BG rising through the morning whatever I do?

[Dusty911]

Hi All. This is my very first post although I have been lurking for a while. I was diagnosed type 2 just over 2 months ago with a hba1c of 95 and fasting BG of 16. Thanks to the advice on here I have been low carbing and testing with a codefree metre for about 3 weeks now. My problem is this, whatever I do I wake up with a BG of about 7 now, whatever I do or eat or even don't eat at all my BG rises through the morning to about 9 mid morning. It is back to 7 by midday and falls through the rest of the day and evening, till reading at night usually about 6.5. Any ideas how I can bring this morning rise down. I have read about the liver dump but this seems to be happening after I get up and through the morning. I am on Metformin 4X 500g and statins. Any advice would to further bring down BG would be appreciated. Thanks

 

[Guzzler]

The fasting blood glucose is the last and trickiest to handle. It does take time and sleep can affect readings. Keep testing and try a creamed coffee or a small bite to eat on waking to try to stem the liver dump. Good luck.

 

[LittleGreyCat]

I would guess at a liver dump.
Fits the description, although it is only supposed to happen if your BG falls low enough for your body to think you need something from your glucose store.
This is why it tends to happen early morning. BG drops slowly over night until your liver intervenes to prop it up.
You could try a small carby snack last thing at night (to avoid going low early morning) or very first thing in the morning to try and persuade your liver to stop dumping.

I wouldn't worry too much at the moment because your weight loss and revised eating plan seem to be working. Allegedly it takes a while for the liver to settle down after you have made major changes.

 

[tubamanandy]

I'm T2 for about the past 4 years, only in recent months looked into it closely. My readings are very similar to yours and I'm on 2 x 500 of Metformin/day.

I too see this and feel your pain. To an extent, I think its normal in that our bodies maybe giving us a glucose boost very early in the morning (mine is 5am) to get us ready for the day ahead (just my thoughts). While its really early days for me testing/trying out my new FS Libre sensor, if I have any carbs for breakfast the problem is just made worse whilst if I have my usual 2 x eggs then you can see the situation is alot better.

I guess in 2 weeks I will know much more about my levels and more importantly for me the trends and results of eating certain foods.

 

[Bluetit1802]

It sounds to me like a liver dump. They can happen at any time, not just early morning.

Putting it simply, in a normal healthy person, certain hormones trigger the liver to dump glucose from its stores whenever glucose levels are low (or lower than normal for that person). The hormones then trigger the pancreas to secrete insulin to deal with this rise in glucose levels to push the glucose into the cells for energy, and at the same time tell the liver to stop dumping. This keeps a good healthy balance of glucose in the blood stream, and keeps us alive.

In T2 diabetics, this system breaks down. This can be due to insulin resistance or insufficient insulin being produced. (or even wonky hormones). The liver dumps, the pancreas secretes insulin but this insulin is either insufficient or most likely can't do its job properly because the cells reject it (insulin resistance), so the liver dumps aren't cleared away for sometimes a considerable amount of time. The worse the IR the longer it will take.

Assuming the T2 does produce enough insulin, the only way to avert this phenomenon is to get rid of the insulin resistance.

That is a basic explanation.

 

[Rachox]

I find I have to eat as soon as I get up. Showering and getting dressed has to come after breakfast these days. If I potter around too much before eating my blood glucose will creep up and up til around lunch time. However as guzzler says the morning reading is the last to achieve lower levels.

 

[lucylocket61]

Mine still does that, several successful years down the line. It always has done this, so I ignore it now, and put it down to my own unique body mechanism lol

 

[walnut_face]

I have the same issue as @lucylocket61 I still get FBG's in the 7's after 2 years, yet an HBA1c of 40. By 6pm I usually have a reading <4.5

 

[kokhongw]

I find Dr Jason Fung gives the clearest explanation
https://idmprogram.com/dawn-phenomenon-t2d-8/

Think about it this way. The Dawn Phenomenon is simply moving sugar from body stores (liver) into the blood. That’s it. If your body stores are filled to bursting, then you will expel as much of that sugar as possible. By itself it is neither good nor bad. It is simply a marker that your body has too much sugar. Solution? Simple. Either don’t put any sugar in (LCHF) or burn it off (Fasting). Even better? LCHF + IF.

