Morning blood sugars high

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jano
New Member


Date Joined Jan 2006
Total Posts : 14
   Posted 7/23/2006 5:48 PM (GMT -7)   
I am new to diabetes since April.  I always have trouble with my morning blood sugars.  They want them under 120 but they are always 130s to 140s and higher sometimes no matter what I do or don't eat at night.  Anyone have a similar problem and if so any tips on how to get them lower.
 
Jano tongue

Jeannie143
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Date Joined Apr 2004
Total Posts : 6056
   Posted 7/23/2006 9:25 PM (GMT -7)   
Jano,
what meds are you on? are you exercising? How many carbs a day are you taking? Need some background to help you out.
~ Jeannie

"People are like stained glass windows: They sparkle and shine when the sun's out, but when the darkness sets in, their true beauty is revealed only if there is light within."

- Elizabeth Kubler-Ross


jano
New Member


Date Joined Jan 2006
Total Posts : 14
   Posted 7/24/2006 8:27 PM (GMT -7)   

I am taking 500 mg at breakfast and 1000 mg at dinner of Metformin.  I have cut way down on carbs.  I have an appointment with a nutricianist next month to get a better hold on what I should be eating. I tried last night to have a high protein snack before going to bed and my blood sugar this morning was 126 which is good for me, so I am wondering if I have hit on something with this.  I can go without a snack and still wake up with too high of a blood sugar in the morning.  I am wondering if your body fights to keep blood sugars up while you are sleeping so they don't go down too low.  I have read that this can happen to insulin dependant diabetics.

Jano


Chutsman
Regular Member


Date Joined Jul 2005
Total Posts : 64
   Posted 7/25/2006 5:03 AM (GMT -7)   
"I am wondering if your body fights to keep blood sugars up while you are sleeping so they don't go down too low". 
Apparently there is an effect like that - odd name for it that I can never pronunce.  One of the mods, Warren, has a good explanation for it.  If I could remember the word you can search for it but I don't at the moment.

Edit: Okay found an article about it (good ole Google):

http://diabetes.about.com/od/monitoringdiabetescontrol1/a/downsomogyi.htm

The effect is called somogyi.


The short form for "you are" is "you're", NOT "your".


spooky
Regular Member


Date Joined Jan 2006
Total Posts : 101
   Posted 7/25/2006 6:29 AM (GMT -7)   

Hi there,

            Since you did not say that you use insulin, i will focus on the "Dawn Phenomenon".

 The "Dawn Phenomenon" commonly occurs between 3am and 8am. In most people, glucose levels rise just enough to provide the body with enough energy needed to wake up and start the day. Any excess glucose is handled by a burst of insulin. People with type 2 diabetes cannot properly use available insulin to respond to this rise in blood glucose. Therefore, blood glucose levels will rise to abnormally high levels and cause hyperglycemia (high sugar levels).

 It is also possible that your blood sugar may be dropping too low during the night causing a compensatory increase in glucose (rebound hyperglycemia). This could also cause your morning reading to be high. You may want to get up in the middle of the night around 2-3am to check your blood glucose level to determine if it is going too low.

 If it is low, you may want to try eating a snack containing carbohydrates before bedtime to see if this helps keep your level from dropping too low and rebounding high. 

The"Somogyi"effect occurs most often in diabetics on insulin.

Your question is partly perplexing because you mentioned you are on Metformin.Metformin is one of the best drugs to counter-act the"Dawn Phenomenon"So there you are!


Jeannie143
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Date Joined Apr 2004
Total Posts : 6056
   Posted 7/25/2006 9:52 AM (GMT -7)   
Spooky said it all! (Brilliantly, I might add!)
~ Jeannie

"People are like stained glass windows: They sparkle and shine when the sun's out, but when the darkness sets in, their true beauty is revealed only if there is light within."

