Hyperglycemia during the night

[bigalxyz]

Hello forum. Haven't been on here for quite some time.

Dx T2D May 2011 with a pretty bad fasting BG of 17 or 18. HbA1c up around 9.5% as well IIRC.

Been taking metformin since, and lost about 10-12kg in weight. HbA1c tested periodically and has fallen to 5.4% as of about 6 months ago. Much better.

Currently metformin 1000mg/day, 500 in the morning with breakfast and 500 in the evening with dinner.

I've got a BG meter but I hadn't used it all that often. However I've been using it a lot in the last few days - mostly because the test strips I have are about to go out of date! Found something interesting.

BG very stable during the waking hours. Typically 5.0 - 5.5 when I get up, before breakfast. Might rise to 7 an hour or two after a carbohydrate based meal, otherwise stays mostly between 4.5 and 5.5. I was feeling quite pleased with myself (although experiencing occasional episodes in the afternoon of shakiness/tiredness/urgent hunger/irritability - BG getting too low?).

And then this morning I woke up at about 5am and decided to test myself, only to find that my BG had shot up to 14!

Tested again a few times over the next hour and the numbers dropped down to 8, then back up to 10.

Fell asleep again. 9am retest, back down to 5.7.

What's going on?!

Should I try to take my metformin dose at a different time - ie last thing at night - to protect myself from BG spikes while I sleep?

Also for the last few years I've had a problem whereby almost every morning when I get up I feel very tired, dazed, groggy, can't think straight, etc. - this then gradually improves during the day. Last night I was doing DIY jobs until midnight, at which point I felt absolutely fine. This morning I feel grotty again. It's the same most days for me. Could the symptoms I have in the mornings be related to BG shooting up during the night?

A bit confused/concerned, hoping for some insights/advice, etc.

Thanks!
Alan.

 

[bigalxyz]

(Will of course speak to my GP about this ASAP and seek his advice)

 

[AndBreathe]

Hello forum. Haven't been on here for quite some time.

Dx T2D May 2011 with a pretty bad fasting BG of 17 or 18. HbA1c up around 9.5% as well IIRC.

Been taking metformin since, and lost about 10-12kg in weight. HbA1c tested periodically and has fallen to 5.4% as of about 6 months ago. Much better.

Currently metformin 1000mg/day, 500 in the morning with breakfast and 500 in the evening with dinner.

I've got a BG meter but I hadn't used it all that often. However I've been using it a lot in the last few days - mostly because the test strips I have are about to go out of date! Found something interesting.

BG very stable during the waking hours. Typically 5.0 - 5.5 when I get up, before breakfast. Might rise to 7 an hour or two after a carbohydrate based meal, otherwise stays mostly between 4.5 and 5.5. I was feeling quite pleased with myself (although experiencing occasional episodes in the afternoon of shakiness/tiredness/urgent hunger/irritability - BG getting too low?).

And then this morning I woke up at about 5am and decided to test myself, only to find that my BG had shot up to 14!

Tested again a few times over the next hour and the numbers dropped down to 8, then back up to 10.

Fell asleep again. 9am retest, back down to 5.7.

What's going on?!

Should I try to take my metformin dose at a different time - ie last thing at night - to protect myself from BG spikes while I sleep?

Also for the last few years I've had a problem whereby almost every morning when I get up I feel very tired, dazed, groggy, can't think straight, etc. - this then gradually improves during the day. Last night I was doing DIY jobs until midnight, at which point I felt absolutely fine. This morning I feel grotty again. It's the same most days for me. Could the symptoms I have in the mornings be related to BG shooting up during the night?

A bit confused/concerned, hoping for some insights/advice, etc.

Thanks!
Alan.

As this is, so far, as single incident, I wouldn't necessarily read anything into it. For all we know, you could have woken from a nightmare (and maybe even not remember it). A nightmare would, for me, lead to a "fight or flight" reaction, with the associated adrenalin reactions, which could raise the blood scores.

Your test strips could be less accurate, as they are close to their expiry date - particularly if the pot has been open for some time, and you've gone back to a part-used pot.

So, so many options, but it sounds like you could be advised to do a bit more testing for a few days, and take note of the scores, food and drink intake etc.

Metformin works on a cumulative basis to forgetting a dose, or within reason the timing of doses are irrelevant to most people. Obviously, there are some people who are extremely sensitive to it, but they are in a tiny minority. Metformin helps diabetics in a number of ways, but making a significant difference to their blood scores (in isolation of other lifestyle choices) isn't usually one of them.

Good luck with it all, and keep us posted on developments.

 

[bigalxyz]

Thank you - much appreciated.

