High Fasting blood sugar & Metabolic syndrome??

[Pabbiel]

Hi, I’m looking for advice. I have been pre diabetic for quite a while and have a monitor to check every now and then. I noticed my blood sugar has been high when I fast and sometimes before I go to bed. During the day it is fine. I had the HbA1c which was fine about a month ago but I keep getting high readings. Previous I was told if you have two fasting blood tests over 7 was evidence of diabetes. Why did this change? I feel anxious about how often I’m getting high blood sugar when fasting so I am confused. I also have high cholesterol (triglycerides) even though I’m on statins and high blood pressure even though I’m on medication that has already been increased. I am disabled I’m not as mobile as I’d like to be. I am worried about metabolic syndrome.
Please can you advise. Many thanks I’ve attached a screenshot of recent readings. Thanks and happy Christmas

 

[Josh DUK]

Hi, I’m looking for advice. I have been pre diabetic for quite a while and have a monitor to check every now and then. I noticed my blood sugar has been high when I fast and sometimes before I go to bed. During the day it is fine. I had the HbA1c which was fine about a month ago but I keep getting high readings. Previous I was told if you have two fasting blood tests over 7 was evidence of diabetes. Why did this change? I feel anxious about how often I’m getting high blood sugar when fasting so I am confused. I also have high cholesterol (triglycerides) even though I’m on statins and high blood pressure even though I’m on medication that has already been increased. I am disabled I’m not as mobile as I’d like to be. I am worried about metabolic syndrome.
Please can you advise. Many thanks I’ve attached a screenshot of recent readings. Thanks and happy Christmas

Hello @Pabbiel ,

Thank you for joining! I will move your post to the newbies section so you will have more responses.

 

[rebrascora]

Hi Pabbiel and welcome

I see in your previous post that your HbA1c in may of this year was 35 but your profile says that you are "at risk of diabetes". Have you had an HbA1c result of 42 or more at some stage or is it just that you have family members with Type 2 and these odd readings which make you concerned that you might be "at risk"?

I think it is important to understand that BG levels go up and down throughout the day and night in response to a number of factors (about 42 of them in fact) and food is just one of them. It is probably the main factor but there are certainly others. One thing which can bump up BG levels on a morning and therefore may impact your "fasting readings" is something called Dawn Phenomenon. This is where the liver pumps out glucose into the blood stream to give you energy to start the day. My levels can rise by 6 whole mmols due to this phenomenon. Some people find their liver starts doing this in the early hours of the morning and others thankfully find that it waits until we set foot out of bed (sometimes referred to on the forum as Foot on the Floor or FOTF). Many of us take our fasting reading as soon as we wake up and before we get out of bed for this reason. The longer you leave it before you eat, the more likely your liver will release this glucose. Food hitting the stomach switches this liver function off. Think of the liver a bit like a back up battery for keeping your vital functions supplied with energy when there is no food in your system (ie overnight or when fasting) and having an automatic turbo boost function on a morning to get you going. Food switches that function off and you go back to mains power. Hopefully that will make sense.

The point I am making is that the time that it can be quite relevant as to when you actually take that fasting reading and if you have been up and out of bed for an hour, that may well be why you are getting higher readings than you would perhaps like, so it might be worth experimenting with taking some readings as soon as you wake up and then an hour later but before food and see if there is much difference. What should happen is that the rising BG levels should trigger the pancreas to produce insulin to transport the glucose into the cells and bring your levels down. If you have some visceral fat around your liver and pancreas, that can make the communication between these 2 organs less efficient and the pancreas doesn't get the message to produce more insulin when the liver starts dumping glucose into the blood stream. When you eat, the pancreas also gets a message to produce insulin and sometimes this message gets through quite well and brings levels down when the message from the liver doesn't. This can mean that eating breakfast as soon as you wake up will result in your BG levels dropping rather than increasing, so the longer you fast the higher your levels go.... Again it is something you can test with your BG meter by one day fasting for a couple of hours after you get up and the next day eating breakfast straight away and see if those 2 scenarios produce different results at the 2 hours after getting up point.

