Why does my BG do this?

[dswan]

Hi, all. This is my first post and I’m in need of some understanding about why my BG behaves the way it does.

First off, I was diagnosed as Type II about two months ago. My diagnosis was made based upon lab BG results of 148 and 154 and A1C of 6.2.

The general practitioner sent me home with a scrip for Glyburide (Micronase) 50mg. I took the first pill the next day and went hypoglycemic (I’m familiar with symptoms from long distance running and periods of extreme dieting in the past). I haven’t taken anymore meds since that one pill.

So, back to the lowcarb lifestyle, and this time with a motivation other than just controlling weight. I need to keep the diabetes from progressing any further.

I’ve been lowcarbing for seven weeks. I’m able to stay pretty faithful, but had to eat some tortillas when I was on a trip to Phoenix. Otherwise, I am pretty close to an Atkins induction diet – very few net carbs each day. I monitor my BG frequently (four or more times a day) to try to understand how/why my BG behaves. My average BG over the last seven weeks is 118 on just a lowcarb diet with no meds.

So here’s what is puzzling me:

Two hours after dinner last night, my BG was 103.

My BG upon waking up was higher at 115. WHY? I was in moderate ketosis. Does ketosis increase my BG?

After two cups of coffee and a 45 minute walk my BG was higher still at 121. WHY? I hadn’t eaten anything. Again, is the body increasing my BG when it burns fat?

Over the seven weeks, my BG is always highest one hour after breakfast. On average, it’s 116 at wakeup, 127 an hour later after coffee, and 150 after breakfast which is usually meat and cheese. WHY? Why does my BG go up dramatically without any carbs?

Can anyone help me with those three “WHYS”?

BTW, I discussed stopping the meds and going lowcarb with the diabetic education nurse. She’s not for the lowcarb diet, but she was opposed to the Glyburide. So she didn’t freak about me quitting the meds. She has ordered a new set of lab tests to measure my progress on the lowcarb diet for my next visit with the doc

Thanks.

[dswan]

Sorry....

"The general practitioner sent me home with a scrip for Glyburide (Micronase) 50mg."

That should be 5 mg, not 50

[CaseyZee]

Dawn Phenomenon.

I think everyone has this but it's more noticeable in diabetics. I believe the basic gist is that the body releases hormones overnight that increase BG.

Try a quick google search.

[Cajunboy47]

DSWAN:
First off, I was diagnosed as Type II about two months ago. My diagnosis was made based upon lab BG results of 148 and 154 and A1C of 6.2.

Your A1C is very much in the tolerance range. I think most doctors hope for you to have from 5.8 to 6.4 on your A1C tests. From the things you're saying, it surely sounds like you can control it by diet alone. I get surprise glucose readings sometimes and it makes me wonder, but I've come to realize, that only causes stress and stress raises glucose levels. So I try not to worry as long as I seem to be averaging out ok.

I don't think being in Ketosis, which means your body is burning fat for energy instead of glucose is a proof that your glucose level should be normal, however, it seems logical in most cases that it would. Maybe someone has a little research on this.

I've had some of my best A1C tests while LCing, but some of my worst A1C were LCing and yo-yoing.

I think you are doing well, you are focused, but like me, we just need to relax. We'll beat this disease.

[dina1957]

So here’s what is puzzling me:

Two hours after dinner last night, my BG was 103.

My BG upon waking up was higher at 115. WHY? I was in moderate ketosis.
It is called dawn phenomenon (DP), is a complex issue, and seem to be due to a low level of insulin after an overnight fast in T2, without food our body does not make insulin while liver keeps pumping glucose.
Does ketosis increase my BG?
I am not sure if it is ketosis itself, but very little carbs =not enough insulin for your body, which results in high glucogen = higher BG. There is a balance between insulin=glucogen in helathy ppl, in T2 liver is making excessive glucose via glucogenesis and gluconeogenesis and mostly due to insufficient insulin and/or IR.

After two cups of coffee and a 45 minute walk my BG was higher still at 121. WHY? I hadn’t eaten anything. Again, is the body increasing my BG when it burns fat?
coffee raises BGs and it is better to eat before any exercise, or liver goes into overdrive.

Over the seven weeks, my BG is always highest one hour after breakfast. On average, it’s 116 at wakeup, 127 an hour later after coffee, and 150 after breakfast which is usually meat and cheese. WHY? Why does my BG go up dramatically without any carbs?
I must have some carbs for BF, or Bgs will stay higher for longer.


[quoite]BTW, I discussed stopping the meds and going lowcarb with the diabetic education nurse. She’s not for the lowcarb diet, but she was opposed to the Glyburide. So she didn’t freak about me quitting the meds. She has ordered a new set of lab tests to measure my progress on the lowcarb diet for my next visit with the doc[/quote]

i would imagine that your Bgs do not warrant glyburide, I wonder why they did not Rx you Metformin, that works on IR but does not give you hypos as sulfonylureas. These class of meds will get you on insulin faster than any diet.
Give this diet some time, and yoour Bgs will level out.
I have troubles with DP too, and if I drop my carbs to induction level, my liver will make up for missing carbs, LOL. Liver makes a mjority of BGs in T2, so it is all about balancing.
Overall, it is a trial and error for everyone to determine what level of carbs, exercise, meds work the best for them.
Read a book or two onb diabetes, Dr.Bernstein's book is very informative.
Good luck.

[eddiemcm]

A locarb snack at midnight will usually make
the dawn phenomona less of a problem.
Good luck
Eddie

[dswan]

Thank you all for the answers. I do feel that I can control this with diet and no meds, but the quirkiness of the BG readings puzzles me. I've got a sufficient baseline of BG readings from all times of the day so I'll cut back to reading my BG three time a day and quit trying to micro-manage it.

My doctor is at the Naval Hospital in the area (I'm a civilian DoD employee). I felt he didn't do a good job with the Dx or Rx. Fortunately, I had some experience with the Atkins diet and found this website. I have re-purchased the Atkins book and read the Bernstein book through pretty quickly. I'll need to go back and read it more thoroughly, focusing on the Dawn Phenomena and liver function. Tomrorow I go back to the doc to discusss the low-carb diet and get his concurrence on quitting the meds.

[rabrijumo]

DSWAN, I TO AM A NEWLY DIAGNOSED DIABETIC TYPE II (OOPS CAPSlock offffffff)
I recomend dr bernsteins books:
Dr Bernstein's diabetic solution
The diabetes diet
I am just finishing them and they are a revelation.

[rosiejames]

I have been a Diabetic for a long time and many years ago I was sent to education classes to learn all about it. In effect, during sleep, everyone's blood sugar levels drop off. If they go too low, the liver produces glycogen which raises blood sugar levels. In non-diabetics it will only raise the level to a normal level. In diabetics it can skyrocket because the pancreas is not working properly and the liver does not know when to stop producing glycogen, thereby producing too much, which causes the blood sugar spikes.

I also read somewhere that in a low carb lifestyle the body exhausts its stores of glycogen. For me my blood sugar no longer goes up during the night and is no longer high in the morning. In fact, it is rather low and often goes so low that it wakes me up and I am forced to have something in order to raise it.