What am I doing wrong? (My morning reading is higher than my bedtime one)

Hi.
Just before bed my reading is around 10.5, but in the morning my reading is *higher*, at around 12.0. - So I'm wondering what I'm doing wrong....

Background: Type 2 but kept my HbA1c at 7 (new:50) by the LCHF diet only, until recently when it was 9.5 (new:80) due to work stress.
Then stopped work (approx 4 weeks ago) & since then, my pre-dinner readings have been approx 7.5 (Yay. ) instead of the 10 they usu were.

Routine:

• Breakfast is small (as pre-reading is around 12). - Greek yoghurt, a chunk of cheese, and a Vit C pill.
• Lunch - Nil. (To give my sugars a chance to drop further, as around 10 by then.)
• Dinner (6pm) - Reading is 7.5 (Yay ) so this is my biggest meal of the day: 300 gm brussel sprouts, 100gm melted cheese, 1 cup frozen blueberries. (Might also have either 85g can of tuna or chicken, plus a small handful of plain nuts.) Vit B pill and Mg.
• Bedtime blood sugar reading: At about 10pm, ie 3+ hrs after meal. Reading usually around 10.5
• Drinks: Almost always only water.

Other info:

• Blood tests (eg liver, kidney, iron, thyroid -and cholesterol) ... all within normal range, except for sodium (which is a little lower than normal, so I'm adding salt to my br sprouts), and of course my HbA1c (altho' my random/spot glucose was within normal range).
• Adrenal fatigue. - This isn't a "widely recognised" medical diagnosis (except by my GP in 2017), but I feel burnt out/exhausted (from overdoing things for decades), and in 2017 I improved in about 6 mths, by complete rest. Am trying (ha!) to do that again now. (Perfectionist/OCD/over achiever. Don't generally rest unless the body makes it impossible to do otherwise.)
• Body temp control. - Feel sick when I'm "too warm". Consequently, now during winter I don't wear a jersey but instead a few thin layers so I can quickly cool down if I'm feeling too hot (instead of feeling dizzy/passing out).
• Sleep: I wake up 3x a night to pee. (Dontcha love getting old, LOL) During the night I add/remove blankets, as req'd. When I finally wake up in the morning I generally feel agitated, not rested/relaxed). (That could be one reason for the high morning reading.)
• Blood pressure: usually tends towards low eg 109/63
• Other: I sometimes get sharp chest pains ... but my Dr won't consider that anything besides Diabetes is wrong with me (& so refer me for tests, even tho' I have private medical insurance) ... until my HbA1c is lower. (I know that it'll be a bit lower than the last one because my 3/day readings are better than they were - but I need to wait 3 mths for it to show on the HbA1c, sigh. (I swear that I could go see him with a broken leg (!) and he would still say that it would be OK once my HbA1c is down, and not follow up on it.)

Thanks for your help.

Kind regards,
Rosalind (in New Zealand)

PS I have tried taking Metformin in the past, but it makes me feel sick - so would prefer not to do that. But I'm thinking now that I might need to take it at night if I can't get my readings down by diet etc.

Hi Ellie

Thank you for your help. <3

>How long have you been T2?

I was diagnosed in 2009, when I was 50 yo. (I'm now 62.) At the time, I was working f/time, studying for my chartered accountant exams, Mum to 6 kids, not getting enough sleep ... and snacking on lollies and Coke to stay awake to get enough study done.
I stopped the lollies & Coke, and after that my bl sugar levels have been OK. (Not always as low as a non-diabetic, but generally pretty close.)

Then in mid-2017, my health crashed. (This was soon after my Mum & husband had both died; I had looked after both of them, while working fulltime & quickly finishing my Masters degree in time for my husband to see me graduate.):

• During the 1st 6mths of the 2017, I had (accidentally) lost 25 kgs. (No obvious reason. I was eating the same as I always had, eg weetbix for b'fast, sandwiches for lunch & lasagne for dinner, with snacks in between. Drs never looked for a reason of the weight loss, but insisted that I must have stopped eating from the grief - and been too stupid to notice... Grrrrr.)
• Complete exhaustion. Had to give up work; just walking from my couch to the kitchen was tiring. (Was told "Adrenal Fatigue"; not a real medical diagnosis but they couldn't find anything in bl test results etc.
• HbA1c was 11 :-/

Then I took Metformin for a few weeks until I found your website & learned about low carbs etc. Since then (until fairly recently) my bl tests results have generally been Ok, ie around my numbers in 2010-2016.

Rested enough so that felt OK enough to go back to work in 2018. Numbers were Ok, until Dec 2020. I struggled on at work but have just been getting more and more exhausted; stopped work last month, had blood tests. Have gone back to being more strict re carbs (but obviously not strict enough yet, sigh).

>Are you carrying more weight than you'd like?

Not anymore; the weight I lost in 2017 unexpectedly, I have not regained. - Not that I look like a relative of Twiggy but Drs no longer routinely advise me to lose weight.