The thing about testing is that just random tests here and there tell you very little and can cause anxiety if you get higher readings than you expect. Following a regular strategy of testing and knowing what you are testing for and adjusting your strategy to learn something about that is by far a more constructive way of using a BG meter.
Most Type 2 diabetics here on the forum use their BG meter to test immediately before and then 2 hours after a meal, to see how that meal impacted their BG levels. That information can then be used to tailor their diet or that individual meal to what their body can cope with. The general rule of thumb is to reduce the carb content of a meal which raised your BG levels by more than 3 mmols 2 hours after eating it. So if your levels were 6.8 just before the meal and 10.2 2 hours later you probably had a few more carbs in that meal than your body could cope with, so have one less potato or a bit less bread (or a lower carb bread) etc or 10g less cereal next time you have that meal and see if you get a better result. Once you can adjust that meal to give you an increase of less than 3 mmols, your premeal readings will start to come down.
It sounds like an awful lot of testing but once you establish a repertoire of meals that don't spike your levels too much, then you only need to test new foods or do occasional checks to make sure nothing has changed.

Hope most of that makes sense, but if your HbA1c is 35 then you probably just need to keep doing what you are doing diet wise and try not to worry yourself about random tests.

 

[Deleted member 21371]

Hi Pabbiel and welcome

I see in your previous post that your HbA1c in may of this year was 35 but your profile says that you are "at risk of diabetes". Have you had an HbA1c result of 42 or more at some stage or is it just that you have family members with Type 2 and these odd readings which make you concerned that you might be "at risk"?

I think it is important to understand that BG levels go up and down throughout the day and night in response to a number of factors (about 42 of them in fact) and food is just one of them. It is probably the main factor but there are certainly others. One thing which can bump up BG levels on a morning and therefore may impact your "fasting readings" is something called Dawn Phenomenon. This is where the liver pumps out glucose into the blood stream to give you energy to start the day. My levels can rise by 6 whole mmols due to this phenomenon. Some people find their liver starts doing this in the early hours of the morning and others thankfully find that it waits until we set foot out of bed (sometimes referred to on the forum as Foot on the Floor or FOTF). Many of us take our fasting reading as soon as we wake up and before we get out of bed for this reason. The longer you leave it before you eat, the more likely your liver will release this glucose. Food hitting the stomach switches this liver function off. Think of the liver a bit like a back up battery for keeping your vital functions supplied with energy when there is no food in your system (ie overnight or when fasting) and having an automatic turbo boost function on a morning to get you going. Food switches that function off and you go back to mains power. Hopefully that will make sense.

The point I am making is that the time that it can be quite relevant as to when you actually take that fasting reading and if you have been up and out of bed for an hour, that may well be why you are getting higher readings than you would perhaps like, so it might be worth experimenting with taking some readings as soon as you wake up and then an hour later but before food and see if there is much difference. What should happen is that the rising BG levels should trigger the pancreas to produce insulin to transport the glucose into the cells and bring your levels down. If you have some visceral fat around your liver and pancreas, that can make the communication between these 2 organs less efficient and the pancreas doesn't get the message to produce more insulin when the liver starts dumping glucose into the blood stream. When you eat, the pancreas also gets a message to produce insulin and sometimes this message gets through quite well and brings levels down when the message from the liver doesn't. This can mean that eating breakfast as soon as you wake up will result in your BG levels dropping rather than increasing, so the longer you fast the higher your levels go.... Again it is something you can test with your BG meter by one day fasting for a couple of hours after you get up and the next day eating breakfast straight away and see if those 2 scenarios produce different results at the 2 hours after getting up point.

The thing about testing is that just random tests here and there tell you very little and can cause anxiety if you get higher readings than you expect. Following a regular strategy of testing and knowing what you are testing for and adjusting your strategy to learn something about that is by far a more constructive way of using a BG meter.
Most Type 2 diabetics here on the forum use their BG meter to test immediately before and then 2 hours after a meal, to see how that meal impacted their BG levels. That information can then be used to tailor their diet or that individual meal to what their body can cope with. The general rule of thumb is to reduce the carb content of a meal which raised your BG levels by more than 3 mmols 2 hours after eating it. So if your levels were 6.8 just before the meal and 10.2 2 hours later you probably had a few more carbs in that meal than your body could cope with, so have one less potato or a bit less bread (or a lower carb bread) etc or 10g less cereal next time you have that meal and see if you get a better result. Once you can adjust that meal to give you an increase of less than 3 mmols, your premeal readings will start to come down.
It sounds like an awful lot of testing but once you establish a repertoire of meals that don't spike your levels too much, then you only need to test new foods or do occasional checks to make sure nothing has changed.

