Stubborn spikes!

[Lelliee]

Hi everyone,
So I'm feeling a bit at my wits end with my blood sugars lately, despite having my hba1c being 47, two less than last time. I'm not satisfied... I've just phoned the DSN to try and voice my concerns and I get told I'm doing fine and there are no concerns. The consultant says the same.

I have the most stubborn morning spikes that seem to take until early afternoon to go away.
Last night I went to bed on 6.4 at 23.27 and woke up on 8.6... I then had my poached eggs and 500mg metformin slow release and I didn't get down to 5.8 until 13.35...
The night before I went to bed on 5.8 at 23.43, by 05.54 I was on 7.2 and I woke up on 7.8 at 10.10, which continued to rise to 8.0 by 11.20, I had cheese and ham for breakfast and my 500mg metformin slow release, by 13.38 I was on 6.2 and didn't drop into 5.3 until 16.09.
The night before I went to bed on 5.3 and woke on 8.3.
The night before I went to bed on 5.8 and woke up on 8.2.
Etc etc...
I'm able to watch my spikes and levels due to using my libre, I use this due to severe blood and needle phobia and I couldn't be without it. which I know at times does run slightly higher with this sensor- the other day sugars were 7.3 and dreaded fingerprick was 6.4. I also checked my ketones whilst I was at it which were 0.2. But even so, I'm really getting very disheartened with my fbgs.
I recently had a panel of bloods done and got these results:
They were drawn fasting at 10.20am and are as follows:
Hba1c- 42
Glucose- 8.8
Insulin- 29
C-peptide- 846
Antibodies- negative
I phoned my consultant to retrieve the units of the latter 3 numbers to which she said I wouldn't understand them!
She just said it's clearly evident that I produce my own insulin but that I definitely have insulin resistance.

I am currently taking 500mg sustained release metformin with breakfast and tea and I also take 200mg sertraline in the morning but I doubt that has an effect (to my knowledge?)
My diet consists of meats, cheeses, fish, veggies, eggs, salad, sometimes I steal the odd new potato or something off my partners plate at dinner time or share a chocolate bar or have the burger out of the bread from McDonald's, but generally very low carb. Drinks I usually have water, the odd decaf coffee with sweetener and whole milk and my weakness... Coke zero.
Please help or advise me, I feel asthough I'm a bit alone in my concerns.

 

[ert]

I'm sorry you're having a tough time. I recommend reading Dr. Jason Fung: The Diabetes Code.

 

[Lelliee]

I'm sorry you're having a tough time. I recommend reading Dr. Jason Fung: The Diabetes Code.

Thank you!

 

[MarkMunday]

... I have the most stubborn morning spikes that seem to take until early afternoon to go away. ...

You are observing the so-called Dawn Phenomenon. In the early morning, the supply of hepatic glucose increases and blood glucose goes up.

 

[Lelliee]

You are observing the so-called Dawn Phenomenon. In the early morning, the supply of hepatic glucose increases and blood glucose goes up.

Yes I think so too... I have spoken to the dietician and it's agreed, got to up the exercise even more to shift more weight and hopefully help combat insulin resistance... I'm 5ft8, size 9 feet and have managed to get from 96kg at the start of pregnancy to 88kg post pregnancy. One of the only people they know who lost weight during pregnancy even though my son was obviously getting bigger, I was losing due to losing fat!

Went to sleep on 5.3, woke up on 8.6, had ham with two eggs, metformin, by midday I was on 7.1, been for a big walk to the other side of the harbour and back, about 2 miles, now on 5.3!

 

[JoKalsbeek]

Yes I think so too... I have spoken to the dietician and it's agreed, got to up the exercise even more to shift more weight and hopefully help combat insulin resistance... I'm 5ft8, size 9 feet and have managed to get from 96kg at the start of pregnancy to 88kg post pregnancy. One of the only people they know who lost weight during pregnancy even though my son was obviously getting bigger, I was losing due to losing fat!

Went to sleep on 5.3, woke up on 8.6, had ham with two eggs, metformin, by midday I was on 7.1, been for a big walk to the other side of the harbour and back, about 2 miles, now on 5.3!

Dawn phenomenon takes forever to go away, and for some, having a tiny smidge of carbs in the morning (and then I mean a small square of extra dark chocolate for instance. Really, next to nothing) would be enough to tell your liver to knock it off with the glucose dumping. At the same time... Just letting it spike is alright too. If it's in your bloodstream on the way out, then at least it's no longer stored on/in your liver, which is progress too. Go with whatever you feel comfortable with. Oh, and dawn phenomenon, you spike higher with interrupted sleep. Which tends to happen with new moms! So do give yourself a break, you're making great strides here! You may not be where you want to be, yet, but the way things are going? Just a matter of time. Believe it or not, you're rocking this, taking charge and everything.

 

[Alexandra100]

I have spoken to the dietician and it's agreed, got to up the exercise even more to shift more weight and hopefully help combat insulin resistance

You mentioned walking, which is great exercise, but have you considered doing some resistance/weight training? I found this article in my inbox this morning, and Google has lots more articles on the benefits of this kind of training if you are interested.
https://www.everydayhealth.com/type-2-diabetes/living-with/weight-lifting-get-strong/

 

[Alexandra100]

the odd decaf coffee with sweetener and whole milk

This is just a tiny tweak, not an adequate answer to your problems. Did you realise that double cream has half the carbs of milk? (And SO much luxurious, IMO.) Which sweetener are you using? Many of them can raise bg, or even may be mixed with sugar, which is so much cheaper for the manufacturer. Personally, I use saccharin in the occasional hot drink. It is very cheap to buy and thetubes are easy to transport in a handbag or similar. I find just one tiny tablet almost too sweet. There was some kind of health scare about it a long while ago, but I think that has largely been superseded. It has been around far longer than most artificial sweeteners and as far as I know no-one has died yet! My other go-to sweetener is Erythritol. This is granulated like sugar but has no carbs. It is expensive and as far as I know only available on the internet. It is much less sweet than real sugar.

 

[lessci]

I know it's tough, but be patient, Fasting BG's are stubborn for many of us. now for the platitudes - Rome wasn't built in a day, it sounds like you're doing all the correct things. Controlling you Diabetes is a marathon, not a sprint, and as longas it's moving in the right direction you're doing great (even if it's not we're all human and slip up sometimes, you just have to not let it get you down and start again)

 

[finsit]

Hi @Lelliee , there are couple of things i would add that might help based on my personal experience.

1. Metformin SR to be taken with the evening meal instead of morning meal because Met SR reaches to its peak at 7 hours as opposed to regular Metformin that reaches peak in 2-3 hours. Taking Metformin SR in the evening, will help you fight the dawn phenomenon. In fact Dr. Bernstein suggests Metformin to many T1 diabetics to combat DP.

2. I am assuming you have an early dinner, which should 3 hours before you sleep, ideally. One thing that will super-help you in this dawn phenomenon is 45 minutes bike/treadmil (if you have one at home) or if you can do a brisk walk 30-45 minutes like 2 hours of your dinner.

3. Make sure you have minimum carbs in the evening meal and have it more of protein. Because protein slowly releases into blood stream as sugar, your sugar levels don't poke the liver to dump more sugar. However, much of this has to do with insulin resistance as well.

Its always trial and error as we all are different, but at the end something always works for everyone. If you try and it works, please share your feedback. Best of luck.