Puzzle

[Kevmawr]

I am type 2. In the last 9 weeks I've manged to lose a few stone, bloods are consistently 4.3-6.8
I'm now off Metformin and exercise every day. I walk about 8 miles a day.
Blood pressure is now normal range.
On Friday morning my fasting sugar lept up to 10.2 in the morning prior to breakfast. I had 2 slices of Wholemeal toast with banana and honey 12 hrs before the reading.
On Saturday all was fine with normal levels.
On the evening of Saturday I had 30g of Special K with Stevia, milk and banana.
13 hrs later my level was 9.8
I went out and walked 5 miles before checking BM at 4.4 then 4.3 at 10 miles.
Tonight I had reading of 5.2 at 1hr after dinner then 6.8 at 2hr Post meal.
Bit concerned at high morning readings albeit fasted for 12 hrs min.
A bit concerned but feel so fit and well. Could it be that I had snack later in the night ( 9pm)?? Or is it the carbs?
Tried 2 different testing machines and strips.
Any thoughts?
Won't push panic button yet! Thanks

 

[VashtiB]

If I had that level of carbs my blood sugar levels would be in double figures also. I go very low carb but if you are able o tolerate more carbs then that is fine- testing often will be the thing that lets you know how many carbs your body can tolerate.

I personally would be concerned at some of the readings you get- is there any reason you haven't reduced your carb intake- I'm confused as to why you would both with stevia when you are having cereal, milk and a banana which all have carbs in them.

 

[JoKalsbeek]

I am type 2. In the last 9 weeks I've manged to lose a few stone, bloods are consistently 4.3-6.8
I'm now off Metformin and exercise every day. I walk about 8 miles a day.
Blood pressure is now normal range.
On Friday morning my fasting sugar lept up to 10.2 in the morning prior to breakfast. I had 2 slices of Wholemeal toast with banana and honey 12 hrs before the reading.
On Saturday all was fine with normal levels.
On the evening of Saturday I had 30g of Special K with Stevia, milk and banana.
13 hrs later my level was 9.8
I went out and walked 5 miles before checking BM at 4.4 then 4.3 at 10 miles.
Tonight I had reading of 5.2 at 1hr after dinner then 6.8 at 2hr Post meal.
Bit concerned at high morning readings albeit fasted for 12 hrs min.
A bit concerned but feel so fit and well. Could it be that I had snack later in the night ( 9pm)?? Or is it the carbs?
Tried 2 different testing machines and strips.
Any thoughts?
Won't push panic button yet! Thanks

Honey is basically liquid sugar, banana's are very, very high in carbs, toast and cereals, same thing.... That's not a puzzle. Seriously, you've eaten a LOT of carbohydrates, and as all of those will spike your blood sugars... You got spikes. https://josekalsbeek.blogspot.com/2019/11/the-nutritional-thingy.html <-- have a read, this'll explain it a bit further.
Also, try these visual guides, check the honey and banana. (They don't even list cereal and bread)
https://www.dietdoctor.com/low-carb/sweeteners
https://www.dietdoctor.com/low-carb/fruits

Hope this helps! The rest of the time you're doing really well, so keep it up!
Jo

 

[Tophat1900]

It's the carbs....

 

[DavidGrahamJones]

On Friday morning my fasting sugar lept up to 10.2 in the morning prior to breakfast. I had 2 slices of Wholemeal toast with banana and honey 12 hrs before the reading.
On Saturday all was fine with normal levels.
On the evening of Saturday I had 30g of Special K with Stevia, milk and banana.
13 hrs later my level was 9.8

Puzzle? 2 slices of bread is 100gms carb, another 25 gms for a banana and honey is 80% carbs. That's a lot in one sitting even if you were having the recommended (for non diabetic) 250gms per day.

