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Fasting BG higher than evening after meal measure

Discussion in 'Type 2 Diabetes' started by AliC, Nov 24, 2012.

  1. AliC

    AliC · Member

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    Hi all

    Just started self-testing my blood glucose levels yesterday, and observed the following:

    yesterday
    - 2030 pre-meal: 4.7
    - 1 hour later: 9.6
    - 2 hours later: 6.2

    today not long after getting out of bed (12 hours since eating)
    - 0850: 6.6

    Should I be looking at the dawn phenomenon literature? That's the only way I can make any sense of this, I can't understand why my BG should be *higher* 10 hours after the post-meal 2 hour measure?

    Any advice welcome :)
     
  2. daisy1

    daisy1 Type 2 · Legend
    Retired Moderator

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    Hi AliC and welcome to the forum :)

    I'm sure that some members will be able to help you with your question soon from their own experience. In the meantime, here is the information we give to new members which I hope you will find useful.


    BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS

    Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

    A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you’ll find well over 30,000 people who are demonstrating this.

    On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

    The role of carbohydrate

    Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

    If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

    The bad news

    Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

    The good news

    People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

    Controlling your carbs

    The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.
    There are two approaches to controlling your carbs:

    • Reduce your carbohydrate intake
    • Choose ‘better’ carbohydrates
    Reduce your carbohydrates

    A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

    The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

    Choosing better carbohydrates

    Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
    http://www.diabetes.co.uk/food/diabetes ... rains.html

    The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

    Read more on carbohydrates and diabetes

    Eating what works for you

    Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

    To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

    The blood sugar ranges recommended by NICE are as follows:

    Blood glucose ranges for type 2 diabetes
    • Before meals: 4 to 7 mmol/l
    • 2 hours after meals: under 8.5 mmol/l
    Blood glucose ranges for type 1 diabetes (adults)
    • Before meals: 4 to 7 mmol/l
    • 2 hours after meals: under 9 mmol/l
    Blood glucose ranges for type 1 diabetes (children)
    • Before meals: 4 to 8 mmol/l
    • 2 hours after meals: under 10 mmol/l
    However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

    Access to blood glucose test strips
    The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

    • structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
    • self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

    Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

    You may also be interested to read questions to ask at a diabetic clinic

    Note: This post has been edited from Sue/Ken's post to include up to date information.
     
  3. Squire Fulwood

    Squire Fulwood Type 2 · Expert

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    Yes it might explain it to you. This is why they carry out a fasting test. Your meter is not approved equipment for this to be an actual fasting test but to all intents and purposes .................
     
  4. Indy51

    Indy51 Type 2 · Expert

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    Hi AliC.

    In my experience, fasting BG was the last to come into line and I've given up trying to work out why it can be high some days, lower on others - there's no discernible pattern I can figure out but it seems that once the rest of your levels are under control, it eventually follows suit. It used to do my head in :crazy:
     
  5. AliC

    AliC · Member

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    Thanks all

    I certainly don't think there's too much point measuring my waking levels (when you factor in the cost of strips) as I'm not on insulin - I can't draw any conclusions from a higher reading versus a lower one.

    That said, I'm confused by the tests "they" do being a better more accurate test than the ones I do at home on a meter. How is it they are able to factor out the liver-glucose dump at some time pre-waking hours, if it even happens?

    Last fasting glucose test I had done in May this year was 6.4 mmol/L - the normal range is 3.6 - 5.5 according to the printout of my bloodwork. They put a note on there saying "Raised but not diabetic level, need to check old notes for diagnosis". Underneath this note was "Fasting Glucose: Indicative of impaired fasting glycaemia if patient correctly fasted for 8 hours"

    I have two comments on this:

    1. pretty sure I had fasted for closer to 14 hours - surely the 8 hour mark would've been higher? Doesn't it depend on when your liver might have "dumped"? (what's the medical term for this? ;-) )

    2. Can NASH (which I was diagnosed with before the diabetes) affect the liver-glucose "function"?

    No wonder I'm confused lol...but mainly because I don't wanna accept it...my logical brain can see way too many "what-ifs".
     
  6. Napolyon1

    Napolyon1 Type 1 · Well-Known Member

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    My B/S is always higher in the morning than the night before, why?
     
  7. Napolyon1

    Napolyon1 Type 1 · Well-Known Member

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    Doing my head in Indy51.
     
  8. princeasl

    princeasl · Member

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    Hi, I've been Diabetic now for 3 years but was only diagnosed with it last year. my reading tonight was 30.2mml which is really very high. I'm really scared about taking medication due to side effects and not being able to come off them. Can someone please advise? What should I do, I've lost a lot of weight and been trying to sort out my diet. To be honest my readings are usually a lot lower around the 17 mark on a good day...
     
  9. Cultivator

    Cultivator · Active Member

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    Hi Princeasl, I'm not a medic but I've been diagnosed type 2 for about 4 years now and on medication all that time. To be honest those levels would scare me silly and I'd be running for the meds -even at 17 on a 'good day'. I was reluctant to take the meds to begin with as I thought it was all a drug company conspiracy to make profits out of me for life - but the diabetic nurse at the hospital said metformin is way out of patent now so costs beans to make and costs the NHS beans to provide and saves a fortune in diabetic complications so I should get over myself (well that is pretty much what I took her to be saying anyway :) )

    When my levels start to creep up I start to notice numbness in my big toe and slightly blurred vision. When I'm on the case and testing regularly and eating well the levels don't go above 8 or 8.5 max and my toes and eyes sort themselves out ! If I were you (and I know I'm not) I would get whatever meds possible to get those levels down - you can alter them and get different ones if the side effects are really bad - and maybe even reduce or come off them once the levels are stabilised - but numb toes and all that is what I find the scariest !

    If you've lost a lot of weight though you could be doing better than me ;) I suppose I've lost a couple of stone in the last 4 years if I think about it, but that was mostly at the start and there is plenty more to go. I've been doing minimal carbs for the last 6 weeks or so. It has really helped with keeping the blood sugar down, but I think all the cream and cheese I've been eating instead haven't helped with weight loss - sadly! One thing at a time though :)

    Good luck anyway - I hope things go well :)
     
  10. Indy51

    Indy51 Type 2 · Expert

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    Princeasl, the side effects of medication are a h*ll of a lot less scary than the side effects of long term elevated (ie. over 8.0) blood glucose levels. Please, please see your doctor/medical advisers and get control of your BG levels as a matter of urgency. As far as I'm concerned, denial is definitely not an option for diabetics if we want to avoid the long term complications. Please seek help.

    Medications like metformin and insulin are very safe drugs. There is absolutely nothing safe about high blood glucose.
     
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