Morning/Evening testing times?

Beating-My-Betes

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Interested to find out from those who've been testing evening and morning numbers, which hours seem to avoid confounding factors. I'm aware that in testing (When I do) between 9 and 11 am, that I might not be getting very accurate numbers.

Morning, I'm guessing is somewhat tied to the release of cortisol and all the other chemicals that prime us to wake up and start the day. So, between 04:30 and 6:00 perhaps? Evening. I'm not so sure about. Is it related to last food eaten or is it nothing more than just before 'lights out', whenever that might be?

Thanks!
 

bulkbiker

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which hours seem to avoid confounding factors.
What do you mean by "confounding factors"?
Most regular testers test when they get up, before and then 2 hours after meals. Some even more if they want to see in the early days what happens after 1 or 3 hours too
Dawn phenomenon may have an effect on the FBG but that doesn't make it a worthless reading.
 

Beating-My-Betes

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What do you mean by "confounding factors"?

Thanks!

Well, there are confounding factors regarding accuracy for most of the testing, whether it be quality of sleep (Even over multiple days), levels of activity, hydration, length of time between last meal etc. I'm interested if there are any that are specific to night-time testing.

Most regular testers test when they get up, before and then 2 hours after meals. Some even more if they want to see in the early days what happens after 1 or 3 hours too

Not currently interested in testing for foods, but perhaps I just don't understand what it is people are particularly looking for when testing before bed. I guess it's an important factor for those with type I, but for everyone else? Is it just a case of having another point of data?

Dawn phenomenon may have an effect on the FBG but that doesn't make it a worthless reading.

Depends on what you mean by worthless. I don't believe it's worthless, as long as the testing is done at the same time, every day. That way trends can be detected. But there is clearly some worth in observing a first, purer (non fasting-liver-dumping) reading, right?
 

bulkbiker

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Well, there are confounding factors regarding accuracy for most of the testing, whether it be quality of sleep (Even over multiple days), levels of activity, hydration, length of time between last meal etc. I'm interested if there are any that are specific to night-time testing.

So your question is really about night time/before bed testing? Not something I have seen people do except as you say T1's who want to ensure they aren't going to be too low overnight.

I'm struggling to see what your actual question is?

I test before bed simply because its the first time I remember after eating my dinner but in my early days I'd test before and after meals because that would give me some more useful information.

Not currently interested in testing for foods
Why not?
It is probably the most useful information that testing shows you.. I mean it may even change your mind about your chosen method..

Have you started anything yet by the way?
 

Beating-My-Betes

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So your question is really about night time/before bed testing? Not something I have seen people do except as you say T1's who want to ensure they aren't going to be too low overnight.

I'm struggling to see what your actual question is?

Then yes...I'm curious about before-bed testing. Yesterday, I read through some of the pages of the morning fbg thread, noticed some before-bed testing and was just curious. That thread didn't seem like the right place to ask

Why not?
It is probably the most useful information that testing shows you.. I mean it may even change your mind about your chosen method.

I don't test for meals because I'm very insulin-resistant. My before meal numbers are high, the rise exponential, and the comedown slower. I've also been sleeping badly for well over a year and like most people took an activity hit during lockdown. There is nothing worth knowing, for me, in all that morass.

I will be using a repeatable 'meal', in lieu of an OGTT, that I can eat on a weekly basis to detect a loose trend in whether my body is responding better to carbs. Other than that I'm preparing to take morning fbg's at an early hour, and average the readings over the week.

As for changing my ideas: Like I said, earlier, my readings would likely be telling me I should be zero-carb. That's wha insulin resistance would have me do, I guess. Still, until i've given a good blemish-free go at improving my insulin sensitivity, I'll keep plodding on.

And this ain't about proving anything to anyone, or being stubborn I have my own reservations about the long-term health prospects of keto, but in terms of what I can quantify vegan keto is not a place I really want to be.

Have you started anything yet by the way?

Anything?
 

Brunneria

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You seem to be saying that you think events like dawn phenomenon, insulin resistance and bad sleep affect the quality of the reading.
I think you are calling them 'confounding factors'.

These factors don't reduce the quality or accuracy of the reading.
The reading is what it is - and what it is varies during the day.

It is very valid to look at readings at different times and work out what causes the variation - food, sleep/rest, sleep deprivation, insulin resistance, exercise, food and drink choices, dawn phenomenon... the list is pretty long. But they are all valid readings. Even the ones that are a bit high or low due to meter inaccuracies teach us something.

In your situation I would be taking all the readings, adding them to an app, a graph or a spread sheet, and looking for consistent patterns.