 

[Kevmawr]

Thank you all for your reply.
I'm not disputing anything your telling me but the fact that I've been doing testing regularly and in spite of all those carbs theres not been one reading higher than 6.5 for past 2 months. I have regularly had my toast, banana and honey with no spike in my morning Pre breakfast readings until these 2 readings.
The puzzle is not purely to do with the carbs alone as I'm not that silly, not to know carb levels but more that it has happened now and not in previous weeks.
I agree with you that my carb intake is too high, especially in the evening. I was getting away with it but not now and I'll just knock it on the head as another learning curve. Walked 66 miles last week and already did 14 today with bloods down to 4.3 - 4.8
Feeling great and thanks again to you all with your response.
BW
Kevin

 

[Daibell]

That diet is very bad for a diabetic. You need to abandon the bananas, have one slice of toast and forget the honey. Also don't have cereal or only a small amount. For breakfast try eggs and bacon etc. Yes, it certainly is the carbs.

 

[Kevmawr]

Dear all,
It seems that I may have a spike in my morning blood sugars down to either the Dawn Phenomenon due to my possible insulin resistance brought on by nocturnal increase in Cortisol, Glucagon and Epinephrine in preparation for when the body wakes up. Non diabetics have enough insulin to deal with this but diabetics don't.
The other possibity is the Somogui effect which is nocturnal hypoglycaemia which triggers the body to spike sugars to deal with this.
Spoke to a friend who is Diabetic nurse advisor and now I need to test my bloods at 3am onwards to check when these spikes start.
I'm then due my HBA1C in July and take matters from there in managing whichever cause.
You all said about carbs being the which your all correct but I suspect I may need additional measures in addition to cutting these down and evaluation which ones metabolise quickest or slowest, doing exercise after dinner, get good sleep to reduce Cortisol to taking 1 tablet of Metformin before bedtime for Dawn Phenomena to nuts or cheese as a bedtime snack to deal with Somogui effect.
All will become apparent in time with some trial and error.
Big thanks to everyone for their valued opinion. So much to learn but determined to make necessary changes to turn my life around.
Kev xx

 

[Geordie_P]

No need to overthink the situation, and no need to panic: your food is pretty much the worst food imaginable for a T2 diabetic- you'd probably be better off with cheesecake and ice-cream. You may be able to handle it sometimes because you seem very active, but if you cut the carbs, you will have better blood sugar levels.

 

[Brunneria]

Hi,

You mentioned the Somogyi effect
https://www.healthline.com/health/diabetes/what-is-the-somogyi-effect#:~:text=The Somogyi effect or phenomenon,levels into a rebound high.
But the important thing to remember with this is that it applies to people (usually T1 diabetics who inject insulin) to explain why they go to sleep and wake up with high blood glucose, yet have a low bg in the middle of the night.
It is also known as the rebound effect.

You ate carbs in the evening, which will have triggered a significant insulin response, possibly caused a drop in blood glucose in the small hours, and then the rise the following morning. So that fits with the rebound effect scenario. Worth testing as a theory.

It is something I have experienced myself, regularly, if I eat carbs in the evening. For me, the two biggest symptoms were waking up from a bad dream at 2.30 in the morning, drenched in sweat (from the hypo) and then the following morning having a fasting blood glucose higher than usual.

Until I used a Freestyle Libre I found it insanely difficult to actually find/test the low point in the middle of the night, because by the time I had woken up from a bad dream, realised that zombies were not, in fact, climbing the stairs ready to rip the top off my head off, and feast on the contents, and got myself together enough to reach for the test meter, then my blood glucose was always above 5.

On using the Libre, I discovered that just prior to the wakeup nightmare and sweats, by blood glucose was regularly dipping into hypo territory, then rising sharply. The stress hormones involved in raising the bg were probably responsible for the dream, rather than the low blood glucose itself.

If something similar is happening to you, then all I can do is suggest that you look at the root cause of the problem. At the moment you are likely distracted with the idea of further medical tests, a potential deterioration in your T2, and concerns about hypos. In reality, the root cause is much simpler than that. If you avoid the excess carbs during the evening, then you likely won't produce the excess insulin that pushes you down to low levels in the night, and you won't see the raised morning readings.

Easy to test this theory (just avoid carbs the evening before, and see what happens the following morning)
and a darn sight simpler and less hassle than a whole gamut of medical appts and tests.

Just to complete my story - I no longer have the night hypos, regular nightmares and/or night sweats. Nor do I have a significant dawn phenomenon. But then I have been low carbing/ketoing for years now, and the progress has been nicely consistent. I do get something called foot-in-floor (which is different from dawn phenomenon) but even that is significantly lower than it used to be, and is directly in proportion to carb intake in the previous few days.

