dawn effect...help

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tutorgirl
Regular Member


Date Joined Aug 2007
Total Posts : 235
   Posted 8/30/2007 9:27 AM (GMT -7)   
As many of you know I have taken the low carb diet to heart ( and every other part of my body :) ) and until the last few days my numbers had been good and I've lost over 5 lbs. in 2 weeks for a grand total of 20. My fasting sugars in the morning are OK for what my doc wants. But about mid morning they are shooting to between 170 and almost 200! I am not eating anything other than eggs sometimes with veggies and sometimes soft-boiled with a Wasa Fiber Rye Light cracker. This has been going on for 4 or 5 days. I thought maybe the byetta I'm on was acting up, because day before yesterday my stomach was upset after I did the injection and I lost my breakfast, and my stomach has been a little queasy since which is a common side effect. So after yesterday morning stopped the injection, but still the same effect this morning 2 hours after breakfast ...fasting 112...2 hours later 188. The only carb was the wasa cracker which hasn't effected me before. Any ideas?

LanieG
Forum Moderator


Date Joined Nov 2006
Total Posts : 5408
   Posted 8/30/2007 9:54 AM (GMT -7)   
I don't know, Tutorgirl.  You should ask your doctor.  It could be related to the byetta and/or the breakfast.  I hope other byetta users will pop in here.  Sorry I can't be of any help.  :(

Lanie
forum moderator - diabetes
 
"pre-diabetic" controlled so far by diet and exercise
following low/no carb diet, no meds


fergusc
Regular Member


Date Joined Dec 2005
Total Posts : 230
   Posted 8/31/2007 2:21 AM (GMT -7)   
Sorry to hear you're having some teething troubles, Tutorgirl. I'm type 1 on insulin so I don't really know very much about Byetta or it's effects. However, it's true to say that the body will convert dietary protein to sugar in a process known as gluconeogenesis (formation of new glucose). It's probably how we got most of our blood glucose before the agricultural revolution 8-10,000 years ago. This takes the body a little while to process, but it may go some way towards explaining why your blood glucose is spiking some time after you've eaten. Just speculating here. How many eggs and which sorts of veggies are you using?
Your doctor may be able to shed some more light here. If it helps, I've eaten eggs for breakfast (2) every day for years and my blood glucose levels are very steady, so there's probably something else at work here in your case. Keep trying!

All the best,

fergusc

gelchick
Regular Member


Date Joined Aug 2006
Total Posts : 477
   Posted 8/31/2007 7:47 AM (GMT -7)   

tutorgirl

I am a type 2, non insulin user. From what I've researched on Byetta, it doesn't cause spikes. The nausea is probably from eating too much fat and not enough carbs with it. My doctor has exact eating requirements for her Byetta users to keep them from getting sick. That's one reason why I wouldn't consider it.

I cannot eat the low amount of carbs that you appear to be eating without causing my sugar level to rise. When I eat straight Bernstein, my numbers run higher and no amount of exercise keeps them down where I want them. 

If you are dead set on low carbing, and Bernstein proportions are not working for you, then I suggest that you read the Atkins diabetes book (not the Atkins diet book). There is a process described in there that allows you to methodically raise your carb levels until you find the level that's best for your body. I used this approach and it worked well for me.

People who struggle with dawn phenomenon have livers that kick out too much sugar for their bodies to process in preparation for the day. Lack of insulin, insulin resistance, or both are at fault. In my case, it appears that my liver kicks out too much glucose for me to handle when I don't give my body enough carbs and my numbers run higher all the time until I feed it carbs. (I am talking about non-starchy carbs, otameal, barley or beans- not junk food carbs).

On a recent trip, I found that adding oatmeal to my breakfast, peas and garbanzos to my lunch salad and a few pumpernickel croutons to my dinner salad made all the difference. When I ate omelets, I ate a piece of whole wheat toast with them which I don't have to do at home because I'm not taking 19,000 steps a day (gotta love the pedometer!).

