BM's are confusing.

jay10

Member
Messages
19
My BM was 5.7mmol last evening and then I had nothing more to eat, this morning pre it was 6.8mmol, I don't take any medication and am following a low carb diet.......I dont understand how my bm could raise over night :? ????????? I have read on here about the dawn phenomenon, but does that not apply to insulin users?
Sorry if this seems a stupid question but I want to control my diabetes not it controlling my life.
 

cugila

Master
Messages
10,272
Dislikes
People who are touchy.......feign indignation at the slightest thing. Hypocrites, bullies and cowards.
If you already know about the Dawn Phenomenon then you should know that it applies to anybody.....Diabetic or not, Insulin user or not. We all have varying degrees of it at times.

DAWN PHENOMENON
Everyone, diabetic or not, exhibits some Dawn Phenomenon. It is a natural part of our bodies' circadian rhythms. Some have said it is the way our ancestors had the strength to rise and slay a wooly behemoth for breakfast.

Since most of us fast while sleeping, with teenagers a possible exception, our bodies use stored energy during sleep. The body uses all three macro-nutrients (carbohydrates, proteins, and fats) to store energy.

The most easily used is the storage medium of carbohydrates, called glycogen. Glycogen is made from glucose, and is stored in the liver and muscles. Since it is basically nothing more than a complex matrix of glucose, it is easy for the body to store and use, something the body does all day long. The technical term for the act of creating and storing glycogen is glycogenesis. When the body calls for the conversion of glycogen back to glucose it is called glycogenolysis.

Another macro-nutrient that is available to be converted to glucose is protein. Most of us think of our protein as being stored in muscle, but the body has protective mechanisms to make muscle wasting its last choice. One of the most useful and readily available sources of protein storage is in blood components, i.e., albumin (plasma). The body uses a process performed in the liver to convert amino acids, the building blocks of proteins, into glucose. The name for this process is gluconeogenesis, literally "the creation of new glucose".

So, what does all this have to do with a high fasting BG? Overnight, usually between 4am and 11am, your body releases some hormones. These are Growth Hormone (GH) from the anterior pituitary gland, cortisol from the adrenal cortex, glucagon from your pancreatic alpha-cells, and epinephrine (adrenalin). These hormones cause an increase in insulin resistance, raising your BG. In addition, these hormones trigger glycogenolysis and gluconeogenesis, adding stored or new glucose to your bloodstream.

Ken
 

theblokefromstoke

Well-Known Member
Messages
177
Dislikes
Pizza (makes my BG go through the roof), Pasta & potatoes.
Interesting post Ken, thanks for that.

If the body has an increased insulin resistance during the early hours, i'm wondering if this is in fact the best time to take metformin?

I am on 2 per day and have been taking at lunch and tea time with meals. I am now wondering whether to take 1 at breakfast as this maybe when my body needs it most.

The reason i have been taking them later in the day is that my previous single wheatabix was sending my BG high so I now have a couple of boiled eggs for breakfast and a slice of ham. They are ever so filling and low carb. I shifted the metformin to lunch as this is my big carb intake at about 25grams.

I was concerned that taking the metformin without any sustantial carb intake may induce a hypo.

I am finding that a cup of tea in the moring with skimmed milk can raise my BG by 2 or 3

I will trial it for a bit and see how it goes

Carl
 

jay10

Member
Messages
19
Thankyou Ken for the clarification. My fasting BG is a little on the high end of the range shown in the nice guidelines (it was 6.8mmol this am) should I try to get it down further or is this ok, last night I did not do my BG but felt very lethargic (this has previously been an indication that my BG is a little low) had not eaten for around 6 hours so had a snack before bed.
I GP is only allowing me 2 strips a a day :x very frustating................. I am waiting for a reply from my PCT on this. Hence I am being little tight with my trips.

thx Jay
 

cugila

Master
Messages
10,272
Dislikes
People who are touchy.......feign indignation at the slightest thing. Hypocrites, bullies and cowards.
Carl.
Metformin typically only lowers Bg levels by around 1 - 2 mmol/l and that is when you are taking the max dose. You shouldn't really be too worried about hypos' unless you are consistently running very low levels....4+. 4 being the floor !

When you are only taking it twice daily it is usual that you take it am and pm so that ties in with the breakfast and main meal timing. What instructions were you given as to when to take it ? Dosage really should only be adjusted after discussing it with your HCP, however I pretty much have the OK from mine to do what I need to at the moment. My levels are still variable even though Cancer treatment is now finished. I have had to lower my Byetta dose because I am over medicated, so I am still trying different things to keep good control. I was previously off oral meds altogether but needs must..... :(

I have experimented with Met at various times most recently during my Cancer treatment when levels were all over the place. I found that the best way was to check my Bg level on waking, if it was say 5 -7 then I would take the Met at breakfast time as it would then help lower the levels even though my breakfast was usually lowish carbs. My meals have to have a certain amount of carbs as I take Byetta twice daily which means if carb levels are too low then I will hypo. Byetta needs something to get it's teeth into. I have taken Met at other times of the day but for me am is the best time. Remember though that Met should be taken with or after meals, helps keep side effects down. See how you get on and let us know.

Jay
I sympathise with your lack of help from the GP regarding strips....an ongoing problem many seem to have. I am fortunate that my GP lets me have as many as I need. That could change when he goes I suppose. I have already had a 'run in' with a new GP who thought he could stop my strips......he knows now that I don't accept that and he as well 'happily' prescribes what I need. :twisted:
Amazing what some 'gentle persuasion' will do ! :wink:

I personally wouldn't be too bothered if the level am was towards the higher end. I am more concerned with what it is 2 hrs after my meals. If they are in target then that suits me. Whatever levels you feel comfortable with is the best for you. I avoid the low levels because I take a hypo inducing drug, Byetta so having suffered many over the last few months I tend to prefer fasting(waking) levels to be between 5 - 7 mmol/l. sets me up for the day and my meds take care of the carbs. It works very successfully for me, but as we say frequently here......we are all different. There are those who go much lower, I can't.....I feel absolutely dreadful if my levels drop to anything around 4.5 mmol/l. I get hypo symptoms which are not good for me. At least I am still hypo aware though. There are others who feel nothing at those levels. Not my way though.

Ken
 

jay10

Member
Messages
19
Thanx ken for the info .................,I think this site may be my salvation (well for diabetes anyway :lol: )
Jay