Fed up with constant high morning levels!

[mehhh2015]

So glad to hear it goes, my morning numbers constantly higher, but hopefully reading these posts it may go down. Ni am experimenting with cinnamon at night as read that helps with bs so thought it could try and help overnight when most needed!! (Needs to be Ceylon, not cassis)

I saw nhs dietician yesterday for first time and one reason she gave for not cutting complex carbs too low was to stop liver doing this....but she also talked me through the plate theory of eating so I guess she's still with traditional nhs dietary advice on carbs et al.

I've cut down my carbs even more and increased slightly the fat plus added 40min walks (all this the last two days) my morning readings so far have been 4.6 and 4.8 (coming down from 5.2-5.9 which was always higher than my evening readings)...

 

[daddys1]

I've just come across this page http://www.diabetesselfmanagement.com/blog/diabetes-metformin-and-your-liver/ which got me wondering if I should change the way I take my metformim. I'm taking 2 with breakfast and 2 with evening meal, but this article suggests taking one 4 times a day is better, taking one at night to help prevent the moring liver dump.

I don't only get the liver dump in the morning, I seem to get it whenever I get huungry so maybe taking them spread throughout the day would be better for me?
What do you think, does anyone else take their metformin this way and does it help?

HI Rowan,
I just take 1 x 1000mg per day supposed to be with my evening meal. which I have been doing for several months. But just finished a 14day experiment where I took the 1 pill at midnight with a tiny amount of food, my normal average fasting was 5.3 based over 70+ tests, on 14 tests I ended up at 5.6 average. I felt the time of day I took it made no difference, and if it did it was upwards.

I would agree however that spreading 4 pills throughout the day seems sensible approach.
Neil

 

[gateian]

Two things I have done to stop morning highs. One is that I used to have quite a lot of protein for dinner. Probably about 7-8 oz of protein. An excess of protein can start to convert to glucose later on and having reduced my evening meals my BS stayed lower during the night. The other thing, is that my Basal insulin dose was not high enough. So while fasting, my BS slowly rose during the night.

Now my Basal is a little high and I need to bring it down a bit as I very often wake up in the morning with a BS lower than 4. I solved that last night by having a handful of nuts before bed. But I don't know if that causes a rise during the night, so may discard that.

 

[rowan]

Thats how I make my hot chocolate at bedtime and so much better than the sugar filled branded rubbish! Hot water and cream so much better than milk! Virtually zero carb

I used to use Cadbury Fair Trade Hot Chocolate Instant until I discovered that made with water it was a whopping 19.5 carbs per serving!

 

[rowan]

Are you taking standard or slow release? both approaches (4 times a day or morning and evening had worked for me) At the moment I take slow release 2 in the morning and 2 in the evenings. But I have done 4 a day before been diabetic.

I'm taking the standard.

 

[rowan]

Hi Rowen,
I am on metformin, 2 twice per day.
I have 2 first thing in the morning and the other at bedtime. I have always taken them like that, my reasoning being I won't forget to take them.
Have only been testing for a week or so, but yes every morning bs is higher than the night before.
.

Until a month ago I was taking two in the morning, one with evening meal and one at bedtime, but doctor changed it to 2 with breakfast (which until last week wasn't until i'd been up for a couple of hours) and 2 with dinner, she said you have to take it with meals otherwise it won't work. Is that wrong? Everything else she told me was!

 

[rowan]

Thank you everyone
So I've decided to cut out one of the gliclazide in the evening (which was only increased last month, just days before I started lo-carbing) and will take 2 metformin in the morning when I'm at my highest, 1 with evening meal and 1 at bedtme, which is what I was doing before. I'll give that a week or two and see how it goes.

I'll tell the doc what I've done when i see her next month, i know that if i speak to her about this now she'll tell me I'm not having enough carbs and to increase them, she didn't like me going on low carb in the first place!

 

[rowan]

I've cut down my carbs even more and increased slightly the fat plus added 40min walks (all this the last two days) my morning readings so far have been 4.6 and 4.8 (coming down from 5.2-5.9 which was always higher than my evening readings)...

That's brilliant! Mine this morning was 15! Was 11.5 at 6am, and 10something at midnight.

 

[rowan]

I wonder if it would help to take my 2 morning metformin really early, say 6am (then go back to sleep!) before numbers start to rise?

 

[jack412]

Thank you everyone
So I've decided to cut out one of the gliclazide in the evening (which was only increased last month, just days before I started lo-carbing) and will take 2 metformin in the morning when I'm at my highest, 1 with evening meal and 1 at bedtme, which is what I was doing before. I'll give that a week or two and see how it goes.