With regard to DP, it is v useful to know if it is true DP (hormones as the body gets ready to get up) or Foot On Floor Syndrome (surge as you get out of bed), because you can handle both differently.
Also, does the pattern change depending on food choices the night before, alcohol, time of evening meal, late night snacks...

These things can be soooooo informative and really help to get your head around.

Years ago, I did a few self-experiments with my DP. Fascinating stuff. Turned out it was Foot on Floor, not DP. Totally unaffected by food choice and timing the night before (unlike some ppl), and I was extremely carb sensitive in the mornings, but that a single mouthful of protein/fat (I chose either a baby bel, half a dozen cashews or a single Brazil nut) would stop the FoF immediately. Brilliantly useful. It meant that I can now keep my bgs lower for most of the morning, on the days I remember to eat the cashews, or nibble an oz of cheese.

Another excellent reason for tracking fasting readings is because they are an interesting window in metabolic health.
Many low carbers here on the forum find that a raised DP is the last thing to improve after they have lowered carbs, lost weight and made a few lifestyle changes. So it can be a sign that all the good work is paying off as the body settles in to its new 'normal'.

Hope that helps.
 

KK123

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All I know is that any testing outside of mealtimes (and the first one of the day) is absolutely useless to me as it tells me nothing at all. It is different every time so no discernible pattern, nothing to suggest why it may have gone up or down a mmol or two, it just sits there being boring. I guess that's a good thing but unless there is a sky high jump or a hypo coming my way there doesn't seem to be much point. Everybody's levels fluctuate during the day, diabetes or not. I think if I didn't use insulin (and was happy my food was keeping me in range by testing at mealtimes) I wouldn't bother at all.
 
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Tophat1900

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Testing pre and post meals is very important info. This helps show what is happening based on what you are eating. If you are insulin resistant, I can't understand why you wouldn't perform these tests. Being the goal is to reduce insulin resistance, without that data you have no idea if you are achieving anything or creating further resistance. Testing just in the morning and just before bed leaves out so much info. Regardless of what readings you are seeing, they are what they are and you just have to accept them. If you're not too happy with them, then you may find you are not going to be happy with what you see during the day, but if you don't test during the day then?

It's a bit like sitting down to watch a movie and just watching the start and then skipping to the end. This just seems like a very flawed strategy. And worth rethinking imo.
 

Beating-My-Betes

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You seem to be saying that you think events like dawn phenomenon, insulin resistance and bad sleep affect the quality of the reading.
I think you are calling them 'confounding factors'.

These factors don't reduce the quality or accuracy of the reading.
The reading is what it is - and what it is varies during the day.

It is very valid to look at readings at different times and work out what causes the variation - food, sleep/rest, sleep deprivation, insulin resistance, exercise, food and drink choices, dawn phenomenon... the list is pretty long. But they are all valid readings. Even the ones that are a bit high or low due to meter inaccuracies teach us something.

In your situation I would be taking all the readings, adding them to an app, a graph or a spread sheet, and looking for consistent patterns.

The problem is that there is no way to distinguish which of all the lifestyle factors is operating on or influencing a particular result, and at which time. Our systems are not linear in that way. A lot of these factors can accumulate and act in symphony. And I'm not interested in chasing my tail trying to work out something for which there is no definitive answer.

But 'm not saying there is no value in numbers. I am interested in trends. So, it's ok to forget the idea of DP and test at 11 am, as long as I test at 11 am everyday. But it's one thing to test for trends, but i'd still like to see where my lowest point in the day is. A reading of 9 @ 11am is not good, but what if it was actually 6.5 @ 5:30 am? I know I'm not the only one who wants to see that lower point, as a frame-of-reference, even if that's all it is.

With regard to DP, it is v useful to know if it is true DP (hormones as the body gets ready to get up) or Foot On Floor Syndrome (surge as you get out of bed), because you can handle both differently.
Also, does the pattern change depending on food choices the night before, alcohol, time of evening meal, late night snacks...

These things can be soooooo informative and really help to get your head around.

Years ago, I did a few self-experiments with my DP. Fascinating stuff. Turned out it was Foot on Floor, not DP. Totally unaffected by food choice and timing the night before (unlike some ppl), and I was extremely carb sensitive in the mornings, but that a single mouthful of protein/fat (I chose either a baby bel, half a dozen cashews or a single Brazil nut) would stop the FoF immediately. Brilliantly useful. It meant that I can now keep my bgs lower for most of the morning, on the days I remember to eat the cashews, or nibble an oz of cheese.

