Pancreas is a lunatic?!

[elaine77]

Hi everyone,

I'm super confused over what is going on at the moment! First of all, I still don't know what type diabetic I am other than type 1.5 for now but I'm having major issues with dawn phenomenon/somogyi effect! My fasting BG has always been the one I can't control and recently it's getting worse not better despite all other times of the day being fine/much better. I used to always be between 7 and 8 mmol in the morning but the last three days it's been 8.1, 8.4, 8.4 and it's really starting to get to me!

I did some research and basically all that I could find was that DP is when I'm too high before bed and Somogyi is when I go too low through the night.... Both of these things are remedied by doing the exact opposite so how do I know what to do? I usually go to bed on BG level of 5 - 6 mmol every night and through the day I am always 4.5 - 7 mmol. I don't understand how my post prandial levels can be absolutely fine and controllable but this morning one getting worse? None of the others are getting worse? I also read that Metformin helps with this but i take Metformin and it isnt helping with that! In the morning i have to eat something to get this level down, i usually have weetabix or cheerios but then, 2 hours later i end up quite low (about 4.3 ish ) which is also baffling? If anyone has any idea why this could be I would really appreciate your help

Also....I ate a piece of pizza the other night (I don't eat pizza usually for obvious reasons) and I decided to test 1 hour after I ate it to see what effect it had on my BG and to my utter shock my BG was 5.8 mmol just 1 hour after eating it? I think my pancreas is a lunatic!


Diagnosed with GD in 2010, Completely disappeared postpartum. Re-diagnosed December 2012 with type 1.5 diabetes, age 26, BMI 23 currently controlled by only Metformin, 500mg twice a day.

 

[hale710]

Hi everyone,

I'm super confused over what is going on at the moment! First of all, I still don't know what type diabetic I am other than type 1.5 for now but I'm having major issues with dawn phenomenon/somogyi effect! My fasting BG has always been the one I can't control and recently it's getting worse not better despite all other times of the day being fine/much better. I used to always be between 7 and 8 mmol in the morning but the last three days it's been 8.1, 8.4, 8.4 and it's really starting to get to me!

I did some research and basically all that I could find was that DP is when I'm too high before bed and Somogyi is when I go too low through the night.... Both of these things are remedied by doing the exact opposite so how do I know what to do? I usually go to bed on BG level of 5 - 6 mmol every night and through the day I am always 4.5 - 7 mmol. I don't understand how my post prandial levels can be absolutely fine and controllable but this morning one getting worse? None of the others are getting worse? I also read that Metformin helps with this but i take Metformin and it isnt helping with that! In the morning i have to eat something to get this level down, i usually have weetabix or cheerios but then, 2 hours later i end up quite low (about 4.3 ish ) which is also baffling? If anyone has any idea why this could be I would really appreciate your help

Also....I ate a piece of pizza the other night (I don't eat pizza usually for obvious reasons) and I decided to test 1 hour after I ate it to see what effect it had on my BG and to my utter shock my BG was 5.8 mmol just 1 hour after eating it? I think my pancreas is a lunatic!


Diagnosed with GD in 2010, Completely disappeared postpartum. Re-diagnosed December 2012 with type 1.5 diabetes, age 26, BMI 23 currently controlled by only Metformin, 500mg twice a day.

Ok so I don't really understand type 1.5, so this is my TYPE 1 perspective!!!

I never go to bed below 8. If I'm below it I eat something around 10g before bed - DSNs orders! Since starting that I e found my morning readings stopped being high. Maybe it's because my body has something to digest (I usually opt for a small toasted scotch pancake at 14g carb) and release glucose and do doesn't feel the need to have a liver dump. But could also be because I get up at 5.30am..... I don't eat breakfast until 7am though and it's never a problem!

On the pizza, I think we discussed the honeymoon period the other day? So it could be that. (I'm currently still living almost insulin free) But also pizza has cheese and oil, both of which slow digestion. So always wait 2 hours for testing ( unless you feel low) because 1 hour you are usually still digesting the food.

Hope somewhere in that ramble there is something that helps!

 

[elaine77]

Thanks hale, I usually test 2 hours after meals I just did it one hour after with it being something I don't usually eat! So if I'm going to bed on a 5 - 6 mmol it could be that I'm going low through the night then and being topped up? I struggle to eat so close to bed time but I have done it once or twice before and it didnt work but il try different things. It's just frustrating that its the only level getting worse and the only level I can't control! You would think food would be the problem for BG levels, not just going to sleep lol

The thing I don't understand is... How am I going low through the night when I don't take insulin? I also dont take medication that makes me produce more insulin? Metformin doesn't cause hypos apparently? Unless its just a timescale thing...no food for a good few hours? Still...I didn't think u could go that low just on Metformin...


Diagnosed with GD in 2010, Completely disappeared postpartum. Re-diagnosed December 2012 with type 1.5 diabetes, age 26, BMI 23 currently controlled by only Metformin, 500mg twice a day.