I'll tell the doc what I've done when i see her next month, i know that if i speak to her about this now she'll tell me I'm not having enough carbs and to increase them, she didn't like me going on low carb in the first place!

ask dr..metformin builds up over 3 weeks, I think time of day doesn't mean much, other than spreading normal to reduce gut symptoms

 

[mehhh2015]

I wonder if it would help to take my 2 morning metformin really early, say 6am (then go back to sleep!) before numbers start to rise?

I don't know cause its very odd, I am noticing mines start to rise after 6 am... and then around 8-9 they are always in the 5's, then before lunch, they go down to 4.6 - 4.9.

So over the last two days, my FBG had been 4.6 and 4.8 but after breakfast goes up to 5.2 - 5.1 which I would initially have thought is due to food BUT it is always around that no matter what I eat (within the limits of my VLC)...

My evening readings had gone down this week in comparison to the last couple of weeks, between 4.2 to 4.9. All this after tightening my carbs and starting to follow Dr. Bersnteins guidelines.

Before bed, I have been eating two table spoons of Chia seed pudding, my rationale been... that since its high in fibers, fats and has a little tiny bit of carbs, it would make my blood sugar levels more constant... so far... it all seems to be working.

I added the exercise as well though... brisk walking for 40min (plus the time it takes me to get to the gym as I walk there), I believe that is also creating the impact...

As good old Tesco says: every little helps

 

[rowan]

ask dr..metformin builds up over 3 weeks, I think time of day doesn't mean much, other than spreading normal to reduce gut symptoms

Not sure what you mean by that?
And I've been on metformin for 9 years now

 

[mehhh2015]

I read you have dr. Bersteins book as well... he mentions that resistance training is more effective for us than aerobic training, and that you get improvement on your insulin effectiveness out of it. Since you mentioned that you are not very mobile maybe what the other forum member said about lifting cans and things like that could make a big difference. I am just learning about all this, so I don't know much about it, but I am finding his recommendations very sound.

 

[jack412]

Not sure what you mean by that?
And I've been on metformin for 9 years now

ask your dr, your mileage may vary..
what I mean is I wouldn't worry what time of day I took metformin, I don't think it makes a difference ..other than same day side effects.

 

[Bluetit1802]

Metformin is a cumulative drug. It builds up in the system, so accidentally missing the odd ones won't make any difference, and neither will time of day. They are well known to cause tummy problems in some people (plenty of threads on here about it) although this usually disappears after a few weeks. This is why people are advised to split doses and take them with food to help alleviate the tummy issues.

 

[millysue]

Hi Rowan,
I stroll with our old dog after breakfast, and this is helping my bs come down.
Our dog is almost 12, I am 64 have arthritis, so it's only a stroll, but it is helping me.

Very interested to see how you get on.
My nurse said not to test.

 

[rowan]

ask your dr, your mileage may vary..
what I mean is I wouldn't worry what time of day I took metformin, I don't think it makes a difference ..other than same day side effects.

And "other than spreading normal to reduce gut symptoms" ?
What are the side effects?

 

[msmi1970]

For what its worth, I was on less than 20gm carbs for about 3 months & went on Metformin for about 1 month before my liver listened to reason and stopped dumping inconsiderately..

 

[jack412]

And "other than spreading normal to reduce gut symptoms" ?
What are the side effects?

if you have been on them for years, I guess you don't have any side effects, some people get the shites, indigestion etc and is a good reason to take metformin during a meal

 

[Bebo321]

I'll just chuck in my thoughts here if that's okay,

Exercise will definitely help lower morning BG spikes - probably even more so if you exercise at the end of the day.

As I understand it, Metformin in the body literally takes on the role of the hormone within the liver that triggers it to stop releasing glucose. Therefore taking it earlier in the day might logically seem like a good idea. As @Bluetit1802 points out though the effects are cumulative - not only that, but it would also depend on how quickly metformin acts after ingestion. Something to discuss with the doctor perhaps?

Dawn phenomenon can also be compounded by the Symogyi effect - that is, if your bloods run low in the night your liver is triggered into giving you a dump of glucose which would give you a much higher BG reading come the morning. It might be worth checking this by setting your alarm during the night and making sure you're not suffering from this effect.

One other thread I have followed previously has suggested that having a snack immediately you wake up can suppress the rise in BGs. Cheese straws kept next to the bed seemed to have a very positive effect if snacked on first thing.

Lasttly, Low Carb rocks!