>The Liver and Blood Glucose Levels (diabetes.co.uk)

Thanks. I'll take my bl sugar reading at 3am one night.
(Interesting that it's the liver... My gall bladder was removed in 1993.)

>Metformin would probably help reduce it. Have you tried the slow release version?

Even tho' studies show the XR version to be more "gastrointestinally tolerable" (https://pubmed.ncbi.nlm.nih.gov/15119994/) than the normal version, I might still feel sick (well, sicker than I already feel), as I've got a pretty dodgy stomach (hence the boring/bland meals), eg I didn't get just "morning" sickness when I was pregnant, I was sick all day and for most of the 9 mths per pregnancy. For several of those months, the only food I could tolerate (& not immediately throw back up) was a plain boiled potato (with one blob of tomato sauce on top, if I was feeling ok at the time). And now, if I go to a restaurant, I might order something bland chicken - but if they've added even the tiniest bit of pepper or spices, I get a tummy ache for 12-24 hrs afterwards.

>Are you seen by your GP or the hospital?

GP only. But I have private medical insurance so see a gastro specialist privately. (I'm due for a follow up colonoscopy but don't want to do that until I have a better HbA1c number.)
BTW, I was sent to see a hospital dietitian in 2009 who:
1. Insisted that I should follow the standard food pyramid -of carbs being the 2nd largest portion of your diet, and
2. That I should increase my carb intake at each meal. (At the time I was having a fairly common diet eg 2 or 3 weetbix for bfast, and sandwiches of 4 pieces of bread.)

Thank you for your help.

Kind regards,
Rosalind

Hi Vashti

> I suggest that you google dawn phenomena as that can cause your levels to increase.

Thank you.

>The dinner you describe has more carbs than I can tolerate. You can have a very substantial meal with a lot lower amount of carbs. You level 3 hrs after is more than 2 higher than your pre meal level. This generally indicates that the meal contained more carbs than your body can tolerate well. The Brussel sprouts and blueberries both have a reasonable amount of carbs. It is also true that some people can tolerate carbs in one form but not another

Ah, thank you. That makes sense. I think that I have allowed myself to have too much of them, thinking (like in Animal Farm, "4 legs good") that because green veges & blueberries are "good", I can eat lots... :-/

>- so for example can tolerate a meal with 20 grams of carbs but if it contains potatoes can't tolerate that amount of carbs. I would suggest dropping one or the other and see what affect that has on your levels.

Thank you. I didn't have either last night (as I'd already eaten lots of food, mid-afternoon so I had just a tuna/tomato can and some nuts) - and my morning reading was almost a whole point lower than my bedtime one. Yay!

Kind regards,
Rosalind

>http://diabetesupdate.blogspot.com/2010/05/understanding-fasting-blood-sugar.html[/QUOTE]

Thank you! Most interesting. - I have naturally low blood pressure (-& often feel dizzy). It could be that this is happening: "if your blood pressure drops too low, you will get a burst of epinephrine and other hormones meant to keep you alive. It will raise both blood pressure and blood sugar."

>I’m wondering if you are eating enough food. It doesn’t sound much at all

That was just my baseline. I also eat say, Eggs Benedict when I go out with friends. And I eat a *lot* of cheese. (If I become lactose intolerant, I'm going to be in serious trouble, LOL)

>and your body could be dumping glucose to compensate.

But wouldn't that be enough to bring it back up to a normal range, not to a (more) too-high number?

>The nighttime peeing is probably aggravated by the higher bgl as well as age.

Plus being woken up eg by muscle twitching or by my temp sensitivity (too hot/too cold), and going to the loo "as I'm awake anyway"...

Hi Mr Pot

>Where do you get your calories from, have you calculated them?

Nope, I haven't. (Mainly 'cos I'm too lazy, lol)
I instead aim for high protein & low carb, as my goal is about bl sugar. (Altho' recently I did a urine ketone test "just in case" I was going too far, and it came back as completely negative.) And I eat -a lot- of dairy, probably 2 kg edam and 1.5kg greek yoghurt, per week.

> I am old, not specially active and not overweight but your meals would be a starvation diet for me. I have egg and bacon for breakfast, salad for lunch and a large meat and low carb veg dinner.

I'm not starving, and generally, I eat because I like the taste rather than because I feel hungry. Maybe that is partly because of the adrenal fatigue/exhaustion/burn out, where an "active" day for me means that I walked out to the letter box to check for mail. :-/

But I really, really like the sound of your meals.

Kind regards,
Rosalind

PS What are your "low carb veg" for dinner? I like brussel sprouts (a lot!) but that may be too high carb for me...

@EllieM @VashtiB @LaoDan
Thank you everybody for your help. <3 My pre-breakfast readings have dropped 2 whole points, from 12 to 10. (Wooohooo!!! )

(I moved [& reduced] my brussel sprouts & blueberries from dinner to breakfast and added more protein to that meal, and my dinner veges are now lettuce, celery and mushrooms.)