Newbie needs advice

Hi Lorrie,

A couple of thoughts: Depending on when you have breakfast, it may well be dawn phenomenon affecting you. This is often thought to be your body's response to getting ready for the day ahead by releasing hormones, some of which raise blood sugar.

Personally I don't think those levels are really too bad given that you are back down to 5 by lunch. If the rest of your readings are okay, you should be fine. Your blood test at review will be the HbA1c, which looks at your average readings over a three month period, so it shouldn't be significantly affected by a couple of hours at 8mmol.

I have heard lots of people say that their readings go up slightly after getting up, having a shower etc. That's why people are advised to take the fasting reading as soon as they wake up.

I know people have different ways of saying things, but going from 5.9 to 8 is not really 'shooting up' and could easily be within an error range for your meter. Even with a low carb breakfast, you're going to see a rise in blood sugar of a couple of mmol as protein can convert to glucose.

Others may have advice on how to try to stop it happening, but if the rest of the day's readings are fine, I wouldn't worry about it too much personally. Sure, I guess it would be nice to have the 2hr readings a little lower, but it isn't going to kill your HbA1c.

Russ is right, but I thought I'd add a little about the dawn effect. My fasting readings when I first get up are about 5.7 to 6.2, but half an hour later, before breakfast, when I've had a shower, shave etc, they're up about another half to three quarters of a point. to something like 6.5 to 7

I've often thought this is a flaw in the fasting blood glucose test at the surgery. Last time I went the fbgt I took at 08:00 was 5.8; the one the nurse took an hour later was 7.7! Even allowing for meter error and lab differences, that is obviously my liver helping out 'cos I hadn't eaten.

Which could call into question the validity of surgery fasting blood glucose tests? if it is in fact measuring liver dump instead of a true fasting level? All thoughts welcome on this one.

I'm going to take my meter with me next time and test just before she draws blood. Might be interesting.

Viv 8)

viviennem said:

Which could call into question the validity of surgery fasting blood glucose tests? if it is in fact measuring liver dump instead of a true fasting level? All thoughts welcome on this one.

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Definitely puts such tests in doubt for the purpose of diagnosis in my mind, UNLESS they allow for such an increase in readings in their prognosis - which I doubt. Especially as it will vary from person to person. It's not a meter thing, because mine go up the amount I suggested in previous post in 30 minutes using readings from my one meter.
I suppose it could be argued that a non-diabetic wouldn't experience such rises because their insulin would swiftly act to maintain their fasting level, and thus a fasting test IS a reasonable tool for judging results. - I'm not sure on this.
I guess also that a fasting level MUCH higher would indicate diabetes regardless.
In fairness, fasting levels are only used as guidance I suppose, not definitive diagnosis, so are at least useful.

I agree with Vivienem that I'm highly suspicious of the validity of morning fasting tests due to the liver-dump effect. I've also had conflicting advice from Phlebotomists on the earliest/latest time for last meal before the blood is actually taken quite apart from the morning effect. For me the HBA1C is a valid test as it measures average levels over 10-12 weeks and I always test, when I do, 2 hours after a main meal in the evening to look out for spikes.