BS suddenly all over the place

[LucySW]

I've been trying to get my BS consistently down to below 6 by keeping to Dr Bernstein's 6 + 12+ 12 carbs a day and even protein, but my BS won't seem to stay below 6 except in the middle of day - always at least 6.5 after supper. This instability coincides with coming off Metformin, but may be unrelated. Now I've had some wild readings which I just can't account for: 9.2 suddenly last night, and still 8.2 this morning. (I double checked them.)

My past readings and the details of what I ate last night just don't explain this. Carbs have been under the 30g/day limit. I suppose I shouldn't panic but just keep on trucking, slowly.

Anyone experience these sudden wild swings with early LADA? I wish I could rent a CGM for a couple of weeks, just to know what is going in there.

A bit discouraged, Lucy

 

[Ian DP]

I guess maybe you need to increase your insulin.... Maybe 1 unit of fast acting evening time, if your BG readings are high..... But hopefully someone with more insulin experience can advise better.


Diagnosed T2 in sept 2013, BS levels 20+. BMI 22, age 59. Then diagnosed T1 / LADA in December. On a LcHf diet taking no insulin or medication, and striving to keep my BS readings to dr Bernstein's recommended 4.6 pre breakfast and 5.6 2hr after eating in order to keep as many insulin making pancreas beta cells as possible for as long as I can.
Sent from the Diabetes Forum App

 

[Bluetit1802]

Have you ruled out the usual culprits such as additional stress, hot weather, or coming down with some bug or other?

 

[smidge]

Hi Lucy,

The wild swings in BG are pretty typical of LADA. I go through patches of them really.

Intermediate insulin is great for early stage LADA in my opinion. You need to learn to time the doses so that the peak catches that post meal spike. I used to use Insuman Basal which is very similar to insulatard. It has a very pronounced peak at about 4 -6 hours. I found splitting the dose morning and night was best - even splitting a small dose helps. Try half or two thirds your dose when you wake - if you're lucky, it will help smooth the lunch spike. The rest of your dose could be before bed to stop the dreaded DP if you suffer from it - or you could use it with your tea to catch the post tea spike.

I think intermediate insulin is pretty good for low carbers as the spike hits quite a bit later than high carb, so the peak in insulin can really smooth that out. I'm on Levemir now, because once I started to use a bolus, the Insuman clashed with it, but I definitely think the Insuman suited low carb LADA control better than Levemir. Or maybe that was just me!

Smidge

 

[LucySW]

Thank you Smidge, that's really helpful.

Honestly, last night 9.2; then this morning 6.5 first thing, then UP to 8.2 before breakfast; post-B down to 7.2, then 6.3 bef L, but 2h after L down to **4.2** !! Then 90 minutes later (no eating) 5.6 ...

I don't think yo-yoing around like this is good for me AT ALL. Bleaghh.

It's bonkers. I've not played with insulin for several days.

 

[LucySW]

Have you ruled out the usual culprits such as additional stress, hot weather, or coming down with some bug or other?

Bluetit, yes. I'm in the prime of health. The only sense-making explanation is that my system really dislikes particular foods plus eating late at night. I've been counting grams rather than logging what.

 

[Daibell]

Hi. As you are LADA you will need insulin at some point and your profile indicates you aren't yet on insulin? If not, then whilst Metformin won't help, meds such as Gliclazide and Sitagliptin can help for a while before insulin. I often had big swings and went thru Glic & Sitagliptin as well as Metformin i.e. all three for a while and now on insulin. Sounds like you should possibly be on more tablets or insulin? When you need it you need it and I was offered it 1 to 2 years too late as I was told it was 'a last resort'; rubbish. I was started on just Basal insulin but the DN and I agreed to add Bolus as well after a few weeks; great decision.

 

[LucySW]

Sounds like you should possibly be on more tablets or insulin? When you need it you need it and I was offered it 1 to 2 years too late as I was told it was 'a last resort'; rubbish. I was started on just Basal insulin but the DN and I agreed to add Bolus as well after a few weeks; great decision.

Yes df want to try insulin early rather than late, tho I'll give it three months trying to get BS below 5 without meds first.

I suspect the culprit here is late-night meals plus a snack at 6pm as I die of hunger. I'll clearly have to serve supper at a normal time and do away with the snack.

Impressed by IanDP doing it without meds. It's df worth trying, so better stop blaming the family and make it as easy as possible.

 

[LucySW]

While reading up abt the dawn phenomenon, which I've never understood before, I find that Metformin is said to stop the DP because it switches off the liver's glucose-releasing hormone.

I came off Metformin two weeks ago. So a good poss explanation ...

Found Brunneria's very interesting thread: http://www.diabetes.co.uk/forum/threads/pesky-dawn-phenomenon.57672/

 

[Daibell]

Yes, Metformin does witch-off some of the liver's glucose dumping so probably does reduce the Dawn Phenomenon; interesting. I've often wondered whether having Metformin, as I still do 'cos it keeps the DN happy, increases the chance of a hypo as the liver can't do emergency dumps when needed?

 

[-Artemis-]

Interesting theory re the metformin @Daibell ! No idea if it's possible - but on face value sounds it...