Should I be concerned?

[happydog]

I have just had my 8th Diaversary so I feel I should know this but I am going to ask anyway. My BG is high when I first get up e.g. in 8's and sometimes even 9's. It can have been between 5.5 and 6.5 before bed. I have not eaten anything overnight. Within an hour or so it will drop to about 6.00 or even lower and then stays below 10.0 even after meals. I mentioned this to the nurse the last time I saw her which was last year. She said that it is nothing to worry about as my HbA1c is 42. I'd like to get it lower but have not managed that yet. I control it by diet and exercise and it has taken me a while to get it where it is. I don't want to ask again at the surgery because last time she said this is exactly why type 2's should not test. So long as your HbA1c test is within the range you don't need to worry and you must accept that you may not always be able to control you condition with diet and exercise and it will deteriorate as you get older. Thought that was very negative. I try to limit carbs. So should I be concerned or just accept that it is high in the morning? Any advice would be greatly appreciated. 🙂

 

[Docb]

If it were me I would keep an eye on things but not be that concerned. The liver can dump glucose into the blood first thing in the morning to prepare you for the morning hunt for food but from what I can make out, it varies from day to day and person to person, the time of year, the price of fish and all those factors other than food intake that affect blood glucose levels.

I am going through a patch at the moment where my waking readings are higher than they have been historically but like you my last HbA1c was fine and I have yet to see double figures after meals and I am treating it as being part of life's rich pattern.

 

[Ljc]

I wouldn’t worry too much about that waking level, it’s likely to be DP getting you ready to hunt a mammoth for brekkie rather than that dratted DF trying to put a spanner in the works.

With lifestyle changes alone you have done exceedingly well at controlling your BG levels.

I too find your nurses comment very negative , it is not a given that T2 will deteriorate as you get older, I am guessing it’s because she probably sees a lot of people who Who follow the standard NHS dietary advice or just totally ignore their diabetes.

 

[grovesy]

I suggest you do a search for Dawn Phenomenon in the forum search. As I use a Freestyle Libre Sensor , I can see from my overnight graph my levels can be steady and from about 4-6 am they start to rise.

 

[Ljc]

Your DN is right about your HbA1c being the proper measure but for me testing is about knowing that I have things under control instead of finding out at my next HbA1c that my levels have climbed without my being aware, with all the associated damage it's been doing to my body.

Martin

I heartily agree.

 

[ianf0ster]

I have been through periods where my highest (known) BG level was the fasting one in the morning. So longa as it was 8.0 or below I didn't take any action (i.e. I would just skip breakfast as normal), but if it was over 8.0 I would eat what I found (for me) would lower it - which was 2 boiled eggs - to convince my liver that I would have enough energy to hunt my meals.

I have been skipping breakfast (doing Restricted Time Eating) for just over 1yr now - so I no longer bother testing my BG in the mornings. If it is high then at least my body is using up its fat stores!

 

[rebrascora]

When do you do that fasting test?
As others say it could be DP or it's counterpart,"foot on the floor" syndrome.
My BG will steadily drop throughout the night, but the minute I get out of bed it goes up by 1-2mmols within 5 mins of my foot hitting the floor and will continue to rise unless I inject insulin. I would suggest you try testing as soon as you wake up and before you get out of bed in case you also suffer "foot on the floor" syndrome rather than DP which usually takes effect in the early hours.

 

[happydog]

Thank you all so much for your responses. As I am on my own now since my husband died I have no one to talk to about my concerns. I think it is probably DP as I have always had it, but it seems to be higher at the moment. (DN told me that she had never heard of DP and wishes I would just be satisfied with an acceptable HbA1c.) I will try doing my test before I actually get up and see what the result is. I do feel reassured now. Thank you. This is such a brilliant forum!

 

[SB2015]

I think that the HbA1c was great when it was all we had access to, but it gives no information about the ups and downs that balance each other out. That is where time in range is much more informative, and the Libre sensors or checks before and after meals tell us more about this.
It is a shame that your nurse is so dismissive.