Hope most of that makes sense, but if your HbA1c is 35 then you probably just need to keep doing what you are doing diet wise and try not to worry yourself about random tests.

What is "foot on the floor"
Does it literally mean a liver dump stops then, or do you mean you needed to actually do so etching like eat?

 

[everydayupsanddowns]

What is "foot on the floor"

It’s a colloquial term for a variant of ‘dawn phenomenon‘ (part of the natural circadian rhythm) but where BG only begins to rise when you get out of bed - whenever that is - rather than beginning to rise at a consistent time around dawn

 

[everydayupsanddowns]

Previous I was told if you have two fasting blood tests over 7 was evidence of diabetes.

Welcome to the forum @Pabbiel

Diagnoses of diabetes do not generally fingerstick BG readings these days. Home fingerstick meters are not really rated for diagnostic purposes.

HbA1c are felt to be much more reliable, because they cover a much longer period.

42-47mmol/mol demonstrates being at increased risk of diabetes, and an HbA1c of 48 or more gives a diagnosis of diabetes.

Do you know what your HbA1c result was?

 

[Deleted member 21371]

It’s a colloquial term for a variant of ‘dawn phenomenon‘ (part of the natural circadian rhythm) but where BG only begins to rise when you get out of bed - whenever that is - rather than beginning to rise at a consistent time around dawn

Ah ok.
I certainly don't do that.
I woke as my liver dumps.
I could actually feel my BG rise in preparation for the day.
I used it to get up, brush my teeth, shower, and then I ate breakfast.
Probably the worst time to test would be in bed.
Not a chance it would stop when my foot was on the floor, it's been and gone by then.

 

[everydayupsanddowns]

Ah ok.
I certainly don't do that.
I woke as my liver dumps.
I could actually feel my BG rise in preparation for the day.
I used it to get up, brush my teeth, shower, and then I ate breakfast.
Probably the worst time to test would be in bed.
Not a chance it would stop when my foot was on the floor, it's been and gone by then.

Like so many things, it is different for different people. FOTF doesn’t stop when you get out of bed, it only starts when you get out of bed.

So if I get up at 6.30am my BG starts rising. But if I have a lie-in (ha! chance would be a fine thing recently!) and I don’t get up until 9am, my CGM trace would be pottering along level at 6.30, and only start trending upwards when my ‘feet hit the floor’.

They are two linked phenomena, and some people seem to get more significant effects than others. But it’s the luck of the draw which you get I guess

 

[Deleted member 21371]

Like so many things, it is different for different people. FOTF doesn’t stop when you get out of bed, it only starts when you get out of bed.

So if I get up at 6.30am my BG starts rising. But if I have a lie-in (ha! chance would be a fine thing recently!) and I don’t get up until 9am, my CGM trace would be pottering along level at 6.30, and only start trending upwards when my ‘feet hit the floor’.

They are two linked phenomena, and some people seem to get more significant effects than others. But it’s the luck of the draw which you get I guess

Mine definitely wakes me on a preset body clock.
Trust me, if I could stop it I would, it's a countdown to an explosion I don't want.

 

[everydayupsanddowns]

Mine definitely wakes me on a preset body clock.
Trust me, if I could stop it I would, it's a countdown to an explosion I don't want.

Yes the classic DP can be a real pain, especially if you get a big rise. Do you find it helps calms your liver down to eat something lowish carb soon after rising? Or have a late snack just before bed?

