Coupla questions

[MsDad]

I was diagnosed as T2 in 1994. BG control has been poor (last A1C was 10+) so Dr started me on Lantus last week. I've also resumed LC WOE (at behest of aforementioned MD!) in an effort to gain control. In addition to Lantus, I'm on 1000 mg of Metformin twice a day and 4 mg of Prandin before meals. Now the questions:

1) I have always dealt with Dawn Phenomena - LC hasn't done a thing to help. Any suggestions/advice on how to stop this PLEASE?

2) Sunday I spent several hours outdoorsat the beach - it was extremely hot and I sweated my a$$ off the whole time. FBG was 170 that morning, then I ate a carb-free breakfast. During the course of the morning/early afternoon (on the way to the beach) I snacked on a couple small handsful of nuts (almonds, cashews & macadamias) and a Glucerna snack bar (which never causes a spike). I was so absorbed in what i was doing I didn't eat any lunch. :( Late in the afternoon, I started feeling crappy, which quickly progressed to nausea, lightheadedness, headache and the general feeling that I might die at any moment (ok, admittedly a tad dramatic on the visions of death). Checked my BG and it was 266! At any rate, I left and headed home. On the way home I forced myself to drink two bottles of water, then laid down for a while to cool off. Wound up falling asleep for about an hour. Shortly after I woke up I checked BG again - 81! That's actually the best reading I've had in almost two years. Does anyone have any ideas what happened and why? I've theorized that I was overheated and actually underhydrated. But can't find anything to support my theory. Anyway, next morning's FBG was 162 (takes us back to question #1, huh?).

Thanks for any input...

[ADE]

Hi Eddie,
I'm going to try to explain what's going on, but first I have no medical background what so ever. I learned everything through experience and reading books and newsgroup such as this.

On your first problem, many people dealt dawn phenomenome by eating small carb snack at night such as; 1 tablespoon of peanut butter, cheese, crackers, etc.

Your second situation was due to not eating lunch. by not eating lunch, your body sensed of lacking glucose and it might be that your glucose was pretty low at that time, as a result your lever started dumping sugar to make up the low. Unfortunately, your body couldn't utilize the insulin that suppose to counter the lever dump, therefore your glucose was that high.

I hope this small explanation can do it until somebody more knowledgeable come aboard. Take care.

[dina1957]

In overweight T2 liver produces the majority of glucose. I have no time to elaborate now why but if you search through the threads, it has been discussed many many times on this forum. DP is a combination of liver glucose overproduction +lack of insulin in the dawn hours, also regulated by release of other hormones by the body. DP most of the times has mind of it's own, meaning it's very hard to predict your fasting number based on food you ate day before. Illness, stress and lack of sleep all can contibute. Liver is on guard 24x7, preventing us from sleeping into a hypo-coma when you skip a meal and/or sleep at night. The best way to deal with DP is indeed eat a protein/carb snack before bedtime, this is assure that you insulin level is higher through the night and it will spike your Bgs a bit preventing getting low and then too high as a rebound. If yopu are on insulin, basal insulin before bed should be helpful too. Eating a no-carb breakfast drive my BGs even higher, generally speaking this is the worst time of the day BGs wise, and I must eat some carbs to stop so called liver sugar dump, otherwise, my Bgs will continue to rise. DP is common for non-diabetics too but what makes the difference between us and non-diabetics, is they have enough STORED insulin to counteract the sugar rise, while we don't (Phase I ). So we must eat some carbs to get insulin spike and lower BGs. VERY LOW CARR DIET DID NOTHING TO MY FASTING BGS TOO, foremore, lack of carbs (<60g) makes my FBG spike even higher. It can prevent suigar spike after lunch and dinner but makes FBG even higher. You take your pick and YMMV as usual.
HTH,
Dina

[MsDad]

I've been increasing my Lantus per my Dr's instructions and eating small snacks before bedtime. FBGs have been better overall, but still need work. I am encouraged though...

[ADE]

Well Eddie, congratulation on your progress. Once you're able to find your correct food, you may want to start looking into different exercises. Since the diagnose, I've been going to the gymn daily to do 1/2 hr cardio and 1/2 hr weight lifting. Muscle is a good sugar storage. I, also, started taking 1 tablespoon of apple cider vinegar prior to each meal. Take care.

[MsDad]

Well, that's one of the problems. We joined the gym a couple of years ago - then DH's business started taking off and we just don't have the time to get there. And it's been in the mid- to upper-90s here all summer so I can't get out to walk or ride my bike. And it's not cooling off in the evenings enough to do it then either. Once it cools off a bit, then I can start walking/biking. As for the cider vinegar thing, YUCK! I tried it for a while. It didn't bring about any noticeable changes and after several weeks I found myself gagging at the thought of vinegar - and I LOVE vinegar! Just goes to show that YMMV is so true. I know tons of folks who swear by cider vinegar.

FBG was 130 mg/dl this morning, so Lantus gets increased by another 4 iu tonight. Maybe 50 iu is the magic number...??

[ADE]

Hi Eddie,
I notice that you live in Florida, because I used to lived in Miami in early 80's attending Miami Dade comm. college north campus and stayed in Opa Locka. Now, I live in San Francisco and the weather is too cold for me at this shape. When my weight was in +225 pounds, I could go out in the cold weather with just a flimsy t-shirt.

I'm sorry to hear that vinegar is not working for you. I know many people who don't like apple cider vinegar, so they choose different kind of vinegar such as; rice wine vinegar, red wine vinegar, etc. I can not say that vinegar brought down my glucose, because I've brought it down through low carb diet and exercise. I'm taking vinegar for health maintenance and for its many benefit for the health in general. I can only emphasize low carb diet and a lot of exercise to control diabetese. The first 3 months after being diagnosed with diabetes, I would go twice a day to the gymn to do 1/2 hr cardio and 1/2 hr weight lifting. Once I stabilize my glucose, I started going only once a day to the gymn. If the weather is too hot for you, you might want to get a stationery bike at home and put it infront of the TV. You may also try water aerobic.

Besides the vinegar, I, also, take 1 teaspoon of cinamon powder with my morning coffee. I don't buy fancy diabetic supplements and pay the hefty price for them. I would buy some supplements when they are very reasonable price and after further research on them. Some supplements that I take based on the recomendation of a friend of mine who was a trained health specialist are Alpha Lipoic Acid, Chromium, Fish Oil, Vit. C, Multi. Vit, B50. I, also, tried taking Gymnema Sylvestre when it is really cheap. All these supplements are YMMV (your mileage may vary) thing.

Well Eddie, I hope you don't mind of me sharing my experience in dealing with this disease. Take care and I hope you'll be able to gain control of this beast.

[MsDad]

I'm working on my supplements right now. I'm taking fish oil, evening primrose oil (to hopefully reverse some mild neuropathy in feet and hands), flaxseed oil, CoQ10, acetyl l-carnitine, multivitamin, chromium, Alpha Lipoic Acid and a fiber/probiotic blend, as well as a few other miscellaneous ones. I almost don't need to eat breakfast - the supplments alone almost fill me up! Oh, and I'm waiting on a new diabetes support supp to be shipped. It has banaba leaf extract plus several other traditional ingredients (gymnema sylvestre, vanadium, fenugreek, etc).

I certainly don't mind anyone sharing their experience - I need all the help I can get!

This morning's FBG was 88, then 129 before lunch and 113 two hours post-prandial. It's definitely more encouragement, but I'm thinking I should add just a few grams of carbs at breakfast - only had 3 net (no sugar alcohols subtracted, just fiber) and BG went up. Oh well, trial and error...

Many thanks to everyone for all the advice and encouragement!