Hope that helps!

 

[ziggy_w]

Dear all,
It seems that I may have a spike in my morning blood sugars down to either the Dawn Phenomenon due to my possible insulin resistance brought on by nocturnal increase in Cortisol, Glucagon and Epinephrine in preparation for when the body wakes up. Non diabetics have enough insulin to deal with this but diabetics don't.
The other possibity is the Somogui effect which is nocturnal hypoglycaemia which triggers the body to spike sugars to deal with this.
Spoke to a friend who is Diabetic nurse advisor and now I need to test my bloods at 3am onwards to check when these spikes start.
I'm then due my HBA1C in July and take matters from there in managing whichever cause.
You all said about carbs being the which your all correct but I suspect I may need additional measures in addition to cutting these down and evaluation which ones metabolise quickest or slowest, doing exercise after dinner, get good sleep to reduce Cortisol to taking 1 tablet of Metformin before bedtime for Dawn Phenomena to nuts or cheese as a bedtime snack to deal with Somogui effect.
All will become apparent in time with some trial and error.
Big thanks to everyone for their valued opinion. So much to learn but determined to make necessary changes to turn my life around.
Kev xx

Hi @Kevmawr,

Some of the current thinking on the topic of T2 and insulin resistance is that we frequently have too much rather than too little insulin. (You might also want to look up some Youtube videos by Prof. Dr. Ben Bikman, an researcher specializing in the effects of insulin, if interested in this topic.) Here is also a graph by Dr. Ken Sikaris, a chemial pathologist, which shows that insulin levels on average are higher for people with diabetes than normal people. This even holds true for people with very high HbA1cs. This graph, of course, also includes Type 1s with very low to no insulin and long-term T2s with burned out pancreases, which might explain some of the results in the bottom range of insulin output.

The high(er) level of insulin, in most T2s, then leads different parts of the body (mainly the liver and the pancreas) to become insulin resistant in an effort to dampen the effects of too much insulin.

It is then argued that as the body becomes increasingly insulin-resistant due to high carb intake in susceptible people, the insulin it does produce can no longer do its job effectively. Thus, in response to the release of cortisol, epinephrine, glucagon and growth hormone in the morning (dawn phenomenon), the beta cells in the pancreas still produce insulin, mostly comparable in level to those people without blood sugar problems), however this insulin is no longer sufficient in overcoming the insulin resistance. This is especially true in the morning when we are most insulin resistant. Consequently, dawn phenomenon seems to be due to insulin resistance in T2s rather than too little insulin.

So, maybe the problem is not too little insulin for us T2s, but rather too much. Thus, lowering your carbs is as much an attempt to lower your insulin levels as it is an attempt to lower your blood sugars.

 

[Buzzer81]

Hi @Kevmawr,

Some of the current thinking on the topic of T2 and insulin resistance is that we frequently have too much rather than too little insulin. (You might also want to look up some Youtube videos by Prof. Dr. Ben Bikman, an researcher specializing in the effects of insulin, if interested in this topic.) Here is also a graph by Dr. Ken Sikaris, a chemial pathologist, which shows that insulin levels on average are higher for people with diabetes than normal people. This even holds true for people with very high HbA1cs. This graph, of course, also includes Type 1s with very low to no insulin and long-term T2s with burned out pancreases, which might explain some of the results in the bottom range of insulin output.

View attachment 41991

The high(er) level of insulin, in most T2s, then leads different parts of the body (mainly the liver and the pancreas) to become insulin resistant in an effort to dampen the effects of too much insulin.

It is then argued that as the body becomes increasingly insulin-resistant due to high carb intake in susceptible people, the insulin it does produce can no longer do its job effectively. Thus, in response to the release of cortisol, epinephrine, glucagon and growth hormone in the morning (dawn phenomenon), the beta cells in the pancreas still produce insulin, mostly comparable in level to those people without blood sugar problems), however this insulin is no longer sufficient in overcoming the insulin resistance. This is especially true in the morning when we are most insulin resistant. Consequently, dawn phenomenon seems to be due to insulin resistance in T2s rather than too little insulin.

