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Rising BS levels but don’t know why

Triffo

Active Member
Messages
41
Location
Cardiff
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Hello. I am hoping for help to solve a conundrum I find myself in. Up until Christmas 2017 my fasting BS readings in the morning were between 4.5-5.2 on average and I could predict fairly well through the day how it would behave.

Since mid February 2018 I find that my fasting BS is now 6-7.2 and by 11am has risen to between 8.9-10.5. This is even if I go to bed at about 6 or below my BS will be higher in the morning.

I eat 3 meals a day. Breakfast(9ish) is raw vegetables/ salad items, cheese, ham and 1/2 an avocado. Lunch (1ish)is a salad or similar and tea (6ish)is normally meat with either salad or veggies. No potatoes, bread, etc. Fruit only berries. Basically LCHF.

I haven’t changed my activity level. I walk on average 50-70 miles a month, Pilates and horse riding, an hour once a week.

Health wise I had my second kidney transplant 4 years ago. It was steroid treatment for severe gout in the lead up to this operation that caused my diabetes. Since the operation as part of my medication regime I take 5mg of Prednisolone daily. This has an effect on my BS levels but it is one that I have factored in since the op.

I am 68 years old and weigh 58kgs. I would be very grateful if anyone has any ideas of possible causes and any hints please. Apologies for the war and peace. Thank you.
 
sometimes things just change. It could be age, a progression of your diabetes, the weather. it just happens sometimes.
 
I started LC?F (for me low carb is the important bit) about 5 years ago and that was fine until 15 months ago when my BG readings started to creep up, despite sticking to low carb (about 40 gms per day). The body doesn't need carbs to make glucose.

More recently I have started trying a VLCD as well as keeping LC and something I have noticed is that if I have a meal at about 19:00 and then skip breakfast the following morning, apart from the almost normal liver dump, if I do anything strenuous, like digging snow, walking to the shops, using the static bike, my BG will go up even further.

We're obviously quite different in that I'm male and sadly twice your weight, but diabetes doesn't seem to be an exact science as we all have different experiences. Your walking alone must cover your 10,000 steps a day (a la NHS) and with horse riding and Palates, you're getting some good exercise.

In my experience of my BG, morning liver dumps and exercise on little or no food will adversely affect my BG.
 
Hi,

I see from your profile you are taking Gliclazide. Is this still the case, or have you stopped or reduced the dose?

As @lucylocket61 said, it could be any of those things. It may also be a touch of physiological insulin resistance (PIR) creeping in. This is a natural thing that happens when someone is low carb. The body thinks the glucose is a bit low, and as the brain and some other bits and bobs (red blood cells) need some glucose, the body tells all the other cells to reject any glucose there may be and save it for the brain. It is known as "glucose sparing for the brain". This has the effect of raising base levels and especially morning fasting. It is not the same as diabetic related insulin resistance.

http://ketopia.com/physiological-insulin-resistance/


here are some various blogposts about it from Hyperlipid:

http://high-fat-nutrition.blogspot.com.au/2007/10/physiological-insulin-resistance.html
http://high-fat-nutrition.blogspot.com.au/2008/05/physiological-insulin-resistance-2-dawn.html
http://high-fat-nutrition.blogspot.com.au/2008/08/physiological-insulin-resistance.html
http://high-fat-nutrition.blogspot.com.au/2008/09/physiological-insulin-resistance.html
http://high-fat-nutrition.blogspot.com.au/2008/09/physiological-insulin-resistance-wild.html
http://high-fat-nutrition.blogspot.com.au/2008/09/terminator.html
http://high-fat-nutrition.blogspot.com.au/2009/09/physiological-insulin-resistance-and.html
http://high-fat-nutrition.blogspot.com.au/2009/09/physiological-insulin-restisance-guess.html
http://high-fat-nutrition.blogspot.com.au/2009/09/chewing-fat.html
http://high-fat-nutrition.blogspot.com.au/2010/02/physiological-insulin-resistance.html

And a couple of posts from Mark Sisson of Mark's Daily Apple:

https://www.marksdailyapple.com/do-low-carb-diets-cause-insulin-resistance/
https://www.marksdailyapple.com/does-eating-low-carb-cause-insulin-resistance/
 
I don't know if this is relevant, but that doesn't sound like HF to me. With all your activity and low carb, are you perhaps consuming too few calories? I don't know if you are trying to lose weight? Many of us find that eating a little fat last thing at night can help fasting levels. Some of us eat something fat first thing after getting up too, as otherwise our bg levels tend to rise. Personally I am experimenting with psyllium husk + water + cream at night (giving me some much needed fibre, and not tempting me to over-eat!) In the morning I have a small pot of cheese strips in my bathroom and eat them as soon as I have tested, especially if the fasting reading is low.
 

