Which strategy..?

[ExiledJack]

Hi guys,

Type 2, 500mg metformin twice a day, last a1c=39.

So I have noticed when I test first thing in the morning my blood glucose is consistently 5.5 - 5.9 but in the hours after that, up until my first meal (lunch about 1pm) it will rise above 6 to around 6.5 and stay there until I've eaten. Once I've eaten, it will peak around 7 and then go down to low 5s for the rest of the day. I assume my meal triggers my pancreas into releasing insulin whereas before my meal, production is lower and not able to clear the early morning liver glucose dump?

I have two possible strategies, the first being to continue skipping breakfast and allow my blood glucose to ride at 6.5 until lunch or the second being to eat something first thing that might initially raise my blood glucose to 7 but then lower to 5 earlier in the day.

If the important number is the amount of time in around the 5s, does anyone have an argument against the second strategy? i.e. is it worth temporarily deliberately raising blood glucose to post-pandrial levels in order to have a few more hours sitting at a lower number?

Thanks.

 

[bulkbiker]

I have two possible strategies, the first being to continue skipping breakfast and allow my blood glucose to ride at 6.5 until lunch or the second being to eat something first thing that might initially raise my blood glucose to 7 but then lower to 5 earlier in the day.

Maybe try eating something that shouldn't raise your blood sugar first thing like eggs cooked in butter and see how that goes?
How long have you been skipping breakfast? My FBG was the last to "normalise" too about 6-8 months so maybe you need to give it some more time.

 

[ExiledJack]

Been skipping breakfast for about 3 months or so. I was on insulin when first diagnosed in March, then reduced medication to just metformin and then halved my dose after my a1c fell from 117 to 39 in the first 6 months. Before my metformin dose was halved, I would wake up with 5.5 and it would pretty much stay there. I am getting pretty good at predicting my blood glucose and working out how my BG reacts to exercise/meals etc but am trying to refine my morning schedule to keep a non-diabetic a1c whilst on less medication.

I think some eggs first thing is a good idea and will try it for a few weeks. Thanks.

One thing I have noticed my blood sugar is very easily spiked to 7 in the morning whereas in the afternoon it behaves like a normal non-diabetic person's... probably something to do with hormones but that's beyond me.

 

[bulkbiker]

Been skipping breakfast for about 3 months or so. I was on insulin when first diagnosed in March, then reduced medication to just metformin and then halved my dose after my a1c fell from 117 to 39 in the first 6 months. Before my metformin dose was halved, I would wake up with 5.5 and it would pretty much stay there. I am getting pretty good at predicting my blood glucose and working out how my BG reacts to exercise/meals etc but am trying to refine my morning schedule to keep a non-diabetic a1c whilst on less medication.

I think some eggs first thing is a good idea and will try it for a few weeks. Thanks.

One thing I have noticed my blood sugar is very easily spiked to 7 in the morning whereas in the afternoon it behaves like a normal non-diabetic person's... probably something to do with hormones but that's beyond me.

I'd just give it time.. FBG can be an odd beast - I had a 6.0 and a 6.1 this week for no apparent reason.. guess I might have been fighting off a cold or something but felt fine. I'm usually in the 5-5.5 range average ....so far this year 5.1 2019 5.0. ( I keep quite detailed records!).

Edit to add my morning is usually composed of 3 coffees with double cream.. maybe that has a calming effect? As I'm an addict I've never tried without those!

 

[LaoDan]

Hi guys,

Type 2, 500mg metformin twice a day, last a1c=39.

So I have noticed when I test first thing in the morning my blood glucose is consistently 5.5 - 5.9 but in the hours after that, up until my first meal (lunch about 1pm) it will rise above 6 to around 6.5 and stay there until I've eaten. Once I've eaten, it will peak around 7 and then go down to low 5s for the rest of the day. I assume my meal triggers my pancreas into releasing insulin whereas before my meal, production is lower and not able to clear the early morning liver glucose dump?

I have two possible strategies, the first being to continue skipping breakfast and allow my blood glucose to ride at 6.5 until lunch or the second being to eat something first thing that might initially raise my blood glucose to 7 but then lower to 5 earlier in the day.

If the important number is the amount of time in around the 5s, does anyone have an argument against the second strategy? i.e. is it worth temporarily deliberately raising blood glucose to post-pandrial levels in order to have a few more hours sitting at a lower number?

Thanks.

