Confused about BSL readings- A follow up

[Classic]

First a big thank you to everyone who answered. I appreciated every reply and learned something from everyone.
One of the reocurring themes was the ´fluctutations´ ´Not worrying´ ´Complexity´ So I did a little research and got the following answer from diabetic researcher. It really helped me understand why fluctuations occur. Maybe it will help someone else too.
Relationship between adrenalin (necessary for physical activity, fear fight or flight etc.,) and blood glucose levels.

• For energy and physical action your body needs glucose.
• Surplus Glucose is stored in the liver, muscles and as fat deposits.
• Brain messages the body it is going to be active. ADRENALIN is produced and shuts down insulin production from pancreas to preserve the current blood sugar levels.
• If extra glucose is needed, Adrenalin stimulates the release of ´stored glucose´ from the liver, muscles and fat stores. Raising the levels of glucose in the blood stream for activity use. So BLG levels can be raised without the ingestion of food at times.

Throughout 24hrs, awake and asleep, adrenalin may be produced, raising blood sugar levels. So diabetics should ensure they are calm and rested when they take readings.

Getting out of bed, rushing to wash/shave/dress, with the thought in mind that you have to take the dog for 2 mile walk, the added stress of worrying about taking the BGL reading BEFORE you go, is more than enough to produce an adrenalin rush. The Adrenalin will stimulate the liver to release glucose into your blood stream. Raising your BGL.

Suggest you get up, relax. Quick drink. Do your walk/run first. Once home have a cup of tea and relax/read for few minutes. Do BSL. I think you´ll find a truer reading of your morning BSL. This should stop the ´morning stress´ and adrenalin powered hike in BSL.

 

[Martin.A]

I'm impressed with the level of research but at the risk of sounding pedantic - technically, if you have a cup of tea before testing it's not a fasting test, which is what the test-on-waking is supposed to be.

I get up, go the bathroom, go to the kitchen and put the kettle on and test while it's boiling - all done and dusted within 5 minutes of getting out of bed and generally on the back of a 10-hour overnight fast.

Adrenalin Powered Hike sounds suspiciously like what we know as Dawn Phenomenon or Foot On The Floor syndrome.

 

[Classic]

I'm impressed with the level of research but at the risk of sounding pedantic - technically, if you have a cup of tea before testing it's not a fasting test, which is what the test-on-waking is supposed to be.

I get up, go the bathroom, go to the kitchen and put the kettle on and test while it's boiling - all done and dusted within 5 minutes of getting out of bed and generally on the back of a 10-hour overnight fast.

Adrenalin Powered Hike sounds suspiciously like what we know as Dawn Phenomenon or Foot On The Floor syndrome.

Hello Martin, thanks for your reply. No idea what DP or FotF even means! And no, your reply is not pendantic. We both seem to have very analytical minds. All information is useful. I´m going to take on board what you say. Change the tea for a glass of water to rehydrate. But I would like to try the new way of taking my BSL after my dog walking. Following on from this I think I will take my BSL before and after our walk. Should prove interesting! Or not!

 

[harbottle]

I doubt going for a walk causes a fight or flight reaction. Intense exercise, like a run, might cause it to go up.
Stress also increases cortisol levels, which counters the effects of insulin.

A walk might cause it to drop, but it could possibly creep back up again.

The body can use ketone bodies for energy as well as glucose.

High levels in the morning are thought to be caused by cortisol and growth hormone.

 

[Docb]

Dawn Phenomenon or Foot on the Floor refer to the observation that for some people blood glucose levels begin to go up after waking and start to move around. Some have it that it goes back to the days when we were hunter gatherers and needed a boost to go and find something for breakfast but that could well be folk law.

My approach is a bit like @Martin.A. Being an ex experimentalist I like to control variables as best as I can when measuring something and so take my blood glucose immediately after getting out of bed. It is the nearest thing I can get having allother factors equal. I watch how this trends over time to see how things are going generally. By time I look at weeks, months and years - looking at day to day readings just leads to confusion.

You might try testing on waking and again after your morning routine. That will give you a bit more information. Interpreting it will another matter altogether!!

