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Old 08-15-2008, 10:37 AM   #1
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CindyB67 HB User
Can you start cycling high fasting bg for no reason?

All this week except for Monday, my fasting bg has been high and stayed high, even though I have not changed my eating habits. I did increase my excercise, but that is the only thing that has changed this week. Is this normal or should I call my doctor?

 
Old 08-16-2008, 10:49 AM   #2
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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.

 
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Old 08-16-2008, 04:07 PM   #3
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CindyB67 HB User
Re: Can you start cycling high fasting bg for no reason?

So I really shouldn't be that concerned my 14 day average is higher than my 30 day average? That was what got me alarmed. I did go ahead and call my doctor and am waiting for a reply, but after your response, I am figuring I am probably ok. Thanks for all you information.

 
Old 08-16-2008, 06:39 PM   #4
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tfkeel HB User
Re: Can you start cycling high fasting bg for no reason?

Well, calling your doctor is ALWAYS a good idea. Don't be afraid to do that, in fact, keep your doc real close on this one. Let he/she know ALL your concerns and bring you the education and the information you need to get a good control of your diabetes.

Your doctor has lots of good medicine and lots of good science at his/her disposal on this. I am quite certain that you and your doctor will manage your diabetes control to a very successful outcome over the next 6 months or so. A couple of HbA1cs down the road, and you
will be feeling great and having confidence in your regimen.

I also think your FBS will go down as your body adjusts to your new glucose-controlled scenario and your liver will "understand" that her
new thresholds are lower....

You will learn the calibration factors for your measurement technique and meter and know exactly how to modify your diet or exercise to get the best results. Be sure and take your measurement information to your doctor.....

Last edited by tfkeel; 08-16-2008 at 06:50 PM.

 
Old 08-16-2008, 06:45 PM   #5
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SamQKitty HB UserSamQKitty HB UserSamQKitty HB UserSamQKitty HB UserSamQKitty HB UserSamQKitty HB UserSamQKitty HB UserSamQKitty HB UserSamQKitty HB UserSamQKitty HB UserSamQKitty HB User
Re: Can you start cycling high fasting bg for no reason?

Cindy,
It's possible that you're going low overnight, and the high in the morning is a rebound. The way to determine if this is the case is to set an alarm for about 3 AM and test. If your blood glucose is low, then the morning high is definitely a rebound. Way to prevent it then would be to have small snack before bedtime...perhaps one or two crackers and a bit of cheese or peanut butter. This will keep your blood sugar more even during the night.

Ruth

 
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