Basically I simply skipped a couple of dinners and viola! FBG became 5.5 mmol and has stayed around there for the past 2 years...

 

[Bluetit1802]

@Dusty911

You posted a duplicate thread about this and have received replies to it.

http://www.diabetes.co.uk/forum/thr...he-morning-whatever-i-do.129041/#post-1612611

If I tag @DCUKMod maybe she can merge them.

 

[LittleGreyCat]

Just to add that my morning bloods are up in the 7s at the moment, although they seem to drift down during the day.

Given that I am long term LCHF and in nutritional ketosis (just checked, and ketones at 2.1 mmol/l) I do wonder where the glucose is coming from at that level. Exercise seems to burn some glucose, but I must be burning mainly ketones. Anyway, as I said, something to keep an eye on but not worry unduly yet.

 

[Kristin251]

While adrenaline and cortisol are waking us up in the morning, they also raise our bs. I found a slow to moderate paced walk for 15 min about a half hour after finishing a small no carb breakfast always helped.

If you skip bf you could try coffee and heavy cream or broth and butter/ghee

 

[OrsonKartt]

While adrenaline and cortisol are waking us up in the morning, they also raise our bs. I found a slow to moderate paced walk for 15 min about a half hour after finishing a small no carb breakfast always helped.

If you skip bf you could try coffee and heavy cream or broth and butter/ghee

I have found that if I drink a large glass of water upon waking followed by food as soon as possible it helps. It can be a small amount of food, just one egg but it does the job for me.

 

[Dusty911]

THanks everyone. It looks like I'm just going to have to wait for my liver to squeeze itself dry.

 

[Bluetit1802]

THanks everyone. It looks like I'm just going to have to wait for my liver to squeeze itself dry.

Lol. But of course, it won't squeeze itself dry. As it empties it fills up again.

 

[Kristin251]

I have found that if I drink a large glass of water upon waking followed by food as soon as possible it helps. It can be a small amount of food, just one egg but it does the job for me.

Yes, just enough to elicit and insulin response. Even a bite of egg would work imagine. But who can stop at a bite haha

 

[OrsonKartt]

Yes, just enough to elicit and insulin response. Even a bite of egg would work imagine. But who can stop at a bite haha

When been desperately short of time I'll take a handful of nuts but taking the short time to scramble and eat an egg starts the day in a much better mood for me.

 

[tubamanandy]

Yes, just enough to elicit and insulin response. Even a bite of egg would work imagine. But who can stop at a bite haha

Stupidly, I hadn't really thought of it that way

 

[LittleGreyCat]

Just to add that my morning bloods are up in the 7s at the moment, although they seem to drift down during the day.

Given that I am long term LCHF and in nutritional ketosis (just checked, and ketones at 2.1 mmol/l) I do wonder where the glucose is coming from at that level. Exercise seems to burn some glucose, but I must be burning mainly ketones. Anyway, as I said, something to keep an eye on but not worry unduly yet.

@Dusty911
Thought I would update this.
I've started a bout of being more rigorous and more active, and have been doing it for just under a week.
No booze.
No little treats; dark chocolate, an apple, bit of hummus. No occasional half tin of baked beans, no M&S panacotta (both options can be fitted into a low carbohydrate count and don't knock me out of ketosis).
Brisk 4 mile walk each day.

Obviously far too many things have changed to work out which changes have made a difference but two days ago fasting BG was in the 7s, yesterday in the 6s, today in the 5s. Who knows what tomorrow holds?

I am now wondering if even during long term nutritional ketosis your body sneakily stashes away little glucose stores just in case, and you have to flush them out now and then. I haven't tried hard core (water) fasting (apart from before a Sigmoidoscopy when I lost a couple of pounds) but that might be something for the future.

So it is possible that if your fasting BG is a bit high despite doing (nearly) all the right things a short sharp shock might bring it down.

 

[Dusty911]

I'm going to try the same LittleGreyCat. I have a feeling that although I have been good at the low carbing my portion sizes have been creeping up. So a week of rigour and we'll see what happens! Will also try to up the exercise a bit. This mornings GP was high 7.9 but interestingly it was still the same 2 hours post breakfast so no continued rise so hopeful of much lower readings by midday! Still got at least a stone and a half to lose at least so onwards and downwards may bring the BG to heel.