Well, I've slept on the floor for the last six years, so my feet are always on the floor. I also don't really sit in chairs, so again...feet on the floor :)

I do get what you mean, of course. By the time I test, I've usually been lying in bed for a while, watching Youtube, then I get up and do the ablution stuff (I have cold showers, also, so that might have an impact). So by the time I get to test, I've already used quite a lot of physical and mental energy, necessitating (In my carb-fed state) more sugar.

Also, to make it clear, I'm not trying to avoid the rise. What I'm trying to avoid is it rising so high that by the time I want to eat Im already in the danger-zone. So rather than looking to blunt the DP with fat or protein i want to eat breakfast. That way, I get to eat breakfast instead of the liver indiscriminately dumping.

Another excellent reason for tracking fasting readings is because they are an interesting window in metabolic health.
Many low carbers here on the forum find that a raised DP is the last thing to improve after they have lowered carbs, lost weight and made a few lifestyle changes. So it can be a sign that all the good work is paying off as the body settles in to its new 'normal'.

I'm not against morning testing, hence the thread. I just noticed in the other thread that some members were posting very early readings, then seeing rises already when testing an hour or so later.
My plan (Hopefully I can shift my body clock around) is to have all my testing gear right by my 'bed'. If I keep a little bowl of water next to it all, I should be able to clean a testing spot and do so, the minute I open my eyes...which I hope to be around the 5am mark.

Hope that helps.

Thanks :)

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EDITED: For bad quote formatting
 
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Beating-My-Betes

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Juice fasting, vegan eating.. you keep saying you are going to try various therapies but then never seem to?

The juice-fasting is something that'll probably have to wait until at least my marathon thing is over, and depending on what challenge I set up to follow it. I have a large amount of maple syrup which I bought at the start of the pandemic, to use for aMaster Cleanse/juice fast, and i don't want to have it in storage for another hot Summer. So, sometime in the next few months, f'sure.

I've been vegan for two years, but unfortunately my use of food as my only vice left has meant eating too much vegan junk food. I did actually do quite well for a two-week period in January. I was weighing and logging food everyday, managing to cut my fbg from 18.5 to 8. Unfortunately, I fell off the wagon, and things got out of hand again.

I've started back on a much better path, today, and thought I'd get an idea about testing

And you're right zero carb would be of major benefit for reduction of insulin resistance whatever Cyrus may say.

It's impossible to do zero-carb vegan, even if I had any interest in it.

And I'm not beholden to what Dr. Cyrus or any other doctor says, vegan or otherwise. I've been around this diet-sphere for around 18 years, and have seen a lot of nonsense spread, and it's only getting worse. I'm interested in results and getting to the truth, no matter if I have to completely drop everything I once held to be true.

I've seen many people over the years, on many now-defunct forums and ning communities, use plant-based and raw-vegan diets to help cure all manner of ills, including diabetes. I actually was even communicating with Robby Barbaro over a decade ago, when he was just this crazy kid documenting a year's worth of fruit meals and showing health and insulin improvements.

My philosophy on health and healing is such that makes it easy to understand why people experience healing on all manner of protocols, zero-carb included. Doesn't mean I'll ever try it.
 

Beating-My-Betes

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If you are insulin resistant, I can't understand why you wouldn't perform these tests[...]Without that data you have no idea if you are achieving anything or creating further resistance.

Because the numbers will tell me what I already know, but with varying levels of inaccuracy.

Think about an OGTT. I think I'm correct in my understanding that the instructions to go back to eating a higher level of carbs for a couple of days preceding the test are to stop errors brought on by physiological insulin resistance. The idea being that having insulin resistance will be a major confounding factor in the accurate testing of glucose-tolerance.

If I am already high before a meal, then experience an exponential rise, and a long fallout/drop-down, I'm not getting any accuracy.

From what I remember, BulkBiker's 'remission' OGTT produced a high peak of about 4mmol, or thereabouts. So, give or take, 75g of glucose would expectedly result in that rise. When I took a home-made OGTT, back in January, I started at 14 and peaked off-the-meter i.e over 30. That's an exponential rise of four times the expected peak. So if my insulin resistance is causing me to spike so exponentially, how does that give me any useful information about the food, that it would be useful to test?

My answer to this is to look to establish trends. And while I have got a ton of glucose powder left, I don't think it's a particularly pleasant experience to keep reading, nor do I think with my IR that it's a great idea. Instead, I will be using a food that I think is pretty consistent (I have chosen raisins) to test on a weekly basis. At the same hour and on the same day, I'll eat a yet-to-be decided quantity of raisins and then measure before, and at every 30 minutes after.

