Re: Can you start cycling high fasting bg for no reason?
Yes. During the beginning period of your therapy, your body goes through "cycles" of adjustment to the intake of your Amaryl.
One of the mechanisms the body has is that the liver outputs glucose during the night according to your sugar level just prior to when it begins its nightly "sentry" activity to preserve your body through sleep and keep enough metabolism going to feed your brain and organs.
In diabetes, it is either that your body doesn't produce enough insulin (type 1) or you have insulin resistance (type 2). This causes the blood sugar level to remain high for longer than a "normal" person's does. The sugar level rises in response to glucose, whether ingested in food, or created by your liver.
The glucometer you use at home takes a "snapshot" of your blood sugar level at one moment in time. If you take that reading just as you awake from sleep, and it's high, you may be observing what is called "dawn phenomenon".
It is not as common in type 2 diabetics as in type 1 but I have it, and many people who have questioned and responded on this board do also.
If you took your readings at other times of the day, you might well find that your readings are lower. Particularly if you take your Amaryl early, and don't eat for a couple of hours, then take it.
Also, remember, that the real focus of your diabetes management is not the "snapshot", but the "surveillance camera" view of your sugar recorded over time. It's how high, for how long, that's the question. A sugar reading of a diabetic may reach 350 and stay there for 10 minutes at the peak output of a syrup-loaded waffle he ate 1-1/2 hours ago. However, at 2 hours past when he ate it, the Amaryl he took at the same time he ate the waffle may reduce that reading to 200. Then, at 3 hours past the waffle, he's got 150.
Then just before lunch, he's got 120 again. If he eats "well" at lunch, with something not so "sinful", containing some complex carbs and protein, he may only get his 1-1/2 hour rise to 225..... and, the residual Amaryl is continuously coming out of his fatty tissues and reduces that reading back down to 130 at 3 hours past the "good stuff".
Then, he eats a salad at supper, and no bedtime snack, and goes to bed. His liver says "...oh, no.... he's STARVING... I am going to convert some fat
to glucose for him....so the liver calls up the fat miners and says, hey, load me some fat in his blood and send it down to me...."
So, he wakes up and does his finger stick, and he's got 195.... and he scratches his head and says "...why?... I didn't eat anything...."
So, the "snapshot" says 195, but if we look at what happened over time:
He had 350 for 10 minutes. That had NO EFFECT at all on the "surveillance camera"....it was too short to affect anything.
He had about 4 hours in which his sugar was over 200 during the day. And he had about 6 hours in which it was 190 during the night. But the other 18 hours of his day, it was 150 or less... to make this calculation easy, let's say it was 120. Actually, during the several hours when he didn't eat, it was probably 100.
So, for the average - it's (18 x 120) + (8 x 200) = 3760
and 3760 / 24 = 156
So, the effect on his body was as if he had a blood sugar of 156 all day.
If he continues this drug, and these eating habits for 2 months, and gets a HbA1c, it will read about 6.7.... good control of diabetes.