- Elizabeth Kubler-Ross


Lex4153
Regular Member


Date Joined Jun 2006
Total Posts : 21
   Posted 7/25/2006 9:53 AM (GMT -7)   
Same thing happens to me, this "rebound", I noticed. When I skip lunch my bg is normal but then raises all on it's own without me eating anything.

jano
New Member


Date Joined Jan 2006
Total Posts : 14
   Posted 7/25/2006 8:55 PM (GMT -7)   
Thanks for everyones input. I have eaten a small high protein snack at night for the last couple of nights and my blood sugars have been in the 120s in the morning which is better. So I am going to keep trying this.

thanks again,
jano

Warren
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Date Joined Oct 2005
Total Posts : 534
   Posted 7/26/2006 6:30 AM (GMT -7)   
Hi Jano,
 
Those are some pretty hefty doses of Metformin.  You should talk to your doctor about adding a sulfonylurea (a type of pill that stimulates your insulin production) to your meds.  Not only will it get your numbers lower, but it may prolong the time you can take metformin before it becomes ineffective.  The combination may get you into the sub 100's for your numbers which is a nice place to be.
 
scool  Warren
It's not that some people have willpower and some don't. It's that some people are ready to change and others are not. - James Gordon, M.D.
What some call health, if purchased by perpetual anxiety about diet, isn't much better than tedious disease. - George Dennison Prentice

I can only please one person per day, today is not your day...tomorrow doesn't look good either.


spooky
Regular Member


Date Joined Jan 2006
Total Posts : 101
   Posted 7/26/2006 6:06 PM (GMT -7)   

Hi there,

               Warren said in the thread"metformin and iron" and i quote"500mg of metformin 3 times a day is not a huge dose.  There are many people that take at least a 1000mg. at least twice a day."

               And now he says in the thread   "morning blood sugars high,when Jano mentions that she takes 500 mgs at breakfast and 1000 mgs at dinner"Those are some pretty hefty doses of Metformin.  You should talk to your doctor about adding a sulfonylurea (a type of pill that stimulates your insulin production) to your meds.  Not only will it get your numbers lower, but it may prolong the time you can take metformin before it becomes ineffective"

Please see this link on Glucophage

http://www.healthsquare.com/newrx/GLU1188.HTM)]

The purpose of this message is that 1500 mgs of metformin if very fine and it won't become ineffective in the near future.The members of our forum need not get confused!



Warren
Veteran Member


Date Joined Oct 2005
Total Posts : 534
   Posted 7/26/2006 9:43 PM (GMT -7)   

HI spooky,

2000mg of metformin in its XR form is the max dose you can take. Or let me put it this way, it is the maximum dose that most Endo's will prescribe or that the manufacturer recommends.  If you are taking this much metformin and your blood sugar is still rising, the med has become ineffective.  Unfortunately, metformin has a long and noted history of being a drug that eventually fails to be effective; and in many people that have been prescribed ONLY metformin (monotherapy), this happens sooner rather than later (clinical trials have shown a nearly 80% failure rate over a 7 year period).  I know you like to quote websites, so perhaps you can do some research and give us a quote on failure rates for metformin, because it is usually the first drug prescribed to a type 2 and the first one to fail.

As patients progress along the natural history of diabetes, multidrug combinations are usually required to achieve glycemic goals. When monotherapy with metformin is inadequate, addition and not substitution of another oral agent or exogenous insulin typically achieves tighter control. For example, the combination of a sulfonylurea and metformin can be effective when patients are failing maximum doses of either medication used alone. Trials using metformin in combination with glyburide (marketed as DiaBeta, Glynase, and Micronase) have also shown that this treatment strategy of adding to and not substituting for metformin can be extremely effective. 

Now, knowing this, and taking 1500mg of metformin and still running fasting blood sugars in the 130's and 140's, would you still advocate using it as a monotherapy; or perhaps increasing the dosage?  I think that is probably irresponsible.

scool  Warren


It's not that some people have willpower and some don't. It's that some people are ready to change and others are not. - James Gordon, M.D.
What some call health, if purchased by perpetual anxiety about diet, isn't much better than tedious disease. - George Dennison Prentice

I can only please one person per day, today is not your day...tomorrow doesn't look good either.


wmnak
Veteran Member


Date Joined Jul 2006
Total Posts : 1123
   Posted 7/28/2006 12:29 AM (GMT -7)   

Geez... I'm overwhelmed!  Sure didn't know that Metformin would peter out after awhile.  I was diagnosed 3 yrs ago with Type 2, have taken Metformin from the beginning, 1000 mg 3x day.  End of June A1c was 6.0, down from 7.? when diagnosed.

Morning numbers were good, 95-105, up until February when I had surgery.  Docs in hospital insisted I eat the ice cream, drink the orange juice, etc ... said I needed the carbs to heal and that they would control sugar with insulin ... which they did.  Readings have been on a rollercoaster ever since, teens and twenties, and I can't seem to get them back to pre-surgery levels.  GP last month was satisfied, but it bothers ME.