 

[fit2drop]

Hi Elaine,

I'm very new to all this too.
I can relate to what you are saying as my BS's are highest in the morning, well until the past 4 days when I have been down in the low 5's. Oh Yea 8)

Each night about nine I have been having a curry, with fish & tomato base + spices double onions and garlic, beans, peppers and any other veg that's about. . (I did take 2 raw cloves before bed which helped but no one else in the family was to happy with that stink so I stopped) After I have either green tea or curry tea, yea curry tea, made from curry leafs and brewed for about a hour, tastes light and fresh not like you would think.

Each morning has been getting better I just hope it keeps up.

If you don't like curry,,,I cant help.

Oh one other thing; frame of mind, I decided this Friday to chill, not get anxious about my reading when I got up, tried to turn off the stress of things before bed and made sure I was happy when I woke up. It's all mind over matter.

My train of thought is that: With the people here your not alone, your not isolated or the only one with this problem, it is really old news and were are bit late to the show, I'm in it for the ride So I'll enjoy the experience. (I'm still working on the concept really ) Although I will try meditation next week, might help me back if nothing else.

 

[hale710]

No you shouldn't hypo on tablets alone, but your pancreas isn't the only lunatic. I just hypod after a nice big dinner of pasta bake and root veg. It was a carb heaven. And I haven't done a single unit of insulin in days. Makes no sense!

So if all else, at least you're not alone!

 

[elaine77]

Ok so I had a snack before bed and made my BG 7.3 before bed.....woke up this morning on 8.1 mmol! Back to the drawing board then :-(


Diagnosed with GD in 2010, Completely disappeared postpartum. Re-diagnosed December 2012 with type 1.5 diabetes, age 26, BMI 23 currently controlled by only Metformin, 500mg twice a day.

 

[blackcat79]

I wish i could get them readings :-( b4 before bed mainly 11-13 and on waking 10-12 but 2day 13.5 but restless night more than normal due to the bad wind n rain outside. Im type 2 on 3 different pills
Sick of feeling rubbish all day n i hate mornings i feel hangover from hell
Sue

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[hale710]

Ok so I had a snack before bed and made my BG 7.3 before bed.....woke up this morning on 8.1 mmol! Back to the drawing board then :-(


Diagnosed with GD in 2010, Completely disappeared postpartum. Re-diagnosed December 2012 with type 1.5 diabetes, age 26, BMI 23 currently controlled by only Metformin, 500mg twice a day.

That's only an increase of 0.8 - that's not bad really! As your not insulin dependant maybe only have a snack if you're under 6.5? Not sure if that will make a difference

 

[hale710]

I wish i could get them readings :-( b4 before bed mainly 11-13 and on waking 10-12 but 2day 13.5 but restless night more than normal due to the bad wind n rain outside. Im type 2 on 3 different pills
Sick of feeling rubbish all day n i hate mornings i feel hangover from hell
Sue

Sent from the Diabetes Forum App

To get your morning readings down you need to first control your pre bed readings. I'm a T1 though so have no advice on that do you low carb at all? If not, maybe try having low carb for tea? I know many people (non diabetics) who won't eat carbs after 3pm as it aids weight loss. They'll happily have a pasta lunch but wouldn't touch it for dinner. I'm not sure on the science behind it though!

 

[blackcat79]

Yes i low carb 130g a day if that as i dont eat lunch due to work shift. If i dont eat BS goes up. I have tried everything but lowst ive got b4 bed is 8 but morning alway higher. Test at 3am n its never below 8 so dont go low. Who nos my DN wants to try victoza injections soon as cant stomach yet more pills but they dont want me to have insulin as overweight as they say
Thanks tho for advice. Guess ill get there one day.
Sue

Sent from the Diabetes Forum App

 

[hale710]

Yes i low carb 130g a day if that as i dont eat lunch due to work shift. If i dont eat BS goes up. I have tried everything but lowst ive got b4 bed is 8 but morning alway higher. Test at 3am n its never below 8 so dont go low. Who nos my DN wants to try victoza injections soon as cant stomach yet more pills but they dont want me to have insulin as overweight as they say
Thanks tho for advice. Guess ill get there one day.
Sue

Sent from the Diabetes Forum App

This is where I get confused. I dont consider myself to low carb. I haven't changed my eating at all since diagnosis. But on an average day I eat 100-120g carb. Around 40g breakfast, 30g lunch and 40g dinner. I thought low carbing would be much less than that!

 

[phoenix]

I would think it's far more likely to be DP than Somogyi.

You'll read about it in lots of places and lots of people, yet many doctors don't think it actually exists or if it does, then it must be much rarer than you read about.
Since they have been able to monitor overnight levels with continuous monitoring no studies that I know of have been able to demonstrate it.
They have found that Lots of T1s have undetected hypos at night (caused by too much injected insulin) but they are associated with low not high glucose in the morning.