That is how I plan on measuring if my insulin is becoming more sensitive.
 
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Beating-My-Betes

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I think if I didn't use insulin (and was happy my food was keeping me in range by testing at mealtimes) I wouldn't bother at all.

Yup! Not telling others what to do, nor am I making judgments. However, personally, I'm just not interested in capitulating to this illness. I became diabetic as a result of my own choices. It's taken three years to finally get me to the stage where I am happy to make most of the lifestyle changes to either get rid of it or to live in a way where I feel confident that I can pay it very little mind.

Morning testing (In the future, perhaps not every day), along with tri-monthly blood-tests (At such a point as I can do that again) is all the concession I want to be making, once I get the lifestyle (Whichever that is) dialled in.
 

Brunneria

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The problem is that there is no way to distinguish which of all the lifestyle factors is operating on or influencing a particular result, and at which time. Our systems are not linear in that way. A lot of these factors can accumulate and act in symphony. And I'm not interested in chasing my tail trying to work out something for which there is no definitive answer.

But 'm not saying there is no value in numbers. I am interested in trends. So, it's ok to forget the idea of DP and test at 11 am, as long as I test at 11 am everyday. But it's one thing to test for trends, but i'd still like to see where my lowest point in the day is. A reading of 9 @ 11am is not good, but what if it was actually 6.5 @ 5:30 am? I know I'm not the only one who wants to see that lower point, as a frame-of-reference, even if that's all it is.



Well, I've slept on the floor for the last six years, so my feet are always on the floor. I also don't really sit in chairs, so again...feet on the floor :)

I do get what you mean, of course. By the time I test, I've usually been lying in bed for a while, watching Youtube, then I get up and do the ablution stuff (I have cold showers, also, so that might have an impact). So by the time I get to test, I've already used quite a lot of physical and mental energy, necessitating (In my carb-fed state) more sugar.

Also, to make it clear, I'm not trying to avoid the rise. What I'm trying to avoid is it rising so high that by the time I want to eat Im already in the danger-zone. So rather than looking to blunt the DP with fat or protein i want to eat breakfast. That way, I get to eat breakfast instead of the liver indiscriminately dumping.



I'm not against morning testing, hence the thread. I just noticed in the other thread that some members were posting very early readings, then seeing rises already when testing an hour or so later.
My plan (Hopefully I can shift my body clock around) is to have all my testing gear right by my 'bed'. If I keep a little bowl of water next to it all, I should be able to clean a testing spot and do so, the minute I open my eyes...which I hope to be around the 5am mark.



Thanks :)

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EDITED: For bad quote formatting

I know you think you understand what I am getting at, but I still think you are missing the point.
All the various fluctuations in blood glucose are normal. Getting up, washing, etc. etc. It makes absolutely no difference what your lifestyle is, or how low your bed is to the floor. Your normal is different from my normal, and we can each learn tremendously useful things from our own normals and trends.

Of course you can spot trends - if you want to.
Of course you can use blood glucose tests to track your progress - if you want to.

Incidentally, if you are interested in finding the lowest reading of the day, that is usually, for unmedicated T2s, late afternoon until before the evening meal.

In which case, measuring the highest fasting reading (which you seem to trying to avoid) and comparing it with your lowest reading (late afternoon), is another very useful snippet of information, because it gives you a good indication of the extent of your insulin resistance.
You could do it to compare before and afters for one of your juice fasts.
That would be interesting too, wouldn't it? To actually measure if, for you, your insulin resistance reduces.

But remember, if you choose not to test, no one is forcing you to. It is your choice.
It just means that a very useful tool won't be in your diabetes management tool box.
 

bulkbiker

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From what I remember, BulkBiker's 'remission' OGTT produced a high peak of about 4mmol, or thereabouts. So, give or take, 75g of glucose would expectedly result in that rise. When I took a home-made OGTT, back in January, I started at 14 and peaked off-the-meter i.e over 30. That's an exponential rise of four times the expected peak. So if my insulin resistance is causing me to spike so exponentially, how does that give me any useful information about the food, that it would be useful to test?

Not quite ... my home OGTT results were these.
Screenshot 2021-04-19 at 16.04.07.png


I went up by nearly 8 mmol/l this was without the carbing up beforehand of course as I wanted to see what my body did on my keto diet.

I am amazed that you tried an OGTT from a start point of 14 mmol/l that's kind of crazy and possibly quite dangerous.
Have you ever had a c-peptide test to check on your endogenous insulin production?
 
