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DP influence on HBA1C?

Discussion in 'Type 2 Diabetes' started by jim1951, Feb 13, 2020.

  1. jim1951

    jim1951 Type 2 · Well-Known Member

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    I am trying to get to grips with my T2 numbers and have been testing 3 times daily. This is first thing in the morning, before my evening meal and 2 hours after.
    Although I am retired I still manage my meals like I did when I worked. I worked in an environment where there wasn't time for lunch most of the time and I never normally eat breakfast unless staying in a hotel etc.
    My DP figure can be relatively high i.e., 9.x and is always a lot higher than my post 2 hour figure taken at circa 2100 hours.
    Over the last 30 days the overall average of my 2 evening figures would see an HBA1C of circa 45 if it was maintained over 90 days. But when I add in my morning figure it would be circa 56.
    I am seeing my 2 hour figure showing significantly less than a plus 2 increase on average.
    So my HBAIC will show potentially an increase from 45 to 56 based purely on the DP which in itself is not being spiked by food?
    Not every day, but I have at random taken my reading at 4 hours after my evening meal to see whether there has been a later increase but this has not been the case.
    What do I need to understand?
     
  2. ~Noodles~

    ~Noodles~ Type 2 · Active Member

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    So since we apparently have a completely different meaning about the abbreviation "DP", could you tell me what it stands for in a diabetic context?
     
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  3. jim1951

    jim1951 Type 2 · Well-Known Member

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    DP, in my context, is dawn phenomenon i.e., the release of glucose in the early hours.
     
  4. ~Noodles~

    ~Noodles~ Type 2 · Active Member

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    Ah thanks, appreciate the clarification. You seem to be on a low-dose metformin regimen, when do you take those?
     
  5. jim1951

    jim1951 Type 2 · Well-Known Member

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    I really need to update my details which are out of date i.e., 5 years ago!

    I am on slow release Metformin 500mg twice a day, early morning and early evening.
     
  6. ~Noodles~

    ~Noodles~ Type 2 · Active Member

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    Gotcha, I thought you may be taking metformin in the morning only and would have suggested a switch to popping them come dinner time due to their reduction of gluconeogenesis.

    Since you seem to have a good grip on your diabetes in general, did you hit up your doc about it yet? He might just up your evening metformin a bit or suggest a bit of detemir in order to get it under control.
     
  7. Robbity

    Robbity Type 2 · Expert

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    @jim1951 - Your pre and post meal figures will tell you how you are managing your diet, but there are also other things which can affect your glucose levels (e.g. medications, stress, illness, pain , exercise...and that dratted dawn phenomenon too!) and they will be changing anyway as you add more fuel and use it up.

    Your HbA1c test takes an average of all your glucose levels for the last 3 months, and as they will be fluctuating all the time it will be taking account of all those you've measured and all those in between which you haven't - it's not selective!

    Have a read of this article about HbA1cs on our main Diabetes.co.uk site for more information.
     
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  8. TriciaWs

    TriciaWs Type 2 (in remission!) · Well-Known Member

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    A few things to understand the DP figures and liver dumps:
    In addition to the main meal what do you drink/eat the rest of the day?
    And how long before bedtime do you eat, do you have anything to drink later? How many carbs in your evening meal?
     
  9. ianf0ster

    ianf0ster Type 2 · Well-Known Member

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    As I have said in other threads, DP for a low carbing T2 isn't a bad thing. From what I have seen, most of us ignore it in one of 2 ways: some who skip breakfast still drink an early morning coffee with double cream/coconut fat in order to stop the effect. Others like me just ignore it and don't even measure BG until just before our first meal of the day - in my case a late lunch.

    I suggest you stop worrying about it (which itself raises BG) and follow suit - i.e drink a fatty coffee or just ignore it .
     
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  10. Tim1966

    Tim1966 Type 2 · Member

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    Thanks for that comment it has addressed a niggling worry of mine.

    I have been really pleased with my numbers as they are all currently in the lower end of my target range apart from when I first get up at about 6.00am. When I test I am getting a reading of, on average, 5.8 - 6.0 mmol/l which, for what I eat, seems quite high. However I do not eat anything until lunchtime on weekdays 12.30(ish) and when I test before my meal my BG is usually in 4.8 -5.0 mmol/l range which seems much better. My post-prandials have all been below 7.0mmol/l so far and less than 2 difference.

    From reading this comment it seems I should not be worried about those early morning numbers but just generally monitor as usual.
     
  11. LittleGreyCat

    LittleGreyCat Type 2 · Well-Known Member

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    Noting that you can't really predict your BG throughput the day when only testing 3 times a day.

    Option 1 - do a short testing campaign through a couple of days testing every couple of hours to estimate how your BG fluctuates. This doesn't cover what happens during the night.

    Option 2 - assuming you have a smart phone with NFC - splash out around £48 on a Freestyle Libre and wear that for a couple of weeks. This should give you a 24 hour continuous profile (as long as you read at least every 8 hours) which will give you a much more detailed understanding of how your body works over a 24 hour period.

    I have found that despite Bullet Resistant Coffee (butter and cream but no coconut) my BG rises steadily from about 06:00 to 12:00. Vigorous exercise spikes it higher. After that my BG drops quite rapidly and I can eat stuff in the afternoon which would spike me n the morning. I'm not sure that finger pricks alone would have given me this picture.
     
  12. carty

    carty Type 2 · Well-Known Member

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    I have tried every thing known to man woman child dogs cats and every other !!! To reduce My D P but My liver is so kind that it thinks that I am dying in the morning so floods me with glucose :arghh:
    Carol
     
  13. MollieB

    MollieB · Well-Known Member

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    Sorry this is off topic but I saw this and laughed because it reminded me of the time I was sitting in a meeting and they started talking about "ED". ("ED" only means one thing in my world). It took me a few moments to realize they were talking about the Emergency Department not erectile dysfunction (I was so relieved). :)
     
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