high fasting despite normal post-dinner glucose levels

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creation27

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My mum is 49,and has diabetes diagnosed 5 years ago - had been diet controlled all this while, but recently her fasting blood glucose levels are 8 mmol/L. Her 2- hour post dinner glucose is normal, and during the rest of the day they are in the normal range as well. It is only the morning sugars that are coming high.She takes early dinners and goes for a walk after dinner, but the fasting levels are still high

Therefore her doctor prescribed slow-release metformin to be taken at night, before going to bed. However, despite this, her fasting blood glucose is still coming high.

Could anyone help and explain?

thanks!
 
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cugila

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Can you tell us what her pre bedtime levels are ? There is the Dawn Phenomenon effect which may be coming into play here.

Ken
 
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creation27

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thanks 4 the reply.

before bedtime the levels range between are 8.2 - 9.2
at 12.30 am at night, the levels drop to 7.2 and then at 2 am, they are at 5.7
however in the morning again the fasting levels are between 7.1-8.7

kindly note that due to practicality, my mum only has single readings of her glucose levels at 12.30am and 2am. the other readings, before bedtime and those in the morning have a range because she does check them quite regularly.


thanks 4 ur help
 
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cugila

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It seems to me that your Mom is probably dropping lower than the 5.2 at 2am. This can trigger a 'liver dump' to prevent her going too low, therefore the Bg levels would automatically rise.

This could be due to taking the Metformin last thing at night which is unusual, most take it in the morning and in the early evening. Maybe the timing of the Met is not right ? The normal dose of Met SR is as follows: initially 500 mg with breakfast for at least 1 week then 500 mg with breakfast and evening meal for at least 1 week then 500 mg with breakfast, lunch and evening meal; usual max. 2 g daily in divided doses

Another point is I presume your Mother has an early dinner, evening meal ? Then she exercises. Now this can in itself trigger a rise and then much later a drop in BG levels which could also affect the readings during the night. Magnifying the effect of going low. A small 'carby' snack before bedtime may help to counteract all of this.

If this persists maybe she should discuss it with the GP or DSN.

Ken
 
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creation27

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The readings I have given you were BEFORE she was commenced on metformin slow release (glucophage) at night 500 mg once daily. the reason her metformin was started at night was precisely because her fasting glucose was high in the morning.

however even after taking metformin at night, her fasting blood glucose levels haven't been helped!


wat is going wrong? wat else could she do?
 
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cugila

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Oh.....I see ! It really would be more helpful if we had the readings now, NOT prior to all this. Then we can see just what level she has at bedtime, what level immediately on waking up (fasting). Perhaps you could come back to us with that information please.

Ken
 
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creation27

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well i dont know her before bedtime glucose yet.

but her fasting last morning was 8, which is still high despite the metformin

i will definitely post more info, as i get it.


thanks
 
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cugila

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Thanks for that. Can you make sure the morning fasting level is taken on waking please and the bedtime one just before retiring.

Ken
 
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