Crash course

[qimqim]

I am Type II, and recently average around 7.5/8.0 in the morning before eating. I decided to have a real go at reducing my diet and increasing exercise and came up with some suprprises which I can't understand. I took three readings yesterday, and three today. For instance:

Yesterday

am 7.9 (breakfast: plain cereals with milk + coffee) short run late morning
before lunch 9.4 (lunch: spaghetti with home-made meat sauce) pm 1 apple. longer run
before dinner 7.0 (dinner: breaded fish, white rice, salad) 90 mins later 2 spoonful cereals w/yoghurt

I woke up at 2 am feeling hungry but managed to get to sleep, eventually.

Today (pretty much same diet and exercise as yesterday, but boiled fish and rice for lunch)

am 8.4 (this was very surprising as I expected a lower reading after smaller meal and more exercse
before lunch 8.8
before dinner 5.5


I wonder why my reading this morning was higher rather than lower. Could it be that when I felt hungry during the night I was actually low on sugar and that the liver started producing glucose to compensate?

qim

 

[totsy]

hya ,
yes you could have had a liver dump in the night, i also find if im busy my bloods can go low upto 48hrs later which could be why u were lower today, if i were u i would buy a collins gem carb counter book to see just what carbs u are eating and this will learn u why you are spiking too,
keep asking the questions

 

[sugarless sue]

Hi Qim,you may be reducing your diet but what you are eating is still high in starchy carbs and these are keeping your blood sugar levels up.
Cereal,spaghetti and rice are all high in carbs.This will explain the higher readings.

 

[qimqim]

Thanks for the reply, but I am unsure about the jargon...

What do you mean by spiking? I want to ensure that I get a low reading in the morning, but if by dieting I end up getting liver dumps,as you call them, then, the whole exercise is counterproductive!

Maybe the answer is to eat something just before going to bed. Yesterday I had dnner at around 19,30; my two spoonfuls of cereals w/yoghurt at 21,00 and did not have breakfast until 8 am today. Possibly, that is too long without eating and the liver produces glucose. Possible?

Incidentally I am on Metformin SR (slow release) and take 1 for breakfast and two for dinner.

Any comments appreciated.

qim

 

[qimqim]

Cereal,spaghetti and rice are all high in carbs.This will explain the higher readings

Yes, but 5.5 is not a high reading. I always had this type of diet and managed in the not too distant past to get morning readings around 6.0.

Besides, if you read advice, they either tell you to diet on carbs; or not to diet on carbs...

qim

 

[hanadr]

qimqim
It dependson who tells you what to diet on. there are loads of bits of misinformation out there.
Is your objective to keep blood glucose under control on minimum medication and to lose weight at the same time?
Despite much of what you will read and hear, even from medically qualified people, A straightforward low cal/ low fat diet won't achieve this for you. You need a serious cut in carbs. this might be just a matter of portion size or as severe as Atkins induction, or anywhere in between which suits you. Try it, perhaps a week at a time, but never lose sight of those blood glucose readings.

 

[qimqim]

Hi. Thanks.

I don't have a weight problem. I am quite fit at 63. maybe I should put things in perspective. My breakfast is 3 spoonfuls od plain porridge otas plus 3 spoonfools of plain barley flakes with some milk on top. Do you consider that to be an exageration of carbs?

What I want is to get early morning readings, similar to the ones I get at the end of the afternoon (see above)

qim

 

[qimqim]

I was hoping for some ideas regarding my original question, but the thread moved onto diet, which is not what intereted me. Let me try again:

Please read the original post and let me know if you have any ideas why my readings are high 4 hours after I take one pill with breakfast; are low 6 hours after lunch when I DO NOT take plls; and are high again when I wake up after taking two pills with dinner.

One unlikely possibility is that the pills have a negative effect; another that the period between dinner, or last food intake, is too long and that I get what you call liver dump.

It does not make sense to me.

Any ideas, please?

qim

 

[cugila]

Perhaps it would help if you clarified when you take the Bg readings and what the numbers are.

The guideline figures for Bg levels are as folows.
Fasting (waking)......................between 4 - 7 mmol/l.
2 hrs after meals.....................no more than 8.5 mmol/l.

You state you are on Metformin SR ? Do you take any other medication which may have an effect on the numbers ? PM me if you want the information to remain confidential.
You state that Diet doesn't interest you ? Unfortunately it should. It can have great effect on the numbers. All the comments made so far are pertinent to your original questions.

Ken.

