Newbie - some questions

[Makedo Andmend]

Hi, I only joined the forum yesterday but have been type 2 for quite a few years. I thought I would be on Metformin for the rest of my life, plus another drug, can't remember its name. I have listened to lots of different advice on food and diet over the past 6 or so months and completely changed my eating habits. I have lost over 2 and a half stone in this time and my HbA1c went from 63 to 54 in the first 3 months without metformin for the most part. My HDL went up and my Triglycerides dropped from 3.8 to 1.7. I have maintained an intermittent fasting eating habit which I find a lot easier than cutting down portions and counting calories and I eat lots more veg, fruit and nuts, along with meat, cheese and fish. Sorry to ramble on but I just wanted to say where my journey had led and as the test was 3 months ago I wanted to know if my blood sugars were under control so bought a Sinocare monitor. My first reading at 5 in the afternoon after the monitor arrived was 6.5 which I was happy with, however the following morning having had nothing to eat and only a cup of green tea my readings were 8.4, 9.2 and 7.6 . I took the 3 readings just before 9.00am after having washed and showered and started work ( lucky to be working from home). Don't know why this would happen as I thought that only eating and drinking affected your levels. From what I have just read it seems that anything and everything can (does this include finishing off with a cold shower?) I tested again before dinner (tea time) and it was 4.3 then 3 hours after finishing eating in was 4.2. Again I was happy with these readings but this morning I was up to 7.6 again. This time it was before my green tean and shower. Can anyone help make sense of this please.

 

[KennyA]

Hi Makedo Andmend

Well done on your success so far. Lots of things have the potential to affect blood glucose levels - mine fluctuate quite a bit in response to things like exercise, stress, illness, ambient temperature (as well as food). It's often just the liver adding fuel to respond to what it thinks we need.

In the early morning our livers often dump glucose via gluconeogenesis - which means it makes the glucose - presumably to help us get going. Often called "dawn phenomenon". For me this process used to continue for hours with more and more glucose being added. I can usually stop mine by having something - anything - to eat. Coffee with cream will do it. The issue is that if you've been running with high blood sugars for a while, that becomes the system's "new normal" and it takes a while before it adjusts to lower levels. Most of us find/found that the fasted first thing morning reading is the last to come down, and comes down much more slowly.

Monitors are essential but they have their limitations. They are not entirely accurate and iirc the total acceptable error is around 15% - this doesn't mean that the reading is always 15% out, but it might be. So your 8.4, 9.2 and 7.6 look all much the same, really.

 

[Makedo Andmend]

Thanks Kenny, that's very helpful. A lot of information there that I was not aware of. I don't eat in the morning during the week as I am not hungry, but did not know this could adversely affect me. I do eat breakfast at weekends but usually around 10 on a Sunday or 11 on a Saturday, after I have been out for the shopping. It will be interesting to check this weekend before I go out and after I get back.

 

[KennyA]

Thanks Kenny, that's very helpful. A lot of information there that I was not aware of. I don't eat in the morning during the week as I am not hungry, but did not know this could adversely affect me. I do eat breakfast at weekends but usually around 10 on a Sunday or 11 on a Saturday, after I have been out for the shopping. It will be interesting to check this weekend before I go out and after I get back.

I didn't mean to give you the impression that not eating in the morning would "adversely affect" you. I almost never have breakfast, because, like you, I'm not usually hungry.

Dawn phenomenon is a completely natural process and it isn't a diabetic thing - everyone seems to do it - it's just your liver trying to get you going in the morning. The issue is what your liver is accustomed to accept as a "normal" blood glucose level, and it seems to be a slow learner.

I think mine took about a year to reliably accept I should be around 5.0 - 5.5, months after I was getting normal A1c results. If you're doing everything else right, it'll catch up.