Understanding CGM data & trends

[lisbon67]

Hi All, Newbie here but Type 2 since 2010. Meds - Metformin 2000mg and Canafilglozen 300mg daily
I've been using a CGM for 6 months and it has motivated me to really get things under control. My A1C (according to CGM) pre xmas was 5.3 and since is 5.8 - i kind of fell off the wagon over xmas.
Below is a typical daily trend and eating schedule. I eat only in the afternoon & evening and yet my peak glucose is always mid day (before food). My carb content is low and contains "good" low carb veg. I never eat potatoes, pasta, bread, rice etc
I'd like to understand the daily trends of the CGM and understand what is good and bad and if I can/should come off my meds in whole or in part.
Q. Why do I ramp and peak in this way? Is this normal? Is a ramp from 4 to 8 OK? With this diet can/should I come off meds and how?

Any advice greatly received.
Thanks in advance

Typical daily curve


last 30 days


Last 90 days Incl. Xmas excesses

 

[Leadinglights]

If you are not eating anything in the morning then your liver is being super helpful and releases glucose to give you energy in the absence of food. It is referred to as Foot on the floor syndrome or Dawn Phenomenon depending on when it happens. People on insulin will take their insulin to stop it but otherwise eating as soon as possible after getting up will usually stop it going up too much.

 

[PerSpinasAdAstra]

As @Leadinglights says - two distinct but similar phenomenon related to morning rises in BG, possibly due to the daily cycle of hormones that can stimulate glucose secretion from the liver and/or inhibit the action of insulin.

Some have reported that eating something very small on waking can stop the effect. I've read of one person eating a few walnuts with their morning coffee (with cream in it) for example.

Alternatively it might be related to your daily activity. What do you typically do between 10am and 11am?

 

[lisbon67]

If you are not eating anything in the morning then your liver is being super helpful and releases glucose to give you energy in the absence of food. It is referred to as Foot on the floor syndrome or Dawn Phenomenon depending on when it happens. People on insulin will take their insulin to stop it but otherwise eating as soon as possible after getting up will usually stop it going up too much.

Thank you for your help. I thought that might have been he case. It’s very repeatable but wasn’t sure if it was a known phenomenon or a weird aberration unique to me. I would like to know where my liver is finding any glucose when my carb count is so low. I’ll try a small snack early in the day to see if the caps the peak. Thanks

 

[lisbon67]

As @Leadinglights says - two distinct but similar phenomenon related to morning rises in BG, possibly due to the daily cycle of hormones that can stimulate glucose secretion from the liver and/or inhibit the action of insulin.

Some have reported that eating something very small on waking can stop the effect. I've read of one person eating a few walnuts with their morning coffee (with cream in it) for example.

Alternatively it might be related to your daily activity. What do you typically do between 10am and 11am?

 

[lisbon67]

Thanks for your help. I’ll try a small snack to see if that mitigates the spike. As for my morning routine. I rise at 0730/0800 I and usually sat in my home office with a glass of water and my meds by 0830 where I remain until 1400 when I grab lunch. Thanks again.

 

[PerSpinasAdAstra]

Thanks for your help. I’ll try a small snack to see if that mitigates the spike. As for my morning routine. I rise at 0730/0800 I and usually sat in my home office with a glass of water and my meds by 0830 where I remain until 1400 when I grab lunch. Thanks again.

Almost certainly morning BG rise then - dawn or foot on floor thingie. Exercise or similar physical exertion can also cause a temporary rise too so was just checking that wasn't part of your daily routine. I've seen many references to a few morsels of food in the morning doing the trick. I've seen one person report that it needs to have a little carb in it, though a very small amount.

BTW your liver manufacturers glucose using (I believe) amino acids - protein. It also stores it in the form of glycogen and releases it into the bloodstream when triggered by hormones. That's where it comes from even if you eat very little carbs.