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Things I don't really understand.

M

Margarettt

Well-Known Member
Messages
367
Type of diabetes
Type 2
Treatment type
Diet only
Morning
Just when I think I'm beginning to understand how it all works there's something to confuse me. I was diagnosed a week past today and have been "properly" low carb since Monday. (Monday readings were all 9, 10 and 12s)
Wednesday my readings were either 6 point something or 7 point something with my first ever 5.8 before lunch. I think "right we've cracked it here we go."
Thursday Similar to Wednesday although breakfast was 7.3 before and 8.2 after
Now today my waking up number is 7 and a couple of hours later before breakfast its 8 How does that work?
I only had 20 carbs yesterday and my dinner last night was only four or five carbs.
I know I sound really impatient and I've lurked about enough to know I should be grateful for the numbers I have but I really want to get everything below 8 and I don't understand the sudden 8 before breakfast when I've been rally low carb for 4 days.
I suppose the question is- Is there a period of time things need to settle down? Am I just impatient? Could anything else make the numbers go up?
Finally on 3 occasions my numbers have been lower after my meal than before. How does that work?
Thank you for being patient with this wee fat middle aged diabetic who wants to be in remission "NOW"
 
Rising numbers before breakfast is down to something called dawn phenomenon or foot on the floor. Essentially the same thing.

When your liver senses lower levels of glucose in the blood than it’s expecting it dumps some stored glucose into the blood to bring it back to where it thinks it should be. Now after a long overnight fast it thinks we need that extra boost to get us up and running. It should turn off when we’re normalised and had enough. In type 2 until we get it under control we have a dodgy perception of where it should be because we’re used to running high and the off switch is a bit sticky.

So after a long fast (overnight) it overdoes it a bit and we get the rise that seems so odd without food. It can happen at other times too but that’s the most common. That faulty perception of “normal” also explains hypo sensations when numbers are not hypo. It’s a level we aren’t yet used to even if it’s healthier.
 
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Lower numbers after meals. That can be for a few reasons. It might still be falling from the previous meal/event that caused a rise. Eating a very low carb meal doesn’t raise it much at all so it continues dropping from the earlier one. It shows that the meal you just ate was great for not causing you trouble. Sometimes if we eat a higher carb meal unexpectedly having been low carb then the body can overshoot on insulin trying to combat it and actually take us lower than our normal. Not a strategy to be repeated deliberately as that would become normal quickly and thus accepted and a new “normal” and levels would overall rise.
 
Finally the meters aren’t perfect. There’s a degree of tolerance there and the occasional wacky reading too. And there’s more than just food that affects our levels. Sleep, infection, illness, stress, exercise, even the weather are just a few others. Food is just the most controllable and one of the biggest.
 
Agree with @HSSS .

I found my morning readings were the last to come down and the least useful in telling me the impact of what I was eating/doing. It really takes quite a bit of time to train your liver to accept lower bg levels as being OK. Until then it will go on adding glucose by itself. I experimented once and it was still adding glucose at 2pm, eight hours after I'd woken.

Your meter has an allowable error of 5% for 95% of readings. That means that a reading of (eg) anything from 5.7 to 6.3 could be based on an actual BG of 6.0, and there's roughly a 1 in 20 chance that it's a totally rogue reading (but those are usually really abnormally high or low in my experience) .

https://diatribe.org/42-factors-affect-blood-glucose-surprising-update gives a list of things people have reported as affecting their blood glucose levels. One of things that affects mine is outside temperature. When it's hot, my BG always goes up. Why? don't know.
 
What do we want? Remission! When do we want it? Now!

It'll take a little bit longer than that, I'm afraid. As you know from the above replies, Dawn Phenomenon plays a role. For quite a while now, your liver has been storing the glucose you couldn't burn off due to your insulin resistance... Your liver is, therefore, rather full of the stuff. And in the morning it helpfully dumps some of it to help you get your day started. The morning fasting numbers are the last to come down, but consider this: If it's out of your liver and in your bloodstream, it is on its way out of your body, which is a good thing! (Most T2 diabetics have non-alcoholic fatty liver diseae, and this helps get that sorted!) So while I know being high in the morning isn't exactly fun, it isn't bad, per sé, if you're depleting what's stored in the liver, and through low carb you're not topping up the stores any longer... Eventually your liver'll be running on empty and THEN your blood sugars will be lower than 8 in the morning. It can take months though. So forget the fasting blood sugars, they don't give an indication on how you're doing. Your measurements before and after food however, do. And those say you're rocking this low carb thing!
 