So, maybe the problem is not too little insulin for us T2s, but rather too much. Thus, lowering your carbs is as much an attempt to lower your insulin levels as it is an attempt to lower your blood sugars.

Yes this is how I see it from Dr Fung. High blood sugars are a consequence of the bigger problem which is hyperinsulinemia. Makes sense then to avoid carbs which will turn into insulin regardless.

Quick question though, if we are most insulin resistant in the morning, would it make sense to fast then and skip breakfast? Then eat later in the day?

 

[Kevmawr]

Thank you so much for taking the time, bother, knowledge and kind advice.
General consensus on Carbs is a no brainer.
Will test first and consider all the points you make.
Massive thanks again
Kevin

 

[ziggy_w]

Yes this is how I see it from Dr Fung. High blood sugars are a consequence of the bigger problem which is hyperinsulinemia. Makes sense then to avoid carbs which will turn into insulin regardless.

Quick question though, if we are most insulin resistant in the morning, would it make sense to fast then and skip breakfast? Then eat later in the day?

Hi @Buzzer81,

Thanks for your comment. Yes, this definitely jives with the thinking of Jason Fung.

As to fasting and dawn phenomenon, there are no easy answers to this as I believe there are different ways of thinking about it.

On the one hand, there is an argument that fasting allows the liver to release stored fat more quickly (i.e. liver fat = blood sugars removed from the blood stream and then turned into liver fat in an attempt to store the extra energy floating around). This is at least the way I understood this way of thinking from Jason Fung. However, imho it does take a certain amount of equanimity to accept these higher morning levels (which may last until noon or early afternoon) until liver fat reduces and we become more insulin sensitive.

On the other hand, the increased stress (and thus release of stress hormones) which some of us experience with fasting in the morning might further increase our blood sugar levels, lead to subsequent insulin release, and make us even more insulin-resistant. So, a so-called "liver block" like a piece of cheese might be helpful in this case.

This is at least, how I understand the arguments. So, in the end, I think it is a very personal decision how you approach dawn pheonomenon and this might very much depend on how your body reacts to fasting in the morning and how well you deal (psychologically) with somewhat elevated morning levels until your insulin resistance (due to liver fat and probably also fat in the pancreas) reduces.

 

[Buzzer81]

Hi @Buzzer81,

Thanks for your comment. Yes, this definitely jives with the thinking of Jason Fung.

As to fasting and dawn phenomenon, there are no easy answers to this as I believe there are different ways of thinking about it.

On the one hand, there is an argument that fasting allows the liver to release stored fat more quickly (i.e. liver fat = blood sugars removed from the blood stream and then turned into liver fat in an attempt to store the extra energy floating around). This is at least the way I understood this way of thinking from Jason Fung. However, imho it does take a certain amount of equanimity to accept these higher morning levels (which may last until noon or early afternoon) until liver fat reduces and we become more insulin sensitive.

On the other hand, the increased stress (and thus release of stress hormones) which some of us experience with fasting in the morning might further increase our blood sugar levels, lead to subsequent insulin release, and make us even more insulin-resistant. So, a so-called "liver block" like a piece of cheese might be helpful in this case.

This is at least, how I understand the arguments. So, in the end, I think it is a very personal decision how you approach dawn pheonomenon and this might very much depend on how your body reacts to fasting in the morning and how well you deal (psychologically) with somewhat elevated morning levels until your insulin resistance (due to liver fat and probably also fat in the pancreas) reduces.

Thank you for that Ziggy, very interesting. I always found skipping breakfast the easiest thing so perhaps I will try it. See what affect it may have for me. Thanks again, Jon

 

[ziggy_w]

Thank you for that Ziggy, very interesting. I always found skipping breakfast the easiest thing so perhaps I will try it. See what affect it may have for me. Thanks again, Jon

Agree with you -- nothing to do but try and see what impact it has on you. I've definitely seen some posts where two meals approx. 12 hours apart seem to work best and other posts where skipping breakfast seems to do the job. As the saying goes, we are all individuals.

 

[JoKalsbeek]

Agree with you -- nothing to do but try and see what impact it has on you. I've definitely seen some posts where two meals approx. 12 hours apart seem to work best and other posts where skipping breakfast seems to do the job. As the saying goes, we are all individuals.

Python was right .