We all have different genetics, our bodies and our diabetes are all different, our metabolic needs are all different, we are all at different stages of our diabetes journey- it only makes sense that one dietary approach will not fit all. Sure, we all take a common approach, but the fine-tuning is up to us. Take everybody's principles (Bernstein, Atkins...forum members) and use them to sucessfully manage your unique requirements.

good luck!

sandy


I just want to live happily ever after-every now and then. Jimmy Buffett


tutorgirl
Regular Member


Date Joined Aug 2007
Total Posts : 235
   Posted 8/31/2007 9:19 AM (GMT -7)   
Sandy, Thanks for the info. This was really helpful. I know that when I first started this low carb thing a few weeks ago my numbers immediately plummeted. But this past week they have been all over the place...from as low as 46 (yuck) to as high as 198. It's been really frustrating to say the least. I think I'll try adding a minimal amount of carbs and see what happens. I have my next blood work week after next and I made an appointment with my doc to go over all of this. She has never given me a lot of guidance as far as diet goes, other than I know she told my sister that she really likes South Beach for diabetics. But she never mentioned it to me. But she is very open minded and willing to work with me. She may have just been waiting for me to get serious about this whole thing. Only took 11 years. :( Hopefully together we can come up with a plan. I definitely don't want to go on the higher dosage of byetta because it makes me incredibly ill. I would much rather do this by diet and exercise. Thank goodness I found this forum. It has literally been a life saver.

gelchick
Regular Member


Date Joined Aug 2006
Total Posts : 477
   Posted 8/31/2007 10:26 AM (GMT -7)   
Hi tutorgirl,
 
I know several type 2's who follow the South Beach diet- Phase 2 with great success. They are members of my hospital support group. I think they were told that Phase 1 was too restrictive. One of these gals eats the packaged products and salads (and that's about it) and has seen her A1c drop from 7.0 to 6.1 in just 3 months.
 
It's good that your doctor is open-minded and wiling to help you get on the right track.
 
I don't know if you have physical issues that prevent you from exercising, but my bg levels dropped and stabilized (no highs or lows-ever) when I started to do three short (10 minutes) walks on my treadmill every day. I continue to do the short walks (just build up my speed and increase the incline periodically) every day. I also take a nice ride on my exercise bike (7 mile/32 minutes) about 5 nights a week (after work) although that will change soon. I was riding a bike in the exercise room at my hotel last week and a very buff guy came in to use the elliptical trainer. We chatted and I left. It turns out that he was a personal trainer in Minneapolis to do demos at the State Fair. I was in the crowd watching him and he invited me to come up and try out his elliptical machine- like, "Hey- I recognize you- I know you use the exercise bike!" I have been afraid to get on one of those, but my daughter encouraged (okay, she called me a wuss) me to go up and make a fool out of myself. I fell in love- all week I found places to 'try out' ellipticals. I stalked him at the hotel and had him show me how to use it to build up my muscles and burn up my sugar. Now, the best part is that my birthday is at the end of September and my daughters, son-in-law, and husband have pitched in to buy me one of those beauties- it's coming on Tuesday- so I'm going to reserve the bike for very lazy days and TV watching. I'm hoping to reduce my insulin resistance with the whole body workout.  Prior to my diagnosis, my exercise bike was in the basement, used as a rack for shirts coming out of the dryer and I had never been on a treadmill in my entire life.
 
My doctor almost fell on the floor laughing when I mentioned a bump on my arm that turned out to be a muscle hiding out in the flab- I'm not losing much weight, but I am building muscle. I'm hoping to be buff in my dotage. And as an added plus, it seems that I get more carbs back in my life - a thankyou from my new-found muscles yeah
sandy
I just want to live happily ever after-every now and then. Jimmy Buffett


tutorgirl
Regular Member


Date Joined Aug 2007
Total Posts : 235
   Posted 8/31/2007 10:54 AM (GMT -7)   
Sandy,

I am totally going to get into the exercise thing. My summer has been crazy because I do in-home tutoring and sometimes have to be at a client's at 7:45 a.m. and then can go until 6. With all the driving I do, by the time I get home I just want to curl up on the couch. When school starts next week, I am back on the schedule I've been used to for the past 10 years...start when the kids get out of school (about 3:30) and get done about 7 and home by 7:30. Occasionally, I end up with a home schooled student that starts a little earlier, but I definitely have my mornings. In the little town we are in in southwest Washington state, we have a small gym that has a small monthly fee with no contract. My husband belongs to it and I'm headed over this weekend to join on his membership. I was just going to do walking, but in Dr. Berstein's book he proposes a more intense regimen. I want to use a treadmill and the elliptical. Can't do weights...shoulder issues. But I am really looking forward to getting started with that. My doc is going to be so surprised since she's been after me forever to do all of this. My poor husband, who's been eating pretty much all this along with me, is down to weighing 4 lbs more that he did in high school. Great side benefit for him!! (And he's 58!)