Ironically, as a pump user if I got classic DP I could preset my basal profile to provide more background insulin in time to offset the rise… but as I get FOTF and mine only really starts rising when I get out of bed (which varies through the week) I have to make do with a bit of a fudge. Fortunately my early morning dog walk pre-breakfast usually deals with most of it. 🙂

 

[Deleted member 21371]

Nothing stops it!
I've always had it, along with an inbuilt clock that kicks it off.
I rarely need an alarm, set one this morning for 8:15, I woke up at 7, so it's a bit out of kilter as I'm in Budapest, an hour in front on the clock here.

 

[Pabbiel]

Hi Pabbiel and welcome

I see in your previous post that your HbA1c in may of this year was 35 but your profile says that you are "at risk of diabetes". Have you had an HbA1c result of 42 or more at some stage or is it just that you have family members with Type 2 and these odd readings which make you concerned that you might be "at risk"?

I think it is important to understand that BG levels go up and down throughout the day and night in response to a number of factors (about 42 of them in fact) and food is just one of them. It is probably the main factor but there are certainly others. One thing which can bump up BG levels on a morning and therefore may impact your "fasting readings" is something called Dawn Phenomenon. This is where the liver pumps out glucose into the blood stream to give you energy to start the day. My levels can rise by 6 whole mmols due to this phenomenon. Some people find their liver starts doing this in the early hours of the morning and others thankfully find that it waits until we set foot out of bed (sometimes referred to on the forum as Foot on the Floor or FOTF). Many of us take our fasting reading as soon as we wake up and before we get out of bed for this reason. The longer you leave it before you eat, the more likely your liver will release this glucose. Food hitting the stomach switches this liver function off. Think of the liver a bit like a back up battery for keeping your vital functions supplied with energy when there is no food in your system (ie overnight or when fasting) and having an automatic turbo boost function on a morning to get you going. Food switches that function off and you go back to mains power. Hopefully that will make sense.

The point I am making is that the time that it can be quite relevant as to when you actually take that fasting reading and if you have been up and out of bed for an hour, that may well be why you are getting higher readings than you would perhaps like, so it might be worth experimenting with taking some readings as soon as you wake up and then an hour later but before food and see if there is much difference. What should happen is that the rising BG levels should trigger the pancreas to produce insulin to transport the glucose into the cells and bring your levels down. If you have some visceral fat around your liver and pancreas, that can make the communication between these 2 organs less efficient and the pancreas doesn't get the message to produce more insulin when the liver starts dumping glucose into the blood stream. When you eat, the pancreas also gets a message to produce insulin and sometimes this message gets through quite well and brings levels down when the message from the liver doesn't. This can mean that eating breakfast as soon as you wake up will result in your BG levels dropping rather than increasing, so the longer you fast the higher your levels go.... Again it is something you can test with your BG meter by one day fasting for a couple of hours after you get up and the next day eating breakfast straight away and see if those 2 scenarios produce different results at the 2 hours after getting up point.

The thing about testing is that just random tests here and there tell you very little and can cause anxiety if you get higher readings than you expect. Following a regular strategy of testing and knowing what you are testing for and adjusting your strategy to learn something about that is by far a more constructive way of using a BG meter.
Most Type 2 diabetics here on the forum use their BG meter to test immediately before and then 2 hours after a meal, to see how that meal impacted their BG levels. That information can then be used to tailor their diet or that individual meal to what their body can cope with. The general rule of thumb is to reduce the carb content of a meal which raised your BG levels by more than 3 mmols 2 hours after eating it. So if your levels were 6.8 just before the meal and 10.2 2 hours later you probably had a few more carbs in that meal than your body could cope with, so have one less potato or a bit less bread (or a lower carb bread) etc or 10g less cereal next time you have that meal and see if you get a better result. Once you can adjust that meal to give you an increase of less than 3 mmols, your premeal readings will start to come down.
It sounds like an awful lot of testing but once you establish a repertoire of meals that don't spike your levels too much, then you only need to test new foods or do occasional checks to make sure nothing has changed.

Hope most of that makes sense, but if your HbA1c is 35 then you probably just need to keep doing what you are doing diet wise and try not to worry yourself about random tests.