I’ve been eating a healthy breakfast and lunch skipping dinner or just having something super light. I figure I’m not active after dinner so I don’t need the fuel... more of my experiments lol

 

[Member496333]

Eat when you're hungry. Not before and not after. Don't let elevated fasting glucose troll you into eating if you don't want to or otherwise don't need to. Your body is trying to purge stored energy. Keep calm and carry on.

Only in my humble opinion of course.

 

[Lamont D]

Hi, I haven't eaten breakfast since March, and before that only a small bite size meal to go to work.
I agree with @Jim Lahey, you don't need to stick to the regimental breakfast, lunch, dinner, supper and all the snacks in between!!!!!
You don't need to if you are not hungry!
You have done well getting to where you are now!
Eat to your meter and don't worry too much about having small spikes postprandial.
Most of the time, a fasting test is not worth doing, it is more important to test around meals.
Keep safe

 

[ianf0ster]

I agree with @Jim Lahey . I'd add that even though I don't normally eat breakfast if I noticed that my BG first thing was over 8.0, I might have some double cream or some cheese or a boiled egg since I have previously found that those things lower my BG when it was high due to Dawn Phenomenon.

 

[LaoDan]

I think my DP is exasperated by high cortisol levels. I’ve noticed a pattern some mornings I.e Monday’s or days I have conference calls, my morning BG gets higher. If I’m up at the crack of dawn, eat breakfast, then hit the gym, BG is great until the next morning. I eat big lunch to refuel. Now that I’m on this cycle, I’m usually very hungry when I wake. I feel much more energetic. A1c is from 5.2% to 5.1%, which is basically no change. I eat more and I’m still dropping weight, so the trajectory is on target.

 

[Resurgam]

My BG was continuing to rise when I ate at midday and again in the evening. When I swapped to morning and evening meals, with 1/4 of my carb intake in the morning and the rest later, I was back to normal in a couple of months.

 

[ExiledJack]

Thanks all. Does anyone know WHY my blood sugar rises fasted in the morning? Liver pushing glucose out and no insulin response?

Today for example 5.2 upon waking, went for a walk, drank water, 2 hours later im 6.7. After lunch I’ll barely go above 5.8 for the rest of the day. Dinner never spikes me above 6 either despite it having the highest carb count.

 

[Dr Snoddy]

Thanks all. Does anyone know WHY my blood sugar rises fasted in the morning? Liver pushing glucose out and no insulin response?

Today for example 5.2 upon waking, went for a walk, drank water, 2 hours later im 6.7. After lunch I’ll barely go above 5.8 for the rest of the day. Dinner never spikes me above 6 either despite it having the highest carb count.

It could be that after the long overnight time without food your blood glucose levels decrease substantially which then kicks off a mild glucagon response which would release glucose from glycogen stores in the liver and muscle. This hormone is also produced in the pancreas along with insulin and its role is to increase blood glucose levels when they fall too low. There is usually an overshoot effect for both insulin and glucagon.

 

[Brunneria]

Insulin resistance can vary quite significantly during the day, depending on all sorts of things - morning cortisol rise can be a biggie, lack of activity overnight, compared with increased activity during the day, sleep interruption, and a few others.

It isn't always as simple as glycogen stores, and it isn't always just about the liver, either. Glycogen is stored in the big muscles of the arms and legs as well as the liver.

It took around 2 years of keto carnivore for my morning bgs to only rise about 2mmol/l. A lot less about glycogen stores and a lot more about hormone dysregulation, in my case, since my morning stress hormones are a bit wangy.

 

[Member496333]

To my knowledge muscle glycogen is used exclusively by the muscles and isn't converted back to glucose for general circulation in the bloodstream. Liver glycogen is one thing, but even if its stores were empty then it would just make glucose by deconstructing protein or fat. Dawn phenomenon is normal but it tends to run out of control when the liver is inulin resistant and doesn't stop releasing glucose in the presence of insulin.

 

[Brunneria]

To my knowledge muscle glycogen is used exclusively by the muscles and isn't converted back to glucose for general circulation in the bloodstream. Liver glycogen is one thing, but even if its stores were empty then it would just make glucose by deconstructing protein or fat. Dawn phenomenon is normal but it tends to run out of control when the liver is inulin resistant and doesn't stop releasing glucose in the presence of insulin.

That is interesting info about the muscle glycogen. Could you post a link to that info, because I would be interested to read it. Thanks in advance.