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KK123

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Yup! Not telling others what to do, nor am I making judgments. However, personally, I'm just not interested in capitulating to this illness. I became diabetic as a result of my own choices. It's taken three years to finally get me to the stage where I am happy to make most of the lifestyle changes to either get rid of it or to live in a way where I feel confident that I can pay it very little mind.

Morning testing (In the future, perhaps not every day), along with tri-monthly blood-tests (At such a point as I can do that again) is all the concession I want to be making, once I get the lifestyle (Whichever that is) dialled in.

Hi there, would a libre help you do you think? Mine (outside of insulin quirks) tends to follow the same pattern, ie, at 4pm I am always at my lowest reading of around 4. EVERY day. If it's a day when I exercise I know that the following 24 hours is going to be a day of lower readings, if I eat a carbier meal in the evening, I know I will be back into normal range 2 hours later BUT the following 24 hours will be an mmol or two higher. It really does help to know your general patterns even if you get thrown a curve ball now & then. x
 
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Beating-My-Betes

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I know you think you understand what I am getting at, but I still think you are missing the point.
All the various fluctuations in blood glucose are normal. Getting up, washing, etc. etc. It makes absolutely no difference what your lifestyle is, or how low your bed is to the floor. Your normal is different from my normal, and we can each learn tremendously useful things from our own normals and trends.

Of course you can spot trends - if you want to.
Of course you can use blood glucose tests to track your progress - if you want to.

Incidentally, if you are interested in finding the lowest reading of the day, that is usually, for unmedicated T2s, late afternoon until before the evening meal.

In which case, measuring the highest fasting reading (which you seem to trying to avoid) and comparing it with your lowest reading (late afternoon), is another very useful snippet of information, because it gives you a good indication of the extent of your insulin resistance.
You could do it to compare before and afters for one of your juice fasts.
That would be interesting too, wouldn't it? To actually measure if, for you, your insulin resistance reduces.

But remember, if you choose not to test, no one is forcing you to. It is your choice.
It just means that a very useful tool won't be in your diabetes management tool box.

I don't think I'm misunderstanding you.

I know that numbers fluctuate all day and in response to different activities, or a lack thereof. That's part of the reason i don't want to get lost in all the tracking. And I understand that everybody's normal is different, especially comparing myself to the rest of the forum, given the MO I've chosen is somewhat controversial. But that's why I'm more interested in trends, and not even all of those. Also, the foot-on-the-floor thing was a bit of a joke. I was clear that I understood that you meant getting up and at it.

And I'm not trying to avoid the highest reading. It's just becoming a waste of valuable strips to test so late in the morning, when I know that the numbers will be increasing, as expected. Just the same, I'm not particularly interested in seeing the lowest, at least not for it's own sake. I have been under 7 in afternoon tests before, but i don't put much stock in it as again it's expected (I'm normally quite active during the day).

The reason for me to concentrate on the fbg is because I understood (perhaps, incorrectly) that it was the fbg that was the last thing to fall. I guess I'm perhaps confused about DP.

As for "diabetes management tool box": Again. like I said earlier. I'm trying to avoid having a toolbox and to manage this condition. I will of course have to pay more attention for a while. but if I ever managed to get it all dialled in, I will just rinse and repeat whatever I did to get me to the point of success. The only concession would be a certain amount of morning-testing, the occasional food testing (with foods I've used to establish a trend) and the quarter-yearly blood-test.

Many thanks :)
 

Beating-My-Betes

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Hi there, would a libre help you do you think? Mine (outside of insulin quirks) tends to follow the same pattern, ie, at 4pm I am always at my lowest reading of around 4. EVERY day. If it's a day when I exercise I know that the following 24 hours is going to be a day of lower readings, if I eat a carbier meal in the evening, I know I will be back into normal range 2 hours later BUT the following 24 hours will be an mmol or two higher. It really does help to know your general patterns even if you get thrown a curve ball now & then. x

But you're kinda making my case for me ;) You've demonstrated that for the most part, you've established tight trends, so theoretically if you keep doing what you did to get the readings you got, there should be little concern. If you want to avoid the day-after 2mmol rise, then you know not to have something carby in the evening, If you know and like how exercise affects your readings, then you make sure to exercise regularly :)

Of course, it's completely different for you, being insulin-dependant but you get my point.

At this point, I wouldn't want a CGM if it were gifted to me. It would just be a source of worry for me and ultimately just tell me what I already know i.e I'm really not tolerating eating carbs very well. Where I differ from most on this forum is that I think that there is enough anecdotal evidence to show that it is possible (perhaps not for everyone) to become more able to to deal with carbs by...eating more carbs. If i ever get there, then I'd like to establish a lifestyle system that allows me to all but forget about diabetes.