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Old 12-23-2007, 07:42 AM   #1
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bedtime 117, fasting 209?

I am trying to figure out what is going on. I have Type II diabetes and I take a total of 2200mg Metformin (850 morning, 850 supper, 500 bedtime). I have recently been struggling to get my fasting numbers under 200, so I ate a good supper last night (plenty of protein, low carb) and my bedtime reading was 117. However, it was still over 200 when I got up (no snacks after supper).

Also, I usually have high blood pressure or at least high normal readings (take four meds for high blood pressure), but I have been feeling very weak in the mornings and my bp was 105/75, which is very low for me (top number especially).

Any ideas? Could it be kidney related? Electrolytes? I do have problems with my electrolyte levels and I take presc potassium and OTC magnesium.

I guess my Christmas is not going to include many food related goodies this year.

Thanks
Ramona

 
Old 12-26-2007, 07:33 PM   #2
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needtoescape HB User
Re: bedtime 117, fasting 209?

Hi,
My understanding is that the liver produces (releases?) sugar at night - and that it is not uncommon to have a morning reading quite a bit higher than your bedtime one. I am having the same thing happen. When I asked about it, they suggested I eat just a little something at bedtime! I guess the liver is less likely to think it needs to release sugar from it's "stores" if you've had a little something to eat. But I would suggest that you talk to your doctor or a diabetes educator re: questions like this. I finally went to a class and am learning a little bit but there is a LOT to learn. Good luck.

 
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Old 12-26-2007, 08:01 PM   #3
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Re: bedtime 117, fasting 209?

Quote:
Originally Posted by ramonamom View Post
I am trying to figure out what is going on. I have Type II diabetes and I take a total of 2200mg Metformin (850 morning, 850 supper, 500 bedtime). I have recently been struggling to get my fasting numbers under 200, so I ate a good supper last night (plenty of protein, low carb) and my bedtime reading was 117. However, it was still over 200 when I got up (no snacks after supper).

Also, I usually have high blood pressure or at least high normal readings (take four meds for high blood pressure), but I have been feeling very weak in the mornings and my bp was 105/75, which is very low for me (top number especially).

Any ideas? Could it be kidney related? Electrolytes? I do have problems with my electrolyte levels and I take presc potassium and OTC magnesium.

I guess my Christmas is not going to include many food related goodies this year.

Thanks
Ramona
Ramona,
Blood sugar levels that are much higher in the morning than at bedtime are usually indicative of one of two things: either rebound effect, or dawn phenomenon.

Rebound effect is when the blood sugar goes too low overnight, and the liver responds by pumping out glycogen (a stored form of glucose) to raise the blood sugar level. Unfortunately, the liver doesn't come equipped with an automatic blood glucose monitor to determine when it's pumped out enough glycogen, so it usually puts out too much...thus the elevated morning levels.

Dawn phenomenon is the natural way the body prepares itself for waking...by raising blood sugar levels an hour or two before you rise. In normal people, this mechanism works well and they wake up with blood sugar levels which. although a bit higher than during the night, are still within normal range. In diabetics, this mechanism doesn't always work correctly and, here again, the liver pumps out too much glycogen and you wake up high.

The way to test for either of these is to set an alarm to wake you at about 2:30 to 3 AM and test your blood sugar level. If your blood sugar levels at that time are below 70-80, then you're probably experiencing rebound. If your blood sugar levels at that time are still up around 100, then the high in the morning is dawn phenomenon. Either way, you'll need an adjustment in your medication.

I don't fully understand the mechanics of how metformin works, but that extra dose at bedtime leads me to suspect this might actually be rebound...that you're going low overnight.

Ruth

Last edited by SamQKitty; 12-26-2007 at 08:03 PM.

 
Old 12-31-2007, 03:35 PM   #4
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Re: bedtime 117, fasting 209?

Thanks to both of you! Ruth, I never really go low, so I suspect it is more of a dawn phen. situation. There is an added element, which I will make another post on (potassium).

Blessings
Ramona

 
Old 01-01-2008, 06:57 PM   #5
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Re: bedtime 117, fasting 209?

Quote:
Originally Posted by ramonamom View Post
Thanks to both of you! Ruth, I never really go low, so I suspect it is more of a dawn phen. situation. There is an added element, which I will make another post on (potassium).

Blessings
Ramona
Ramona,
Do you test before bedtime? What are your numbers then? Also, you might not know if you go low overnight...many of us sleep through nighttime lows, and the only way to determine if they're occurring is to set an alarm for the middle of the night and test.

I saw your post about the potassium supplements, but I don't know about that.

Ruth

 
Old 01-02-2008, 01:36 PM   #6
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Re: bedtime 117, fasting 209?

Ruth,
Yes, I test before bedtime and those numbers are always lower than my fasting bg's. I am not sure of the connection, but I have found that taking my 3 potassium pills one at a time throughout the day does seem to help, so I will stick with that for now. My fasting was down to 157 today!

Blessings
Ramona

 
Old 01-02-2008, 05:29 PM   #7
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Re: bedtime 117, fasting 209?

Quote:
Originally Posted by ramonamom View Post
Ruth,
Yes, I test before bedtime and those numbers are always lower than my fasting bg's. I am not sure of the connection, but I have found that taking my 3 potassium pills one at a time throughout the day does seem to help, so I will stick with that for now. My fasting was down to 157 today!

Blessings
Ramona

Hey, Ramona...sounds like you figured it out yourself, and apparently it does have something to do with the potassium supplements.

However, even 157 is quite high for am fasting, but if your numbers the remainder of the day are okay, your A1c might still be fine. Only time will tell, but I hope this was the solution for you. Good luck, and let us know how it goes.

Ruth

 
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