Thank you so much for all the information, today my fasting blood test was 8, this is the highest it’s been but I read your post after I had been out of bed. The next time I will do the test before I get out of bed. I am concerned I may have metabolic syndrome as I do meet the criteria of high cholesterol, high blood pressure, high morning blood sugar and waist larger than I would like. I do have fatty liver and high GGT on blood tests. I am disabled which makes exercising very difficult. Dawn phenomenon is very interesting and I will take this into account. Thanks again for your help.

 

[Nayshiftin]

Hi Pabbiel and welcome

I see in your previous post that your HbA1c in may of this year was 35 but your profile says that you are "at risk of diabetes". Have you had an HbA1c result of 42 or more at some stage or is it just that you have family members with Type 2 and these odd readings which make you concerned that you might be "at risk"?

I think it is important to understand that BG levels go up and down throughout the day and night in response to a number of factors (about 42 of them in fact) and food is just one of them. It is probably the main factor but there are certainly others. One thing which can bump up BG levels on a morning and therefore may impact your "fasting readings" is something called Dawn Phenomenon. This is where the liver pumps out glucose into the blood stream to give you energy to start the day. My levels can rise by 6 whole mmols due to this phenomenon. Some people find their liver starts doing this in the early hours of the morning and others thankfully find that it waits until we set foot out of bed (sometimes referred to on the forum as Foot on the Floor or FOTF). Many of us take our fasting reading as soon as we wake up and before we get out of bed for this reason. The longer you leave it before you eat, the more likely your liver will release this glucose. Food hitting the stomach switches this liver function off. Think of the liver a bit like a back up battery for keeping your vital functions supplied with energy when there is no food in your system (ie overnight or when fasting) and having an automatic turbo boost function on a morning to get you going. Food switches that function off and you go back to mains power. Hopefully that will make sense.

The point I am making is that the time that it can be quite relevant as to when you actually take that fasting reading and if you have been up and out of bed for an hour, that may well be why you are getting higher readings than you would perhaps like, so it might be worth experimenting with taking some readings as soon as you wake up and then an hour later but before food and see if there is much difference. What should happen is that the rising BG levels should trigger the pancreas to produce insulin to transport the glucose into the cells and bring your levels down. If you have some visceral fat around your liver and pancreas, that can make the communication between these 2 organs less efficient and the pancreas doesn't get the message to produce more insulin when the liver starts dumping glucose into the blood stream. When you eat, the pancreas also gets a message to produce insulin and sometimes this message gets through quite well and brings levels down when the message from the liver doesn't. This can mean that eating breakfast as soon as you wake up will result in your BG levels dropping rather than increasing, so the longer you fast the higher your levels go.... Again it is something you can test with your BG meter by one day fasting for a couple of hours after you get up and the next day eating breakfast straight away and see if those 2 scenarios produce different results at the 2 hours after getting up point.

The thing about testing is that just random tests here and there tell you very little and can cause anxiety if you get higher readings than you expect. Following a regular strategy of testing and knowing what you are testing for and adjusting your strategy to learn something about that is by far a more constructive way of using a BG meter.
Most Type 2 diabetics here on the forum use their BG meter to test immediately before and then 2 hours after a meal, to see how that meal impacted their BG levels. That information can then be used to tailor their diet or that individual meal to what their body can cope with. The general rule of thumb is to reduce the carb content of a meal which raised your BG levels by more than 3 mmols 2 hours after eating it. So if your levels were 6.8 just before the meal and 10.2 2 hours later you probably had a few more carbs in that meal than your body could cope with, so have one less potato or a bit less bread (or a lower carb bread) etc or 10g less cereal next time you have that meal and see if you get a better result. Once you can adjust that meal to give you an increase of less than 3 mmols, your premeal readings will start to come down.
It sounds like an awful lot of testing but once you establish a repertoire of meals that don't spike your levels too much, then you only need to test new foods or do occasional checks to make sure nothing has changed.

Hope most of that makes sense, but if your HbA1c is 35 then you probably just need to keep doing what you are doing diet wise and try not to worry yourself about random tests.

Sorry to jump in but want to ask as it appears you are knowledgable about metabolic disorder. Do you need to have high blood pressure with it ? I have the other symptoms but seeing nurse next week. Just unsure if no high bp would I be doing myself no favours questioning it ?