I can't believe how happy he is that I finally got my act together about all of this. I had no idea he was so worried about it until he realized how serious I was. Then he voiced the concerns he's had for several years. He's definitely your typical male as far as communicating his feelings. Anyway, I have a ton of support from him for this whole endeavor.

What's been the most important support is this forum. I love being able to share with others who totally get it. My family begins to get a bit tired of my blood sugar reports, etc. You guys here are all so great.

Have fun with your new equipment!! My house is way too small for any of that...would have to go in the garage...yuck. Thus, the gym. Let me know how you like it and I'll keep you posted on the gym. Thanks!!!!

Karen

LanieG
Forum Moderator


Date Joined Nov 2006
Total Posts : 5408
   Posted 8/31/2007 11:15 AM (GMT -7)   

Sandy, I was laughing at your shirt rack bike because mine also held the shirt hangers for awhile until I got back to serious use.  I go to a gym now to use the elliptical trainer and treadmill.  One of the trainers gave me some tips.  On the ET, you get a good workout especially at higher levels because of the resistance.  Level 1 seems to be too easy.  I started on level 3 and now do level 5 (over 7 months, that is).  Your speed is how fast you go.  Also, doing a couple of minutes going backward first gives different muscles a workout they wouldn't normally have, so I now do 3 min. backward and 17 forward.  On the treadmill, if someone is not comfortable jogging, they can get a very good workout by raising the elevation with only a moderate speed.  I don't like running so I start off on elevation 10 (no idea what the 10 means on this machine but the slope is steep) at a speed of 2.7 for 5 minutes and then lower the elevation to level 3 for 4 minutes and then back up to 10 and repeat the whole process for about 20 minutes.  The trainer says that raising the heart rate for a few minutes and then slowing down and then back up is particularly beneficial for people with high blood pressure.  True or not, it sure feels like it's doing something.  I know that I can get my heart rate up to about 132bpm on the higher elevation on the treadmill just by walking up the incline.  I don't need to jog.  Then, I can lower it for a couple of minutes.  The ET also gets the heart beat up quickly.  Just some thoughts.

Tutorgirl, maybe you could speak to the doctor about going off byetta and taking another medication.  What is the reason she chose to put you on byetta to begin with rather than another one?     


Lanie
forum moderator - diabetes
 
"pre-diabetic" controlled so far by diet and exercise
following low/no carb diet, no meds


tutorgirl
Regular Member


Date Joined Aug 2007
Total Posts : 235
   Posted 8/31/2007 6:39 PM (GMT -7)   
Lanie,

I think she put me on the byetta because I was already on the glucophage/glyburide and actos. I had to stop the actos due to the swelling in my ankles. I have very small ankles and they got huge! They felt like they were going to burst. And I don't think she wanted to start insulin yet since it has a tendency to add weight. Byetta isn't an insulin and is supposed to suppress the appetite and cause some moderate weight loss. My weight loss came when she increased the dosage and I lost weight through one of my 2 major orifices. It wasn't pretty. And since I'm self employed, I couldn't afford missing work several days a week. I guess it can take 6-8 weeks to get over the side effects. Mine were a bit worse than what people normally experience. So, I think we have pretty much hit all the classes of oral meds there is. And I really don't want to start the insulin. We will be discussing all this at my appointment in a couple of weeks. My numbers should be down and I've had a weight loss since I last saw her in June, so she may just leave it at a status quo for now. Do you know of another class of oral meds other than those I've already tried?

And thanks for the advice on the machines. I'm getting pumped to get over to the gym and get started! That may also help some of these other issues. Whew!!! What a guessing game!

Karen

LanieG
Forum Moderator


Date Joined Nov 2006
Total Posts : 5408
   Posted 8/31/2007 7:21 PM (GMT -7)   

Hi Karen,  I'm going to try to put a website in here that talks about the different classes of drugs.  There may be more combinations of drugs than what you're using so it just might be a matter of trial and more time involved, also, what you eat and when with the particular drugs you take.  Hopefully, your doctor is up to date on all this.  And you can probably find people here taking some of the same meds.  about the machines, I was surprised to learn that alternating speed and elevation on the treadmill is excellent for the heart.  At this point, I'm not training for a marathon or looking for endurance records, but since I'm dealling with high blood sugar and blood pressure as well as getting close to being 59, having a more efficient workout on the treadmill looked good to me.  It's also less boring.  Elevating the treadmill with the controls gives you really good exercise for the heart.  The only change you can make with the elliptical trainer is the "level"  with is the resistance, similar to the elevation of the treadmill, and, again, it makes you sweat.  This and the no carb diet has taken 35lbs off me in 1 year.  And I'm sure that helps with controlling the blood sugar.  You'll be fine!  Get some new clothes to workout in.  :)    (I'm an ESL tutor and substitute teacher now that I resigned from the ESL program at our local university.  I'll be picking up more students next month.)