 

[Classic]

I doubt going for a walk causes a fight or flight reaction. Intense exercise, like a run, might cause it to go up.
Stress also increases cortisol levels, which counters the effects of insulin.

A walk might cause it to drop, but it could possibly creep back up again.

The body can use ketone bodies for energy as well as glucose.

High levels in the morning are thought to be caused by cortisol and growth hormone.

Hi Harbottle. My initial ´confusion´ was having exactly the same reading of 7.4 at bedtime and 7.4 again next morning.
I would have thought it should have gone down overnight. So I was trying discover the why.
There is no suggestion that going for a walk causes a ´fight or flight´reaction. This was just included for my ignorant benefit by the researcher so I understood the physiology and effect of adrenaline on the body and pancreas and BSLs.
It was agreed that the levels should have reduced after an 10hr ´fast.´ But there are a few explanations, the first was being over anxious and stressed when I woke up. Bad dreams. To the other extreme that my pancreas is still a little damaged from having suffered Septicemia in January along with severe urinary tract infection etc,. (of course I could just be sleep walking and enjoying a good nosh-up and not remembering 🙂
So, it has been suggested I try slow down and relax before taking a reading first thing. Even go for my walk first. If the reading lowers then all is well.

 

[Docb]

The readings of 7.4 are really telling you that at the time they were taken that your blood glucose was probably somewhere between 6 and 8. So if you get two readings the same, the actual values you would get from a lab test of blood from a vein could easily be a bit different.

Hand held monitors are amazing bits of kit but you will get tied up in knots if you try and interpret reasons for readings that are less than two units in difference. The number after the decimal point is an illusion, the meters cannot measure to that level of accuracy.

 

[Leadinglights]

First a big thank you to everyone who answered. I appreciated every reply and learned something from everyone.
One of the reocurring themes was the ´fluctutations´ ´Not worrying´ ´Complexity´ So I did a little research and got the following answer from diabetic researcher. It really helped me understand why fluctuations occur. Maybe it will help someone else too.
Relationship between adrenalin (necessary for physical activity, fear fight or flight etc.,) and blood glucose levels.

• For energy and physical action your body needs glucose.
• Surplus Glucose is stored in the liver, muscles and as fat deposits.
• Brain messages the body it is going to be active. ADRENALIN is produced and shuts down insulin production from pancreas to preserve the current blood sugar levels.
• If extra glucose is needed, Adrenalin stimulates the release of ´stored glucose´ from the liver, muscles and fat stores. Raising the levels of glucose in the blood stream for activity use. So BLG levels can be raised without the ingestion of food at times.

Throughout 24hrs, awake and asleep, adrenalin may be produced, raising blood sugar levels. So diabetics should ensure they are calm and rested when they take readings.

Getting out of bed, rushing to wash/shave/dress, with the thought in mind that you have to take the dog for 2 mile walk, the added stress of worrying about taking the BGL reading BEFORE you go, is more than enough to produce an adrenalin rush. The Adrenalin will stimulate the liver to release glucose into your blood stream. Raising your BGL.

Suggest you get up, relax. Quick drink. Do your walk/run first. Once home have a cup of tea and relax/read for few minutes. Do BSL. I think you´ll find a truer reading of your morning BSL. This should stop the ´morning stress´ and adrenalin powered hike in BSL.

If you want to be comparing day to day and looking at trends over weeks then you would need to follow that procedure every time which might not be realistic but testing in bed just as you wake up would likely to be much the same each day, unless you had been having weird dreams.

 

[Classic]

Loved your post. No judgements, just simple advice. I tend not to remember my dreams, not even the weird ones, sadly!

 

[Classic]

The readings of 7.4 are really telling you that at the time they were taken that your blood glucose was probably somewhere between 6 and 8. So if you get two readings the same, the actual values you would get from a lab test of blood from a vein could easily be a bit different.

Hand held monitors are amazing bits of kit but you will get tied up in knots if you try and interpret reasons for readings that are less than two units in difference. The number after the decimal point is an illusion, the meters cannot measure to that level of accuracy.

Hi, it´s a minefield! Who´d have thought it would all be this complicated. I´ll stick to the plan to begin with, until I go to the hospital mid April and see what the new scans, xrays and blood tests reveal. If nothing else, my readings and chart will show at least I tried. Thanks, Doc, for the info tho.