Do high fasting glucose levels suggest nocturnal hypoglycaemia? The Somogyi effect—more fiction than fact?
http://onlinelibrary.wiley.com/doi/10.1 ... 5/abstract
Nocturnal hypoglycaemias in type 1 diabetic patients: what can we learn with continuous glucose monitoring
http://www.ncbi.nlm.nih.gov/pubmed/1765 ... t=Abstract
(there are a couple of other similar studies with similar findings)

From continuous monitoring I know that I follow the pattern described in the studies. if I go to bed too low or with too much insulin still working then I may have a hypo in the night . My liver very quickly compensates to normal but not high levels. I may wake after the hypo and realise that I have had one but my levels won't be hypo by then. In the morning I will wake with perfect glucose levels.
(of course overnight hypos, though common are potentially dangerous the problem occasionally arises that the liver is unable to compensate; maybe because the signals don't work properly, the glycogen stores are empty or the liver is busy dealing with alcohol . That's why doctors are insistent that people on insulin aim for safe levels overnight)

For me the level of exercise in the day (period) before is the most crucial factor in what happens to my glucose over night.

I can't really give you any advice as to what to do in your circumstances since I take insulin. However, I am very certain that I have better morning levels when I am exercising regularly. Just a day or two off and the difference in morning levels is noticeable.

 

[elaine77]

Thanks Phoenix,

Since my bedtime levels are usually between 5 and 6 mmol and my mornings ridiculous no matter what I eat or when think I Mite try exercising before bed, see if that works! I guessing should also maybe set my alarm to wake me up at 3am or something too and test, see what happens in middle of the night.. If I'm really low then I think somogyi must exist and liver dumping taking place but as I said before...not meant to go low when just on Metformin...apparently.

And same here hale... I haven't went terribly low carb since diagnosis...I've basically changed all carbs to low GI and reduced portion size.


Diagnosed with GD in 2010, Completely disappeared postpartum. Re-diagnosed December 2012 with type 1.5 diabetes, age 26, BMI 23 currently controlled by only Metformin, 500mg twice a day.

 

[hale710]

I havent even reduced portion size. I hadn't realised my portions are so small but apparently they are!

 

[phoenix]

I don't exercise before bed! Earlier in the day seems to work fine.

 

[elaine77]

Ok, so I went to bed on 6 mmol.... Tested at 3am and was 6.8 mmol.... Tested at 8am and was 7.6 mmol! Don't understand? Why would it randomly but gradually go up like that??


Diagnosed with GD in 2010, Completely disappeared postpartum. Re-diagnosed December 2012 with type 1.5 diabetes, age 26, BMI 23 currently controlled by only Metformin, 500mg twice a day.

 

[hale710]

Ok, so I went to bed on 6 mmol.... Tested at 3am and was 6.8 mmol.... Tested at 8am and was 7.6 mmol! Don't understand? Why would it randomly but gradually go up like that??


Diagnosed with GD in 2010, Completely disappeared postpartum. Re-diagnosed December 2012 with type 1.5 diabetes, age 26, BMI 23 currently controlled by only Metformin, 500mg twice a day.

What did you eat for dinner and at what time? And what time did you go to bed?

 

[elaine77]

I had pork with veggies at about 8pm (finished eating 8pm not started eating) went to bed about 11pm


Diagnosed with GD in 2010, Completely disappeared postpartum. Re-diagnosed December 2012 with type 1.5 diabetes, age 26, BMI 23 currently controlled by only Metformin, 500mg twice a day.

 

[hale710]

I had pork with veggies at about 8pm (finished eating 8pm not started eating) went to bed about 11pm


Diagnosed with GD in 2010, Completely disappeared postpartum. Re-diagnosed December 2012 with type 1.5 diabetes, age 26, BMI 23 currently controlled by only Metformin, 500mg twice a day.

In that case I have no idea! I was hoping you'd say something high in fat which would have delayed digestion but nope I've got nothing lol

 

[Sid Bonkers]

Hi Elaine a small increase in bg levels in the morning is quite normal and the level you describe dont appear to be horrendously high.

Every morning an hour or so before we wake our adrenal glands secrete cortisone and other hormone to get us ready to wake up, it helps get us going in the morning, cortisone causes a release of glucose again to get us going first thing in the morning, this is quite normal and happens to everyone, diabetic or not.

The dawn phenomenon is just this but some apparently experience greater increases than the norm, but I wouldnt have thought a raise of 1.5 mmol/L was extraordinarily high.

If you are T1.5 then you may be in your honeymoon phase and is it not normal in this phase to experience some unusual quirks in control due to this?

As aT2 myself I obviously dont have any knowledge of honeymoon periods so I may be well off the mark here but thought Id mention it as 6's and 7's are not really that high for fasting readings especially in the early days.