 

[samcogle]

Hi Qim, as Ken says the other posts do apply to your question. Spiking is if your bllod sugar peaks quite quickly due to a high intake of carbs it then lowers...like when you hear people who eat a big dinner and then have a low and want a nap [sorry I am still in the learning phase so please bear with me ]
As far as i am aware the dawn phenomenon [liver dump] is just one of those things and should even out once you have eaten.
The lower readings could be a number of factors...the fact that you run so use up glucose or the lower carbs for your lunch that day as the fish was boiled not with breadcrumbs.
It really is a case of trial and error and writing down everything you eat as well as testing before food and 1 then 2 hours after to see if a pattern emerges.
I personally would have very high numbers if I ate breaded fish and rice. I have to avoid them as well a bread. Any form of cereal including oats makes my levels go very high too. I try to eat protein for breakfast and avoid the carbs til lunch and even then I keep them pretty low.
Hope this helps...and welcome to the forum.

 

[qimqim]

Thank you Cugila

First, I said that diet does not interest me to answer this query, because I am comparing one situation with another that is similar, the only difference being that the dose (of food) is lower an that of exercise is higher.

I am at pains to explain why before lunch my readings are higher than when I get up (fasting) despite taking a tablet. You could say that it is because of the carbs; but then why is it lower by the end of the afternoon when I took even more carbs for lunch and had no tablets?

Even more suprising, and this is the main focus of my query, why are my readings high in the morning despite taking two tablets with dinner,when dinner has the same amount of carbs as lunch?

As I said before, maybe the liver releases glucose during the night beacuse my levels get low; but that does not explain the levels going up during the morning.

Hope you can throw some light.

qim

 

[qimqim]

As far as i am aware the dawn phenomenon [liver dump] is just one of those things and should even out once you have eaten.

Hello Samcogle

Maybe I am misunderstanding what a liver dump is. I thought you meant that when glucose in the blood gets very low, the liver converts glucogen into glucose and releases it to the blood to compensate.

That is one idea that I got to explain why my levels were up from evening to morning.

Yesterday, before dinner, I had 5.5. This morning before eating it was up to 7.0. This was a slight improvement, due perhaps to the fact that I made sure to eat again (a little carb) just before going to bed to make sure my sugar level did not go down dramatically during the night and avoid, if that is what happened before, the liver releasing extra glucose into the blood.

Does this make any sense to you?

qim

 

[samcogle]

You are spot on with the explanation. It may be a good idea to eat a little car if it is working for you. As I say it is trial and error so keep doing it and if it works then sorted
I was just going from what my endo said which was it happens and so be it but nothing to say he is totally right even if he is an expert!
I know some people do also have a slight increase in levels after exercise...could that be an explanation?

 

[cugila]

Hi qim.

Metformin is not a wonder Drug. It typically only lowers your Bg levels by around 1 - 2 points. this also depends on the actual doseage. A low dose will not give anything like that reduction.
Here is alink which explains Met more fully and may help to answer some of your questions.
Link: http://www.healthyontario.com/Assets/Pd ... Advice.pdf

Here is a fuller explanation of the:
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.

Hope this helps.
Ken.

 

[timo2]

Hi qimqim,

Try eating protein rather than carbs at your bedtime snack, something like cheese or cold meat.

Also, take it easy on the carbs during the early part of the day, this is when levels of insulin resistance tend to be highest.

Regards,
timo.

 

[qimqim]

Thank you, everybody.

I understand what is happenig much better now, and your advice will be taken into consideration.

Best regards
qim

 

[Trinkwasser]

What you really need to look at IMNSHO is what is happening *after* you eat

http://loraldiabetes.blogspot.com/2006/10/d-day.html

as to what happens next, well you may find you are spiking high from the carbs, which is sending you low later as your pancreas notices and wakes up, and the low from the exercise is waking up your liver and causing it to overproduce glucose, and these effects are combining with one another.

 

[EricD]

Hi qimqim,

Try eating protein rather than carbs at your bedtime snack, something like cheese or cold meat.

Also, take it easy on the carbs during the early part of the day, this is when levels of insulin resistance tend to be highest.

Regards,
timo.

timo, just a question.

cugila wrote that "Another macro-nutrient that is available to be converted to glucose is protein" so what's the point in eating protein as a "bedtime snack" if that is going to be converted in to glucose anyway?

 

[timo2]

Hi Eric,

Protein causes a much gentler rise in blood sugars (compared to the spike seen with
carbohydrates), so you avoid both the spike in blood sugars and the risk of reactive
hypoglycemia later in the night.

Protein's lower but longer BG rise (peaking at around 4 hours and continuing for 6-7) is
much better suited(it goes the distance) to effectively 'switch off' those hormones involved
in the dawn phenomena.

Regards,
timo.