I have a goal of keeping the spike from pre-meal to 2hrs after first bite to be lower than 2.0 mmol/L. Any meal that spikes it more than that I note and won't eat that (or as much ) again.

The Post Meal BG difference from before the meal is purely because of what you eat, but the Fasting BG mostly depends upon how much Glucose your Liver dumps into your bloodstream in order to give you the energy to hunt/gather your breakfast - just like it did for our pre-agriculture ancestors.
Click to expand...

Thanks for replying. ‘Intermittent fasting’ and lower carb diet are my short/long term aims. I have good intentions but often fall off the wagon. I’ve put my target a little higher than I really mean as a psychological device to kid myself I’m doing really well if I stay 1-2 numbers below it.

I think Ill just ignore the ‘fasting’ reading in early morning and eat something small before I test my BG. I was getting far too low evening readings - less than 4 - by trying to make the morning fasting test conform to a target.
 
Which insulins do you use Ann? They each have their own characteristics so it's better to find that out first before saying 'just don't eat' ! I like the strategy re targets by the way - akin to using a smaller plate 😉
 
trophywench said:
Which insulins do you use Ann? They each have their own characteristics so it's better to find that out first before saying 'just don't eat' ! I like the strategy re targets by the way - akin to using a smaller plate 😉
Click to expand...

Only just seen this post.
Thanks for replying
I have the ‘Innulet pump.‘
I‘m making a big effort to control my diabetes at the moment. I had fallen off the wagon. It was getting too tempting to grab a sandwich rather than prepare a ‘balanced plate’ My plan is to stop being so lazy and to prepare multiple portions of food ahead. I’m expecting a few hiccups while I adjust - but the increased morning bg isn’t new so I was just wondering if it mattered too much.

I’ve invested in an agamatrix ‘bluetooth‘ glucose monitor. It took a while to work out how to use it - but now I have its absolutely brilliant. Combined with a calorie counter app I found - its doing the work for me. Not everyone wants to use apps but for those who do I‘d recommend it.

Ann
 
Well I've worked out your meter is a Wavesense Jazz, but still clueless about your insulin pump or what brand of insulin you use in it - many folk use Medtronic or Roche or Omnipod pumps - but with different brands of insulin, each of which has its own characteristics, so it is the latter I was asking.
 
AnnSebastian said:
I know. I use twitter a lot and there are ongoing posts from people giving advice, many of them don’t know what they’re talking about. This is why I always make a point of saying ‘ I’m not a clinician’.
Click to expand...
ianf0ster said:
Hi AnnSebastian,
I'm not a doctor, just somebody who has/is reversing their T2 Diabetes. I'm doing it through LCHF and Time Restricted Eating (aka Intermittent Fasting though it's really just skipping Breakfast in my case). Grazing, if you consume any carbohydrates at all in your snacks, can be very bad for Type2 diabetes in my opinion, since carbs raise your Insulin and you need to get that low in order to become less Insulin Resistant.

The Post Meal BG level is the most important one, since this is the only one you yourself can directly affect. However I feel that your target of below 9 mmol/L is rather high. I use a Target on under 8.0 (some are even more strict and use 7.8) which should be low enough to avoid the possibility of Neuopathy or Retinopathy. In addition to that I have a goal of keeping the spike from pre-meal to 2hrs after first bite to be lower than 2.0 mmol/L. Any meal that spikes it more than that I note and won't eat that (or as much ) again.

The Post Meal BG difference from before the meal is purely because of what you eat, but the Fasting BG mostly depends upon how much Glucose your Liver dumps into your bloodstream in order to give you the energy to hunt/gather your breakfast - just like it did for our pre-agriculture ancestors.
Click to expand...
Hello
I just reread my reply to your reply to my post.
I hope it didn’t sound rude - it wasn’t meant to be.
There’s relentless conflict over coronavirus on twitter - ‘everyone’s an expert‘ - thats what was running through my mind at the time - not suggesting anyone on here is uninformed. Just being over careful.
 
trophywench said:
Well I've worked out your meter is a Wavesense Jazz, but still clueless about your insulin pump or what brand of insulin you use in it - many folk use Medtronic or Roche or Omnipod pumps - but with different brands of insulin, each of which has its own characteristics, so it is the latter I was asking.
Click to expand...
 

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And it quite clearly states it uses Insulatard insulin. A 70/30 mix so not so suitable if your lifestyle doesn't support a fairly fixed routine and mealtimes. When we were all having to use mixed insulin, if we didn't eat and behave to fit the insulin's pattern our BG would be haywire. BUT if it suits you and your body I ain't going to knock it for you, but just wouldn't recommend it for all and sundry.

Mmmmm - be VERY careful indeed how you adjust your pump when fasting - you still need the 'long acting' insulin for your body to function, but not the 'short acting' part which takes care of what you eat, but you can't do that with mixed insulin.
 
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