The first readings of the day are probably a sign of progress, of lowering insulin levels in general so that glucose can be got out of storage and used up.
Your reaction to eating results in the usual response for type 2s, an outpouring on insulin which was, previously ignored, now you are seeing a proper reaction to it, though it might be a bit over the top at the moment.
It will take time for things to get back closer to normal as there is a lot going on, but you should be able to see things happening - hopefully what is going on is all to the good and will result in remission with any luck.
 
Thank you so much for taking time to explain everything. Your posts really helped me today.
 
Thank you for this really useful list. I exercised before breakfast (it would have been light for an ordinary person but felt like hard going for me) It may have an explanation as simple as this. I'm going to try not to focus on high morning numbers and just look at the great things that are happening at lunchtimes.
 
Resurgam said:
It will take time for things to get back closer to normal as there is a lot going on, but you should be able to see things happening - hopefully what is going on is all to the good and will result in remission with any luck.
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I needed to read this today. Thank you.
 
Margarettt said:
Just when I think I'm beginning to understand how it all works there's something to confuse me. I was diagnosed a week
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I'm 3 years and 4 months in, and still learning! Don't worry if it takes time, and then just when you think you've got it sussed, something changes and there's more learning to do!

Remember too that many other factors affect bg, not just carbs and sugar which are the main ones, but it can change due to
Exercise, duration and intensity
Temperature, high or low (mine rises in the shower!)
Illness
Stress
Medications
Sleep, or lack of or duration or depth
...and much more . Someone mentioned 42 factors. So use your meter as a guide not a rule!
 
i started 3 weeks ago on about 40-50g carbs which suits me and my morning levels where high 9’s i have since lost nearly a stone in weight and mornings down to low 7s and some days high 6s and during the day 5s, i was worried too but it is coming down slowly and happy about that but i have been told to give it at least 6mths if not more i am on 500mg metformin once a day .. I only test now if i eat something new and i keep a list of everything that is ok and a list of no go’s good luck on your journey x
 
Thank you for being patient with this wee fat middle aged diabetic who wants to be in remission "NOW"

That made me smile.
I was you 4 months ago, albeit a few years older.but just as impatient.
Initial diagnosis was a big shock with hba1c of 87
Prescribed Dapagliflozin and Metformin. Bought a GM monitor and scoured this forum and started low carb. Anywhere between 15-40 ish a day. My first GM reading was 14.3.
Levels soon began to drop, so did the weight but my morning reading stayed stubbornly high. 8 ish.
My bloods after 3 months, (which was an agonising wait) came back at hba of 38

All meds have stopped, I’m now diet only and my lovely DNurse has challenged me to maintain and stay at 42 or below for my next bloods in 3 months. Then she will class me as in remission.

I’m still getting around 7 in the mornings, but this doesn’t concern me as much anymore. Other readings are more than decent through the rest of the day.
Impatience is not a bad thing, keep doing what you’re doing, pat yourself on the back and don’t be frightened of carbs. Knowledge is power
 
The cynic in me thinks the challenge, is so that she can claim it as a win for her, totally disregarding the hard work YOU'VE put in.
 
Thank you for this. Three weeks, WOW. I'll be one week low carb on Monday. I've only been using it for five days but my meter has a function on it that works out your average BG over 7 days. Over today and yesterday the average has moved down point by point from 8 to 7.2. I know its to early to mean anything real but it gives me hope. My weight has been steady all week, which in itself fascinates me with all that frying and cheese and cream. Fingers crossed that will drop too. Thank you for your encouragement x
 
Kernow Debra said:
Impatience is not a bad thing, keep doing what you’re doing, pat yourself on the back and don’t be frightened of carbs. Knowledge is power
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I'm still very new to the game and sometimes a bit overwhelmed with everything. Caring, supportive posts like this make me well up. I'm so glad I found this forum. Thank you
 
ajbod said:
The cynic in me thinks the challenge, is so that she can claim it as a win for her, totally disregarding the hard work YOU'VE put in.
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Blimey that is cynical!!
In her defence, she’s relatively new to our Surgery, ex chemo nurse.
Has been really supportive and encouraging, is pleased to see someone actively try and get their numbers down. Not the norm she said sighing.
 
Margarettt said:
I'm still very new to the game and sometimes a bit overwhelmed with everything. Caring, supportive posts like this make me well up. I'm so glad I found this forum. Thank you
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It gets easier Margarett, you’ll soon be in the swing of it. .
Totally agree with sentiments about this forum
 
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