Lanie

www.mendosa.com/drugs.htm

 


Lanie
forum moderator - diabetes
 
"pre-diabetic" controlled so far by diet and exercise
following low/no carb diet, no meds


tutorgirl
Regular Member


Date Joined Aug 2007
Total Posts : 235
   Posted 8/31/2007 8:32 PM (GMT -7)   
Lanie,

I am so prepped to exercise. :) I have a couple of pairs of pedal pusher sweats, t-shirts with the necks cut out for comfort. I went to a shoe store that actually trains their people on how to properly fit shoes, and they specialize in diabetics and got a great pair of New Balance and I have my MP3 loaded with my favorite music. I am ready to rock the house (or gym in this case). I have never been this motivated to exercise. I think I'm scaring my husband with all this motivation. I'm not usually like this. Must be the time of life. And thanks for the web site. I'll check it out and talk to my doc about it. Have a great Labor Day Weekend.

Karen

Warren
Veteran Member


Date Joined Oct 2005
Total Posts : 534
   Posted 9/1/2007 6:50 AM (GMT -7)   

Hi Karen,

One of the things that Byetta does best is ameliorate the spikes in your daily routine.  It is a designer drug that specifically fires up the bodys systems in response to high blood glucose and then backs them down when your blood sugar returns to normal.  This being said, you are on a 5mcg dose.  Your doctor probably put you on Byetta just like thousands of others, because you were reaching maximum limits on your oral meds and not achieving the results you should.  This is exactly what happened with me. 

Well, in many many cases, the 5mcg dosage is not effective or is marginally effective.  You only really see the miracle results when you step up to the dosage the makes most people sick initially.  Talk this over with your Doctor, but Im guessing if you are taking your Byetta AND your orals 1/2 an hour or more before you eat, you aren't getting the benefit from the Byetta that you should and you need to step up your dosage. (BUT typically only after you've been on byetta for a month so you can adjust to the medicine).  Im sure when this med does what its supposed to do you will find that you may even go under 100 a couple hours after you eat a low carb meal.

scool Warren

tutorgirl
Regular Member


Date Joined Aug 2007
Total Posts : 235
   Posted 9/1/2007 8:14 AM (GMT -7)   
Warren,

Warren,

I did go on the 10mcg for a week and spent that week vomiting and having major diarrhea and feeling absolutely horrible. I lost 10 lbs. in 5 days, my blood pressure went so low from dehydration that I became dizzy every time I stood up. I knew I could not tolerate 6-8 weeks of that. So the doc put me back on the 5 and you are right...it really didn't do anything. But when I started doing the low carb, it was amazing. I dropped more weight and my numbers were good. This morning I started thinking about another Byetta blog I am on and I remembered a lot of discussion about several people who had received ineffective pens. I started a new pen the end of last week and it was right after that my numbers rose a bit. Other than that dawn effect thing going on my numbers haven't been bad. Shoot, 4 months ago I would have been happy with them. It's just they're not what they were. So, I'm going to get through this pen, continue the low carb thing, which is doing wonders for my weight, start the exercise, and talk to my doc about Januvia. We haven't tried that one and since my numbers are getting back in line, she might be willing to let my give it a go. It is such a joy to be constantly trying to figure this mystery out. :) I would just like to get settled into a routine again. It's the not knowing that drives you crazy!! But, hey, Warren, the input is totally appreciated!

gelchick
Regular Member


Date Joined Aug 2006
Total Posts : 477
   Posted 9/2/2007 12:23 PM (GMT -7)   
Hi tutorgirl
 
I have been taking Januvia with great results for about 3 months now. I replaced glipizide with Januvia and immediately stopped haveing the hi-low swings that forced me to be eating all the time. I have not had one reading out of the 75-105 range even after eating. Januvia seems to work best with people who still make a reasonable amount of insulin. I hope it works for you if you decide to try it.
sandy
I just want to live happily ever after-every now and then. Jimmy Buffett

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