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Somogyi effect or sugar bounce

TMoxhay

Newbie
Messages
1
Type of diabetes
Type 2
Treatment type
Non-insulin injectable medication (incretin mimetics)
Hi, I am new to this forum and am hoping someone out there may be experiencing the controversial SOMOGYI EFFECT. I have been T2 for the last 6yrs, but only on meds for the last 2, currently taking Metformin, Jardinance and the all new Trulicity weekly injection. Every time I have had an apt with my diabetic nurse I have informed her that my sugars "bounce" from normal, say 6, to 9 within less than an hour with no food or drink consumed. For instance I will take my sugar reading at 17:00hrs and it will be low to normal, by the time I have cooked tea it has bounced way up. She has informed me that this cannot happen and I must be eating something.......I am not!! She will not even discuss this with me so I can find a way forward. It doesn't just happen in the afternoon, but mid morning also. No matter what I have for Bfast by around 11:00 my sugars are plummeting if I don't catch it and eat something they bounce way up again. On the plus side I guess I don't need to worry about Hypo's . I have now insisted that I see a diabetic consultant and am hoping they will at least listen to what I have to say. Question......does anyone else out there experience anything similar ??? Also does the nausea every go away with Trulicity??
 
Before I say hi, I'm just going to mention that I'm useless because I don't have your meds, and have no real answers on Somogyi.

So, Hi!

Our cat had Somogyi, (he's a type 3c, doesn't make insulin since a bout of pancreatitis) but that was because the kitty-insulin wasn't agreeing with him and he was switched to Lantus for humans. That sorted him right out, and he's been on exactly the same amount of grams of food twice a day and the same amount of insulin to cover for it since. No surprises anymore. That said, the swings were extreme, from hypo to severe hyper, above 33,3 (the meter didn't go any higher). Yours seem moderate in comparison, but hey, you're not a cat, so what do I know? All in all though, I'm not sure if this is Somogyi we're talking about. Since you're new, I have to ask: what are you eating? Are you completely med dependant, or have you changed your diet as well? Because I have a feeling your meds might not be doing what you would want them to do (sometimes they're like that, and the nausia.... I can see you might want to get rid of that.). For me, metformin did more damage than good, glyclazide didn't do much, and since absolutely everyone was on holiday when I was diagnosed, I had time to work out for myself, what would work for me, before seeing the specialist, 2 dieticians, the DN and what have you. I'm going to sound like a bit of a fanatic maybe, but as T2's, we can't process carbs efficiently anymore. It's a bit of a no-brainer then, to reduce carbs. But you still need energy, so you up the other 2 macronutients: fats and protein. Voila, energy issue solved, and you don't have to feel hungry or anything either. (Plus you shed weight like water, should you have an issue with that.) How many grams of carbs a day your body can still handle varies from person to person, which is why most of us here self-fund a meter: you're obviously already in posession of one, so maybe you might want to try this: Test before a meal, and two hours after the first bite. If your BG went up more than 2 mmol/l in that time, the meal was carbier than you could process. For me, 20 grams of carbs a day or less is hitting the sweet spot. Even with a (now receding) sinusinfection I didn't hit double digits. When I'm not fighting off an infection, I'm more often than not hovering between 4 and 6, usually am a 5 though. Others are fine on 80 grams, or 120 grams of carbs a day... It's a very individual thing. I've been med-free three months into starting low carb, and I could even ditch the statins for my cholesterol. And I went from 102+ kilo's (204 pounds) to 76,5 (153 pounds), HbA1c is currently 34. I've been a diagnosed diabetic for little over 2 years now, and it is working for me. I can't guarantee anything, but it might work for you too. Provided you eat what you actually enjoy eating. (I know I threw out a lot of stuff I got but tasted like soggy newspaper. It's hard to follow a diet that feels more like a punishment than anything else.). For me, meals look like this: Eggs and bacon with cheese, maybe mushrooms (or sausages) and a bit of cherry tomatoes. Salad with tuna, olives, capers, mayo, and cubed avocado. Dinner's usually meat or fish with cauliflower rice or broccoli-rice, bacon and cheese. Snacks are extra dark chocolate, olives, cheese, that sort of thing. I've completely nixed bread, potatoes, pasta, cereal, corn... You know, carb-heavy stuff. Fruit too, though a few berries in double cream or full fat greek yoghurt won't harm you. (Other fruits are too full of fructose). Is this sounds like something you might want to try, and maybe be able to reduce or get rid of all medication, you can find more meal ideas over at dietdoctor.com . You can pay a fee and sign up and they'll send you a meal plan, but you can skip that and just browse their recepies: those are free, as are their low carb guides and video's. Do keep in mind that you shouldn't try this on hypo-inducing medication because your sugars can and will drop. So maybe do it together with your doc and/or dietician, if you want to try it? And if you do go for it while on meds, keep dextro or jellybabies handy, and your meter with you at all times, because well, like I said, I don't know your meds... So do be careful.

Oh, and I'll tag @daisy1 for her super-helpful info-pack. She'll be more useful than I have been, I'm sure. I just hope you'll feel better soon.

Good luck!
Jo
 
One more thing: if I eat something carb-heavy, I peak, and when my sugars finally go down, they do come crashing. They go lower than where I started out. If you go relatively low, your liver might panic and start dumping stored glucose/fructose into your bloodstream, so you can indeed go up without having eaten. Your nurse should be open to discussion and shouldn't be calling you a liar. Diabetes is different for everyone and very few of us are textbook. Our responces to carbs and their amounts differ wildly. You might want to discuss the unwillingness to talk about things and not believing you with your GP. She's there to help you, not to shut the door on your face.
 
She has informed me that this cannot happen and I must be eating something.......I am not!! She will not even discuss this with me so I can find a way forward.

I politely suggest that you do everything possible to dump her. It's bad enough having some issues but it's no good if you're not believed. I hope you get to see a consultant soon and I think you should suggest "borrowing" something like a FreeStyle LIbre for a few weeks, I know my surgery will lend CGMs if required. At least you can show what's happening . . . . . . and ask for an apology.

I've experienced fluctuations which I can't always explain. I sometimes wonder if slow intestinal transit times may affect when glucose gets into the bloodstream.
 
@TMoxhay

Hello and welcome to the Forum Here is the Basic Information we give to new members and I hope it will be useful for you. Ask as many questions as you want and someone will try and help.

BASIC INFORMATION FOR NEW MEMBERS

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 235,000 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

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.

Over 145,000 people have taken part in the Low Carb Program - a 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

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.
Take part in Diabetes.co.uk digital education programs and improve your understanding. Most of these are free.

  • Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why

  • Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.
 
@TMoxhay



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
t
OK I have to ask the question- This 2 hours after a meal. Is it meant to be 2 hours after you start your meal or finish it?

I have just taken mine after about 2 .75 hours after the start and it was 7.7. I am staying away from home and had something I never include in a meal i.e. a load of new potatoes which I think were oven cooked . I also had a mushroom omelette and a small side salad. I then came back to my room and ate a third of one of those oaty biscuits you get in hotel bedrooms (sugar second ingredient) I never eat biscuits but forgot to bring fruit with me!!

I ate earlier than usual (I am usually at the gym) but have some nuts if I get peckish later!!

Any comments on the 7.7?
 
2 hours after first bite. Is the usual consensus.
What about how long it takes you to eat your meal. It could take 20 mins or an hour. I would have thought that was more important- at least it makes sense to me
I suppose its best if you are consistent which ever way you do it.
 
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