Unfortunately I cannot tolerate psyllium husk as it causes extreme intestinal transit. Same with Chia seeds. I do include full fat Greek yoghurt and crepe fraiche and Benecol probiotic drinks (original 2g sugar) but I take your point. I will double check to make sure what my fat intake is as it should. Thanks.
 

Yes I still take Gliclazide. 40mg in the morning same time as the prednisalone. I did manage to do without the Gliclazide for a short period of time just before the fasting BS levels started to rise so I went back onto it. I have looked at the first of the attachments which is very interesting. I have never heard of Psychological insulin resistance before but it could fit. Thank you very much.
 

I had to click 'Winner' on that post, just for the use of the phrase Extreme Internal Transit. Thank you

I don't think I can offer any suggestions over the above that seem likely based on what you say. All I've noticed for myself is that the one and only thing which is guaranteed to lower my morning blood sugar is significant calorie restriction the day before. That's more of a predictor for me than carb intake. Not great because of course you can't always restrict calories, but just throwing it out there.
 

Calories is something else I can look at. Haven’t detailed calories as have concentrated on carbs up to now. Thanks.
 
I know this is a fairly old thread but have recently learned that prednisolone can have a marked affect on blood sugars this is because it reduces or hinders the livers sensitivity to insulin , insulin produced by the pancreas should trigger the liver into lessening its production of sugars or even stop it altogether but preds can cause the liver not to be triggered and it will just carry on producing sugars thus causing high blood sugar levels and an increase in IR. A complication of this is that it is not constant and the affect can vary and at times disappear for periods the liver then recieves the message to cut down or stop producing sugars and can cause unpredictable hypos this is an unfortunate complication of prednisolone induced or Type 3E diabetes.

As I am now only just coming to understand.

This can also be a problem for T1's or insulin dependent T2's as the prednisolone acts in the same manner on insulin that has been produced by the pancreas or injected insulin. If they are given Prednisolone therapy.
 

I have this exact problem. Although on a fairly low dose of Prednisolone (5mg) daily it appears to stop my insulin production in its tracks. My blood sugars rise steadily during the morning, even if I’m fasting. (My overnight BG is normally fairly good at between 4.8 and 5.6. ). I have found getting up and taking the Prednisolone with my other pills at 7.30am is the only way to live with it with any amount of control. If I forget to take the Prednisolone my BG results are almost perfect, I struggle to even go above 7 all day. With it I have to be extremely careful with my diet throughout the day, every day. It’s a never ending task. I do get some respite occasionally in the afternoon/evening when for no good reason I find myself a little low going into bedtime I can have something high in carbs to see me through the night. If I have a ‘blow out’ for a celebration etc I pay for it. The med staff who look after me now and in the past at first were not sure but now they accept that I am correct. Only snag is that I can never come off it as it’s part of my transplant medication routine. It’s worth noting I was insulin for a period after the transplant in Sept 2013 and that was gradually replaced by Gliclizide 80mg x twice daily. At that time I was 83kgs. I am now 56kgs and down to 40 msg x once a day but any further reduction is probably out of the question long term. xx
 
Yes your right I have found preds best to take early in the day rather than later and since putting my dose back up to 20 mg a day I find control very difficult bloods some times up some times down and no rhyme or reason to it.

My neurologist has always been adamant that the benefits outweigh the draw backs and that I can't come off them but recently some other problems have arisen so he now says idealy I should come off them at some point but I have been taking a highish dose for years now so don't know if I will be able to or not.

I do hope things settle down for you and you and your health team manage to get to the bottom of it and find a solution soon.
 

Yours is a much more difficult problem than mine it seems. On 20mg I would have to go back on insulin I think. I have followed the low carb healthy fat routine for some years now which is how I’ve managed to get what control I do have.

I find that hot weather is also a game changer. I’m currently in France and the temperatures are very high. I’ve had to come off my diabetes meds for over a week due to suddenly having thundering great hypos. Go figure!! However today after eating the same diet its shot up and stayed above 10. I suspect due to the amount of exercise I’ve done today. Anyway enough of that. There’s the odd silver lining sometimes. I made as good use of the hypos as possible. Lol. Thank you for your good wishes. I hope you too manage to lower your dose and maybe even come off it altogether.
 
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