 

[Classic]

Dawn Phenomenon or Foot on the Floor refer to the observation that for some people blood glucose levels begin to go up after waking and start to move around. Some have it that it goes back to the days when we were hunter gatherers and needed a boost to go and find something for breakfast but that could well be folk law.

My approach is a bit like @Martin.A. Being an ex experimentalist I like to control variables as best as I can when measuring something and so take my blood glucose immediately after getting out of bed. It is the nearest thing I can get having allother factors equal. I watch how this trends over time to see how things are going generally. By time I look at weeks, months and years - looking at day to day readings just leads to confusion.

You might try testing on waking and again after your morning routine. That will give you a bit more information. Interpreting it will another matter altogether!!

I think we are thinking along the same lines. It will be better when I can look back over results from weeks. Right now, I´m only on day 10! But from a standing start at 14.3, down to 7.4s, I´m hopeful I´m on the right track. Thank you.

 

[Docb]

From 14 to 7 ( I always round to the nearest whole number for single readings) is significant in anybody's book. You are on the right track for sure!

 

[helli]

If you want to understand what happened between the night time 7.4 and morning 7.4, you need readings in between because, I can guarantee, your BG did not stay at 7.4 all night.
You could try waking to take extra readings but I find the interrupted sleep affects my BG.
An alternative could be to take up the 2 week Libre trial available on their website
As a CGM (continuous glucose monitor), there are some limitations but as long as you understand these, it should give you a good understanding of what happens between finger pricks

 

[Nayshiftin]

I get on my high horse … However.
Do not let the test you take results get to you.
They are average so a 5 can be a 7 or a 7 can be a 5 and so on . Give yourself an upper limit to aim for and if well you go low to worry i suggest either a Dexcom or Libre or testing very often and making sure you can cope with a Hypo.
The lower HbA1c is what I aim for and to be honest we can get so worked up about the numbers it upsets us.48 is norm
At home on a morning f2f Some get 5.2 which they say is good not too high not too low but then they take medication or inject insulin . Good for-them. If it works it is good.
Therefore it is about making yourself in control of your diabetes whatever way works for you.
It is like weight I am never going to be slim but i need to ensure I do not become a non working Suma wrestler type. Just me and my body and where i do not want to be. its all so personal . Good luck.

 

[Classic]

I get on my high horse … However.
Do not let the test you take results get to you.
They are average so a 5 can be a 7 or a 7 can be a 5 and so on . Give yourself an upper limit to aim for and if well you go low to worry i suggest either a Dexcom or Libre or testing very often and making sure you can cope with a Hypo.
The lower HbA1c is what I aim for and to be honest we can get so worked up about the numbers it upsets us.48 is norm
At home on a morning f2f Some get 5.2 which they say is good not too high not too low but then they take medication or inject insulin . Good for-them. If it works it is good.
Therefore it is about making yourself in control of your diabetes whatever way works for you.
It is like weight I am never going to be slim but i need to ensure I do not become a non working Suma wrestler type. Just me and my body and where i do not want to be. its all so personal . Good luck.

Good morning, good advice. Hopefully it will not be too long before I have more control. As you say, less worry and more control is the main aim. Think I´m getting there. Just no control of the possibly damaged pancrease. But will cross that bridge when I get there. Have a nice weekend.

 

[Nayshiftin]

Good morning, good advice. Hopefully it will not be too long before I have more control. As you say, less worry and more control is the main aim. Think I´m getting there. Just no control of the possibly damaged pancrease. But will cross that bridge when I get there. Have a nice weekend.

You too. Have a good weekend . Enjoy

 

[Classic]

I doubt going for a walk causes a fight or flight reaction. Intense exercise, like a run, might cause it to go up.
Stress also increases cortisol levels, which counters the effects of insulin.

A walk might cause it to drop, but it could possibly creep back up again.

The body can use ketone bodies for energy as well as glucose.

High levels in the morning are thought to be caused by cortisol and growth hormone.

Good morning. Thought you might like to know, my reading of 7.6 was exactly the same straight out of bed and after my walk 🙂 Have a nice weekend, Harbottle.