Now ya'll say the Metformin may not be effective?! 

sad   Martha

spooky
Regular Member


Date Joined Jan 2006
Total Posts : 101
   Posted 7/28/2006 4:30 AM (GMT -7)   
Hi there,
               Diabetes is a progressive disease.Medical treatment at the time of diagnosis depends on many factors.In a newly diagnosed overweight diabetic the usual drug of choice in normal circumstances would be Metformin.You start with a low dose and gradually increase to acheive optimum results.The rule in PHARMACOTHERAPY is to start with a low dose and go up to as high an amount as safely possible,assess and then add a second drug.
               In Jano's case too, similar should have been the circumstances because SHE HAS BEEN A DIABETIC ONLY SINCE 3 MONTHS AND WARREN ALREADY WANTS TO ADD A SECOND DRUG. THEORETICAL RHETORIC AND TRYING TO PROVE A POINT ARE FAR DIFFERENT FROM REALITY CHECK .The endo has to factor in so many things,most importantly her apprehensions,anxities and the stress of being told that she is a diabetic,self-monitoring her blood glucose and the amount of time taken by her to come to grips with the fact"YES!IAM A DIABETIC AND I HAVE TO MAKE SACRIFICES EVERY STEP OF THE WAY IN MY LIFE FROM NOW ON"
               
               It takes time for proper counselling,diet adjustments,exercise and medications to exert their influence on Jano,and i would surely would'nt mind 3 months of slightly higher fasting values.She's touching 120's now and that's only 10 to 20 mgs away from control IN A NEWLY DIAGNOSED DIABETIC!Have a heart,man!Give her some breathing space!
 
              Warren has neatly side-tracked me into the above when my simple contention was that 1500 mgs of metformin is a perfectly safe and therapeutically acceptable dose.

Post Edited (spooky) : 7/28/2006 6:33:58 AM (GMT-6)


flippin out
Regular Member


Date Joined Mar 2006
Total Posts : 137
   Posted 7/31/2006 11:27 AM (GMT -7)   
HI there been over on the Prostate cancer forms for a few months and found you from them. sort of a double whammy on me.
Back to you guys I’m not sure if this applies but I’ve been on Glucophage 500mgs three times a day and Avandia now twice a Day (not sure what category drugs these are) in an attempt to lower my morning numbers as well. My HBA1C numbers have been satisfactory Pre Cancer . post was 6.7 - Just the mornings have been higher. ?The protein snack your talking about what might that be? thanks!

Jeannie143
Veteran Member


Date Joined Apr 2004
Total Posts : 6056
   Posted 7/31/2006 4:25 PM (GMT -7)   
mjr,
The best evening snack that I use is a one by one inch block of motzarella cheese plus 18 peanuts. This has lots of fat (to slow stomach emptying) and protein to take care of hunger. Not many carbs present to prevent rebound insulin secretion. Hope this helps.
~ Jeannie

"People are like stained glass windows: They sparkle and shine when the sun's out, but when the darkness sets in, their true beauty is revealed only if there is light within."

- Elizabeth Kubler-Ross


flippin out
Regular Member


Date Joined Mar 2006
Total Posts : 137
   Posted 8/4/2006 10:43 AM (GMT -7)   
Thank You Jeannie, I guess using Ice Cream as a fat source won't do it ? I will try your recommendations thanks again !

IpheliaPayne
Regular Member


Date Joined Aug 2006
Total Posts : 35
   Posted 8/8/2006 9:40 AM (GMT -7)   
Hi Jano- Just wanted to throw my 2 cents in the bucket. This may be part of the "Dawn Phenomenon" that was previously mentioned, but I had something simular to the high morning sugar when I was diagnosed and started metformin.

After researching and talking to my Dr this was the answer I was given. I found out that high amounts of sugar that are stored in the liver are released at night when the body is at rest and can make for a high morning reading, which happened with me. The morning readings did eventually normal out, but in the beginning they were all over place, generally being in the 200+'s.

Anywho, I don't know if that will help, but I am a layman term gal. Too many medical terms leave me boggled. ;)
Take care,
~Jen

wmnak
Veteran Member


Date Joined Jul 2006
Total Posts : 1123
   Posted 8/8/2006 6:39 PM (GMT -7)   

Good definition, Jen.  Thanks!

:-)   Martha
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