As it happens, I *had* just woken up from a very vivid (albeit not frightening) dream! I've been having a lot of these just over the last week or so - not sure why because normally it's just an occasional thing with me. Hadn't realised this could interfere with BG though...interesting.

Might be time to buy a fresh batch of test strips I suppose.

 

[bigalxyz]

Some more data to share...

Went to sleep about midnight, feeling ok.

Woke up at 4am. Test BG, was 4.8. Felt very good - wide awake, didn't fall back to sleep for a while, but relaxed, alert, good mood, etc.

Woke up again at 8:30. BG 6.0. Felt a bit queasy but also hungry. Got up and ate a bowl of porridge.

Fell asleep again (didn't plan to). Woke up again at 10:30, felt AWFUL. All the grogginess, dizziness, confusion, etc. that I described in my first posting.

BG had shot up to 13.

Dragged myself out of my pit and went for a walk for about two hours in the hope of course of burning off this excess glucose.

Now just after 1pm, got home, BG back down to 4.7. My head is starting to clear now, although it took a long time. I'm also very sweaty.

It feels like sleep has something to do with all of this - maybe? I've tested BG an hour or two after bowls of porridge before and I've seen numbers more like 7-8 ish. I can also recall a number of instances in the past where I've eaten refined carbs (toast, croissants, etc.) first thing in the morning and felt very weird indeed for a couple of hours afterwards (whereas if I eat eggs or some such, it doesn't happen).

This tendency I've had - to feel very rough first thing in the morning and gradually improve as the day goes on - has always been labelled as "depression" by the GPs ("would you like some pills for that?") - and I always suspected that there was something physical going on which had been missed.

This is all tentative of course, based on just a couple of days' testing, hardly a conclusive scientific result, but makes me think I may have found something out about my body that I didn't know before.

 

[AndBreathe]

Some more data to share...

Went to sleep about midnight, feeling ok.

Woke up at 4am. Test BG, was 4.8. Felt very good - wide awake, didn't fall back to sleep for a while, but relaxed, alert, good mood, etc.

Woke up again at 8:30. BG 6.0. Felt a bit queasy but also hungry. Got up and ate a bowl of porridge.

Fell asleep again (didn't plan to). Woke up again at 10:30, felt AWFUL. All the grogginess, dizziness, confusion, etc. that I described in my first posting.

BG had shot up to 13.

Dragged myself out of my pit and went for a walk for about two hours in the hope of course of burning off this excess glucose.

Now just after 1pm, got home, BG back down to 4.7. My head is starting to clear now, although it took a long time. I'm also very sweaty.

It feels like sleep has something to do with all of this - maybe? I've tested BG an hour or two after bowls of porridge before and I've seen numbers more like 7-8 ish. I can also recall a number of instances in the past where I've eaten refined carbs (toast, croissants, etc.) first thing in the morning and felt very weird indeed for a couple of hours afterwards (whereas if I eat eggs or some such, it doesn't happen).

This tendency I've had - to feel very rough first thing in the morning and gradually improve as the day goes on - has always been labelled as "depression" by the GPs ("would you like some pills for that?") - and I always suspected that there was something physical going on which had been missed.

This is all tentative of course, based on just a couple of days' testing, hardly a conclusive scientific result, but makes me think I may have found something out about my body that I didn't know before.

Porridge has a very patchy reputation for diabetics, as it's very carby. How good your personal reaction is to porridge will depend on many factors, and the "after" numbers will be influenced by what the number was before you ate, if you understand what I mean?

I still say your data is extremely inconclusive as it is likely your digestive processes are slower when asleep, and not all digestive processes have finished at 2 hours. In particular rice, and higher fat based meals, can take longer to digest, and therefore the peaks can take longer to show, with 2 hour tests potentially missing them. (I appreciate you're not discussing rice or fatty foods in this instance.)

For your data to be truly meaningful, you need to start on a detailed diary of all you eat, all you drink, what exercise you take and when, and as you feel sleep is influencing things, also when you nap. Sometimes there are stand-out conclusions to be made, where there is a truly direct correlation between an action and a reaction, but otherwise a couple of week so of data at least may be required to show trends.

Please don't think I am being unsympathetic to your plight, but we all have peculiar readings and experiences from time to time; even those who are extremely well controlled and show little variance.

 

[bigalxyz]

Thanks. No, I'm not thinking that you're being unsympathetic. A couple of days' worth of numbers is of course very inconclusive, you're quite right. Might give a few pointers but a long way short of a statistically credible data set at this stage. Will continue testing regularly and recording what I eat, when I sleep, activity levels, etc. in the hope of understanding the patterns better over time.